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Monday, June 30, 2008

Could NEHTA Have Been Done Better and Cheaper?

The following article appeared last week.

HITSP works on communication, inside and out

By: Joseph Conn / HITS staff writer

Story posted: June 25, 2008 - 5:59 am EDT

The federally supported Healthcare Information Technology Standards Panel (HITSP) has come up with a plan to improve its own internal communications as well as to educate members of the broader healthcare community about its work to promote healthcare IT interoperability.

The 43-page plan was presented and accepted Monday during a meeting of the HITSP by its education, communication and outreach committee. The HITSP was created in 2005 by the American National Standards Institute under a $3.3 million contract with HHS to develop a process to select and recommend appropriate healthcare IT standards.

"The measure of our success is not just harmonizing the standards, it's actual implementation," said HITSP Chairman John Halamka in a telephone interview after the meeting. "You want all systems to be plug and play. You want e-prescribing to be universal."

To do that, Halamka said, will require educating everyone in the healthcare community about HITSP and the availability of the HITSP-vetted standards. And in doing that, "You can't overcommunicate," he said.

Work on the education, communication and outreach plan in February, said its chairman, Walter Suarez, president and chief executive officer of the Institute for HIPAA/HIT Education and Research, Alexandria, Va. According to the plan, the committee "anticipated building a multidimensional package of tools and recognizes that significant maintenance will be required to keep these resources up-to-date."

The tools will include one- and two-page fact sheets on the HITSP process and interoperability specifications, slightly longer issue briefs, lists of frequently asked questions that will be kept current and amended in response to reader input, all of which will be published online. The plan also calls for the issuing of news releases as needed and the writing of articles and, possibly, columns for industry publications. The group also contemplates creating a speakers bureau and library of PowerPoint presentations on specific topics such as the use of HITSP harmonized standards in medication management.

In addition, the plan calls for the development of various case studies of interoperability success stories presented either in print, audio or video format and maintaining "a significant presence" at industry events such as trade shows and annual meetings of member organizations.

One key order of business, the plan's authors recognized, will be overcoming the incomprehensibility of the patois of standards development organizations for many people in segments of the plan's target audience who are not IT geeks, particularly patients, government officials and healthcare organization leaders outside of IT. "The single biggest challenge is the need to translate what we do from what we call 'HITSP speak' to a description and a presentation that is simplified and is provided at a level of language that can be understood by nontechnical people," Suarez said. "If I'm a CEO, HITSP speak is not going to cut it for me. It really requires a translation from the technical world to the nontechnical audience, because the nontechnical people are the ones that make the decisions of either creating the products that are HITSP-compatible or compliant and buying those products.

More here

http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20080625/REG/528301340/1029/FREE

A visit to the HITSP Web site is very worthwhile.

It can be found at www.hitsp.org

Before commenting it is sensible to provide a description of what HITSP does. To quote:

HITSP Background

In the fall of 2005, the U.S. Department of Health and Human Services' Office of the National Coordinator for Health Information Technology (ONC) awarded multiple contracts to advance President Bush's vision for widespread adoption of interoperable electronic health records (EHRs) within ten (10) years. The contracts targeted the creation of processes to harmonize standards, certify EHR applications, develop nationwide health information network prototypes and recommend necessary changes to standardized diverse security and privacy policies.

The American National Standards Institute (ANSI), in cooperation with strategic partners HIMSS, Booz Allen Hamilton, and Advanced Technology Institute, was selected to administer the standards harmonization initiative. The resulting collaborative, known as the Healthcare Information Technology Standards Panel (HITSP), brings together experts from across the healthcare community - from consumers to doctors, nurses, and hospitals; from those who develop healthcare IT products to those who use them; and from the government agencies who monitor the U.S. healthcare system to those organizations who actually write the standards.

The Panel's objectives are to:

  • serve and establish a cooperative partnership between the public and private sectors to achieve a widely accepted and useful set of standards that will enable and support widespread interoperability among healthcare software applications in a Nationwide Health Information Network for the United States.
  • harmonize relevant standards in the healthcare industry to enable and advance interoperability of healthcare applications, and the interchange of healthcare data, to assure accurate use, access, privacy and security, both for supporting the delivery of care and public health.

Most telling is this FAQ response:

“Who can join the HITSP?

The HITSP reaches across the stakeholder community and facilitates the broadest possible participation of all affected parties. Membership on the Panel is open to groups within any of four major categories: standards development organizations (SDOs), non-SDO stakeholder organizations, government bodies and consumer groups.”

Two other facts are useful to be aware of. First the HITSP has its priorities set by the American Health Information Community which is the peak HIT advisory body chaired by the equivalent of the Federal Health Minister and having a wide variety of government, industry, health informatics and consumer representation.

The membership is found here:

http://www.dhhs.gov/healthit/community/members/

It includes all sorts of heavy hitters including the Chairman of Intel and the Vice-Chairman of Wal Mart!

Second the CCHIT (often mentioned in this blog) works with HITSP to ensure products are certified to meets HITSP standards.

Now, while HITSP has not had a totally criticism free of successful run over the last three years much has been achieved and it seems that the internal mid course review will only make what is a good effort even better.

The emphasis, from the get go, on full and broad consultation and involvement makes a refreshing contrast to the situation in OZ.

HITSP is doing much of what NEHTA is doing and more in some ways. Maybe NEHTA 2 (which must come soon) could look a little more like HITSP. It could really help I think!

David.

3 comments:

Anonymous said...

Of course NEHTA could have been done better and cheaper. But to infer that the HITSP approach would have been better is quite wrong. It is just another every man and his dog version of everyone sitting round the table pontificating, nodding and watching each other pontificate and nod.

NEHTA’s core failure was it didn’t know how to engage with the practitioners - by that I don’t mean doctors. The practitioners of health IT need to be engaged in such a way that they can and will work together to achieve goals and outcomes that are not overly ambitious and which can be progressively expanded and built upon.

NEHTA has demonstrated it still does not understand what this means. The concept of Clinical Leads was developed in the UK and picked up by NEHTA following the BCG review recommendation. That this approach is premature and off-target is clearly not appreciated given that the ‘recent EHR discussion summit’ was restricted only to ‘peak’ health bodies and emphatically rejected any suggestion that practitioners of health informatics should be invited to participate.

Anonymous said...

Absolutely, I completely agree. But there is some considerable difference between what the Clinical leads are doing in the UK and here in Australia. In the UK they have something to ‘sell’ and they can give some hand-holding and support and they can also act as facilitators to resolve problems at the coal-face with their clinical peers.

Whilst in Australia NEHTA’s man in charge of its Clinical Lead program, Dr Haikerwal, is flogging blue sky and fresh air and hoping to appoint a handful or more of ‘clinical lead’ practitioners to follow him and do the same. They are trying to sell a message of what they (NEHTA) want to do - not what they can do and certainly not what they have done. If that is what they call industry engagement I’ll opt for divorce before marriage.

Anonymous said...

What else would you expect when NEHTA has so little industry expertise on board. NEHTA doesn't have the right mix of people. It needs people with practical implementation experience who have got their experience from getting their hands dirty at the healthIT implementation coalface. It is all very nice to have an exPresident of the AMA and bucketloads of PhDs and researchers but it is pragmatic people with real implementation experience who are needed to help keep the titanic they call NEHTA well away from the icebergs.