Now I Think This Is A Biggie From The Health IT Standards Perspective! Not Quite As Good In OZ!

The following popped up a few days ago.

Single vocab standard for each EHR reporting domain seen as 'momentous'

August 18, 2011 | Mary Mosquera

The Health IT Standards Committee has endorsed a single set of vocabulary standards and a single guide for putting them in place for each area of quality reporting measures, an accomplishment that some individuals and groups have been working on for 10 years. The domains include medications, labs and allergies.

The committee will recommend to the Office of the National Coordinator for Health IT to incorporate the vocabulary standards and implementation guides in certification criteria for electronic health records (EHRs) for stage 2 of meaningful use.

Standards provide the common technical methods that can be installed in EHRs to support functions that improve care and help physicians and hospitals meet meaningful use.

ONC has offered choices of vocabulary standards associated with some quality measures in stage one, according to Dr. John Halamka, committee co-chair and CIO of Beth Israel Deaconess Medical Center.

“Today we have achieved something that some of us have been working on for a decade. For the first time in history, we will be declaring a single set of standards for each domain with one set of implementation guides,” Halamka said at the Aug. 17 committee meeting. “This is truly a momentous event.”

In categories where more work is needed, the committee will suggest that pilots be the next step.

One criticism of stage one where vocabulary standards are involved is the availability of choice. “Every time we say ‘or,’ we really mean ‘and.’ It creates a dizzying amount of mapping because vendors must support every variation,” Halamka said.

Over the past month, the committee has fine-tuned the proposals of two of its work groups to require a minimal number of vocabulary standards, primarily SNOMED-CT, LOINC or RxNorm.

“For every category of vocabulary, they have chosen one standard,” Halamka said.

The Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT) is a standard medical vocabulary for use in electronic health records for sharing information across specialties and sites of care. The Logical Observation Identifiers Names and Codes (LOINC) is used for lab and clinical identifiers. And RxNorm is a standard for the names for clinical drugs and drug delivery devices produced by the National Library of Medicine.

More here:

http://govhealthit.com/news/panel-endorses-single-vocab-standard-each-ehr-reporting-domain

A few days earlier we had a closed loop lab ordering approach moving forward at a good clip.

ELINCS lab order specification completed

By Joseph Conn

Posted: August 12, 2011 - 12:01 am ET

A key communications specification for laboratory orders between office-based physicians and community health centers and hospital and commercial clinical laboratories has been completed, the Califorinia Healthcare Foundation has announced.

The release closes the loop on the Electronic Health Record-Lab Interoperability and Connectivity Specification, or ELINCS, a project of the foundation that dates back to 2005 to standardize communications out of an electronic cacophony of standards and channels between providers and the labs they routinely use in patient care.

ELINCS Orders, as its name implies, aims to facilitate standardized orders between providers and labs and is the product of about a year of work, according to Glen Moy, the Oakland, Calif.-based senior program officer for the foundation.

“Now that Version 1.0 has been developed, we’re going to start doing pilot implementations both here in California, and we’re going to select some partner sites across the country as well,” Moy said. “We haven’t finalized that list yet. We’re probably kick off the pilots in early fall or this winter, with the plan of taking the feedback from those pilots and producing a Version 1.1, if you will. We’re also looking at taking the specification and having it balloted through HL7 (Health Level Seven, a healthcare-oriented standards development organization) as a draft standard for trial use. That’s going to take a while, so we’re going to try to do the two in a slightly staggered approach.”

More here:

http://www.modernhealthcare.com/article/20110812/NEWS/308089988/

All one can conclude from this is that there is a good deal of activity leading to clear outcomes on what will be used in the US for the foreseeable future. It is also clear that the choices being made have been carefully considered and that each has been selected to cover its areas of strength.

In Australia, for a reason that is not clear, the NEHTA Standards Catalogue and we are told that “The PCEHR Standards Catalogue currently being updated and will be available soon.” (As of 24/08/2011)

See here:

http://www.nehta.gov.au/standards-catalogue

I know a report was prepared on PCEHR Standards but for reasons that are not clear it has also not been made public. Its status is pretty murky at present I have to say.

An indication of what might be included can be browsed her from a recent presentation - albeit a lot of it is still draft.

www.ihe-australia.wikispaces.com/file/view/GRain_+standards+for+PCEHR.pdf

Of course, at last report, there is still a stand-off on the DoHA / Standards Australia funding agreement as far as has been heard.

There are also some issues with Standards choice identified here:

http://blog.healthbase.info/?p=253

A problem that can’t be sugar coated

All in all, one gets the sense that, right now, Australian E-Health Standards Delivery does not have the management and governance that is needed. It really is feeling like a bit of a mess, despite all this architecture effort!

David.