Quote Of The Year

Quotes Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Sunday, November 22, 2009

NEHTA is Swimming Against the Tide of Expert US Opinion on Health IT Standards.

With the passage of the US HITECH Act which provides massive financial stimulus for ‘meaningful use’ of Electronic Health Records in patient care there has been renewed focus on US Health IT Standards and how they may be best used – as well as how to fill what gaps there are!

The first few paragraphs of reporting – in draft – the November 19th Meeting of the key Committee (provided as audio, video, transcripts and presentations as opposed to the secrecy we get from NEHTA) make for very important reading.

Thursday, November 19, 2009

HIT Standards Meeting 11-19

The HIT Standards Committee met on Thursday, November 19, 2009. The meeting distilled much of their work and there were some great presentations from the committee, workgroups and stakeholders. The meeting materials from the ONC website and the rough draft transcript of the meeting are below. Also be sure to check out the FACA blog and join the conversation to help "pull adoption forward" and bring our healthcare system into the 21st century.

John Halamka, co-chairman of the committee, gave the following list of guiding principles for standards recommendations which were polished at the meeting:

  • Keep it simple; think big, but start small; recommend standards as minimal as possible to support the business goal and then build as you go
  • Don’t let “perfect” be the enemy of “good enough”; go for the 80% that everyone can agree on; get everyone to send the basics (medications, problem list, allergies, labs) before focusing on the more obscure
  • Keep the implementation cost as low as possible; eliminate any royalties or other expenses associated with the use of standards
  • Design for the little guy so that all participants can adopt the standard and not just the best resourced
  • Do not try to create a one size fits all standard, it will be too heavy for the simple use cases
  • Separate content standards from transmission standards; i.e., if CCD is the html, what is the https?
  • Create publicly available controlled vocabularies & code sets that are easily accessible / downloadable
  • Leverage the web for transport whenever possible to decrease complexity & the implementers’ learning curve (“health internet”)
  • Position quality measures so that they will encourage adoption of standards
  • Create Implementation Guides that are human readable, have working examples, and include testing tools

----- End Quote from Brian Ahier’s blog.

The full blog with audio links, presentations and transcript is here:


John Halamka’s (CIO Harvard Medical School) blog where these ideas were first published is on the link above.

For what it is worth everything that John states as guiding principles for Health Information Technology Standards setting I pretty much totally agree with and those who have read my blog will have seen many of these points mentioned – if not so succinctly and clearly.

I leave it as an exercise for the reader to figure out for themselves just how far NEHTA is off beam with all their theoretical complex documentation and so on.

It just makes you weep we are all being so badly led in all this. Don't they get, as the Americans surely do, that if you open up your processes you get much better outcomes for all concerned. Nah, not these turkeys!


Just in case you were wondering, here is the brief of the committee:

Health IT Standards Committee (a Federal Advisory Committee)

The Health IT Standards Committee is charged with making recommendations to the National Coordinator for Health IT on standards, implementation specifications, and certification criteria for the electronic exchange and use of health information. Initially, the Health IT Standards Committee will focus on the policies developed by the Health IT Policy Committee’s initial eight areas. Within 90 days of the signing of ARRA, the Health IT Standards Committee must develop a schedule for the assessment of policy recommendations developed by the Health IT Policy Committee, to be updated annually. In developing, harmonizing, or recognizing standards and implementation specifications, the Health IT Standards Committee will also provide for the testing of the same by the National Institute for Standards and Technology (NIST).

Lots more here:


As you can see from the membership list – a very serious, very important and very smart lot indeed. We won't have a hope in hell of "fast following" this lot. We have already been left behind and will likely never catch up.


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