Category Archives: Standards

Health IT Listening Session Apr 6 Agenda Set: Strategic Framework

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Listening Agenda set for Health IT Strategic Framework Session
HIT Policy Committee Strategic Plan Workgroup
Tuesday, April 6, 2010
Per Office of the National Coordinator (ONC) for Health IT, “The objective of the listening session is to obtain feedback from the healthcare community regarding the Health IT Strategic Framework which will become foundation for the updates to the Federal Health IT Strategic Plan. The Health IT Strategic Plan will focus on 2011 through 2015 time period as well as lay the ground work for the period beyond 2015 to create a learning health system through the effective use of HIT.”

Presentation [PPT - 1.60 MB]

AGENDA (pdf version)
12:00 Welcome
     –Jodi Daniel, JD, MPH, Co-Chair, Strategic Plan Workgroup
12:10 Overview of the Health IT Strategic Framework Paper: Development & Vision
     –Paul Tang, MD, Vice Chair, HIT Policy Committee, Chair, Strategic Plan Workgroup
12:25 Learning Health System
     –Presenter / Moderator: Patricia Brennan – 10 min
     –Public Comments – 25 min
1:00 Meaningful Use of Health Information Technology
     –Presenter / Moderator : Paul Tang – 10 min
     –Public Comments – 25 min
1:35 Policy and Technical Infrastructure
     –Presenter / Moderator: Paul Egerman – 10 min
     –Public Comments – 25 min
2:10 Privacy and Security
     –Presenter / Moderator: Deven McGraw – 10 min
     –Public Comments – 25 min
2:45 Open Discussion, Closing Remarks & Next Steps
     –Paul Tang

Registration required:
Visit http://events.signup4.com/hitstrategic to register to attend the session.  Meeting materials will be posted at http://healthit.hhs.gov/StrategicPlanWG as they become available.

For more details about strategic framework, please see earlier post on e-Heathcare Marketing.

NHIN Info Revamped on ONC site: Nationwide Health Information Network

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Nationwide Health Information Network (NHIN): Key Info and Site Map
With revamped organization of NHIN information on Office of National Coordinator (ONC) for Health IT Web site, this post includes excerpts from NHIN Overview page and Limited Production Exchange page (accessed April 1, 2010) as well as a site map to key NHIN and NHIN Direct material. The NHIN Limited Production Exchange is being overseen by two committees–Coordinating Committee and Technical Committee–which were granted authority under DURSA (Data Use and Reciprocal Support Agreement) .

Nationwide Health Information Network (NHIN): Overview
“The Nationwide Health Information Network (NHIN) is a set of standards, services and policies that enable secure health information exchange over the Internet. The NHIN will provide a foundation for the exchange of health IT across diverse entities, within communities and across the country, helping to achieve the goals of the HITECH Act. This critical part of the national health IT agenda will enable health information to follow the consumer, be available for clinical decision making, and support appropriate use of healthcare information beyond direct patient care so as to improve population health.

“The NHIN Work Group, part of the Health IT Policy Committee, is currently developing recommendations for extending the secure exchange of health information using NHIN standards, services and policies to the broadest audience possible. Activities of the NHIN Work Group and Health IT Policy Committee can be found at http://healthit.hhs.gov/policycommittee.

“A group of federal agencies, local, regional and state-level Health Information Exchange Organizations (HIOs) and integrated delivery networks, formerly known as the NHIN Cooperative, has been helping to develop the NHIN standards, services and policies. Today, these organizations are demonstrating live health information exchange through the NHIN Limited Production Exchange. By the end of 2010, it is expected that approximately a dozen entities will be securely sharing live health information as part of this Exchange. For more information about the NHIN Limited Production Exchange, please visit NHIN Limited Production Exchange.

“Based on initial recommendations from the NHIN Work Group, a new initiative, the NHIN Direct Project, is being launched to explore the NHIN standards and services required to enable secure health information exchange at a more local and less complex level, such as a primary care provider sending a referral or care summary to a local specialist electronically. For more information about the NHIN Direct Project, please visit http://nhindirect.org/.

“Moving forward, the NHIN will continue evolving to meet emerging needs for exchanging electronic health information securely over the Internet. This evolution will be driven by emerging technology, users, uses, and policies.

“The Office of the National Coordinator for Health IT (ONC) believes that with broad implementation, the secure exchange of health information using NHIN standards, services and policies will help improve the quality and efficiency of healthcare for all Americans.”

NHIN Limited Production Exchange
“Today, the Nationwide Health Information Network (NHIN) is operating as the NHIN Limited Production Exchange. This Exchange connects a diverse set of federal agencies and private organizations that need to securely exchange electronic health information. These entities currently include the Social Security Administration, MedVirginia, the Department of Veterans Affairs, the Department of Defense, and Kaiser Permanente. 

“Entities participating in the Limited Production Exchange have:

  • Completed an application for participation (which are available through the sponsoring Federal agency)
  • Executed a trust agreement called the Data Use and Reciprocal Support Agreement (DURSA)
  • Completed required testing / validation procedures
  • Been accepted by a Coordinating Committee – which supports operation of the NHIN Limited Production Exchange

“Today, non-federal agencies can only participate in the Exchange through a federally-sponsored contract that pertains to NHIN implementation. NHIN-related contracts currently include:

  • SSA – just awarded contracts to 15 organizations 
  • Virtual Lifetime Electronic Record (VLER) – VA, DoD, KP, others TBD
  • Beacon Communities
  • State HIE Cooperative Agreements
  • CDC
  • Other federal programs that focus on the NHIN exchange

“Federal agencies are assessing and prioritizing their rollout strategy and will prioritize their expansion over the next 12 to 18 months.

“Entities that are interested in exchanging data with the NHIN Limited Production Exchange should:

  1. Determine whether the existing functionality meets its needs:
    • Does the organization have a need to exchange summary patient records for care coordination?
    • Does the organization need to submit state public health reporting information to CDC? 
    • Does the organization wish to provide summary records to SSA for disability determination purposes?
       
  2. If the organization requires any of the functionality listed above, does it have a contract with one of the sponsoring federal agencies noted above?
    • If so – the organization should coordinate through the sponsoring agency.
    • If not, the organization should pursue one of those contracts or partner with one of the existing recipients (such as SSA awardees, state HIEs, Beacon Communities, etc.)

“The NHIN specifications, testing resources, legal agreements and accountability measures are available to the public to stimulate implementation of secure electronic health information exchange.  These helpful resources are available below as well as on the Resources page in the left column, and entities are encouraged to review them if they plan to engage in the NHIN limited production exchange in the future. 

“The work products of the NHIN Coordinating Committee, including policies and procedures and meeting notes, are available by clicking HERE.”

“It is important to note that the NHIN will continue to evolve to support additional information exchange models – ranging from less complex to more robust. For more information about the evolving vision of the NHIN please visit” the Ongoing Development Activities Page.

“For more information about the NHIN, please revisit” the NHIN site regularly for updates.

NHIN Limited Production Exchange – Committee Resources
“NHIN Limited Production Exchange participants elected to use two committees – a Coordinating Committee and a Technical Committee – to help oversee the production exchange. These two committees were granted authority under the DURSA to serve these functions for the exchange. Parties that sign the DURSA agree to Committee process.

“The Technical Committee is responsible for determining priorities for the NHIN production exchange and creating and adopting specifications and test approaches for that exchange. The Technical Committee works closely with the Coordinating Committee to assess the impact that changes to the specifications and test approaches may have on NHIN exchange participants.

“The Coordinating Committee is responsible for accomplishing the necessary planning, consensus building, and consistent approaches to developing, implementing and operating the NHIN exchange, including playing a key role in NHIN exchange breach notification; dispute resolution; exchange membership, suspension and termination; NHIN exchange operating policies and procedures. In addition, the Coordinating Committee informs the Technical Committee when proposed changes for interface specifications have a material impact on exchange participants.The Coordinating Committee uses a set of operating procedures to guide its activities and will conduct self assessments to refine the committee process over time. These documents, along with minutes of Coordinating Committee meetings, are available” on the NHIN Limited Production–Exchange Committee Resources page.

NHIN Site Map
NHIN: Overview
NHIN Limited Production Exchange
NHIN Limited Production Exchange – Committee Resources
NHIN Ongoing Development Activities
NHIN Inventory of Tools
NHIN Resources  Includes NHIN Limited Prodcution Exchange Committee Resources, Coordinating Committee Policies & Procedures, Meeting Notes, 2010 NHIN Final Production Specs, Materials related to Data Use and Reciprocal Support Agreement (DURSA), NHIN Validation Plan, Trial Implementations, past NHIN Forums.
NHIN History and Background with links to Phase 1: Prototype Architectures and Phase 2: Trial Implementations

NHIN Direct Project:    http://nhindirect.org
NHIN Direct Blog
NHIN Direct FAQs
For additional information on NHIN Direct, see a previous post on e-Healthcare Marketing.

Listening Session for Health IT Strategic Framework: April 6

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Listening Session for Health IT Strategic Framework: April 6, 2010
Preview HIT Strategic Framework:  Strategic Themes, Principles, Objectives, and Strategies
Review 2008 Strategic Plan
ONC emailed and posted  information March 24, 2010, about the listening session scheduled for April 6, 2010. The plan dated March 23, 2010 is marked as version 30, and a version has been previously shared online and discussed as part of at least one HIT FACA public meeting.  Information on session is excerpted from ONC email and Web site.

“The Strategic Plan Workgroup of HIT Policy Committee will hold a public listening session on April 6, 2010, 12pm ET, to obtain feedback on the Health IT Strategic Framework. This Framework will be a key input to the Federal Health IT Strategic Plan.* 

 ”The objective of the listening session is to obtain feedback from the healthcare community regarding the Health IT Strategic Framework which will become foundation for the updates to the Federal Health IT Strategic Plan. The Health IT Strategic Plan will focus on 2011 through 2015 time period as well as lay the ground work for the period beyond 2015 to create a learning health system through the effective use of HIT.”

Draft Framework (pdf) has been posted on ONC Health IT Web site for review.

“Registration for this event will be required in order to accommodate the number of interested parties. Visit http://events.signup4.com/hitstrategic to register to attend the session.  Meeting materials will be posted at http://healthit.hhs.gov/StrategicPlanWG as they become available.  Thank you for your interest.”

“*The HITECH Act requires the Office of the National Coordinator for Health Information Technology (ONC), in consultation with other appropriate Federal agencies, to update the Federal Health IT Strategic Plan published in June 2008.” 

Health IT Strategic Framework: Strategic Themes, Principles, Objectives, and Strategies
PDF version with selected excerpts below.

Strategic Planning Scope
“–The Federal Health IT Strategic Plan Update will encompass three levels:
          –The full array of entities in the public and private sectors who have a role in affecting and implementing the use of HIT to improve health and health care;
          –The broad array of Federal HIT policies, regulations, systems, and activities; and
          –The specific mandate, authorities, and role of the ONC.

–The Update will emphasize the implementation of legislative imperatives to achieve widespread adoption and meaningful use of HIT.

–The Update will also focus on features that would be essential to continue the adoption and value of HIT beyond ARRA funding.

–The Health IT Strategic Plan Update will focus on 2011 through 2015 time period.

–It will also focus on laying the ground work for the period beyond 2015 to create a learning health system through the effective use of HIT.”

VISION AND PREAMBLE
“Vision – A learning health system that is patient-centered and uses information to continuously improve health and health care of individuals and the population.

“A learning health system is a system that is designed to generate and apply the best evidence for the collaborative health care choices of each patient and provider; to drive the process of new discovery as a natural outgrowth of patient care; and to ensure innovation, quality, safety, and value in health care. A learning health system focuses on the needs of individuals and population health and aims to create a health system that is Patient-centered, Safe, Timely, Effective, Efficient, Equitable. An effective learning health system is where individuals can make informed decisions about their health and health care; patients can exercise choices about sharing of their data; decision makers have access to the right information at the right time in a secure environment; the health delivery system is more efficient; and the health care industry continues to improve population health.

“Health Information Technology (HIT) provides a critical infrastructure for an effective learning health system. HIT offers tools that can expand current capabilities to collect and manage data that can help creation of a sustainable system that facilitates getting the right care to people when they need it and then captures the results for improvement in care, and create and share knowledge.

“Despite the important role of HIT to a learning health system, only a small number of health care organizations have implemented a comprehensive EHR. Getting to widespread adoption and use of HIT is one component of a reformed system – necessary, but not sufficient to effect, the broad change needed in our health system.

“Inherent in the vision of a learning health system is a set of values that provide the foundation for public policies at the Federal and state levels aimed at reforming and improving the health system. The HITECH Act specifies this broader set of values and helps to focus Federal health policy regarding information technology in the following areas:

–Improving privacy and security protections for health information;

–Facilitating individual access to his or her health information;

–Improving quality of health care by improving care coordination, reducing medical errors, reducing chronic disease, reducing health disparities, improving population health, and advancing research and education;

–Addressing the needs of children and other vulnerable populations;

–Collecting information for quality reporting, biosurveillance, public health, medical and clinical research, and drug safety; and

–Improving efficiency and reducing the burden on patients and health care professionals.

“The HIT policies and programs of ONC and its Federal partners aspire to achieve this vision and its inherent values, leveraging the programs authorized by the HITECH Act. To achieve this vision, a transformation of our current health care delivery system is required.

“To begin this transformation, the Federal government proposed a set of priorities for meaningful use of HIT which can also be applied broadly to help achieve the vision. They include:

–Improve quality, safety, efficiency and reduce health disparities;

–Engage patients and families in their health care;

–Improve care coordination;

–Improve population and public health; and

–Ensure adequate privacy and security protections for personal health information.

“Implicit in enabling the HITECH Act and addressing the health priorities are a number of roles that only the Federal government can play in promoting the adoption and use of HIT. One key role involves the provision of resources to support the public-good infrastructure (serving public health, biomedical research, quality improvement, and emergency preparedness). The government also has a role to play when information asymmetries hinder the development of a private market. The efforts involving standards, implementation specifications, and certification criteria are a solution to such problems. Government action is also necessary to spur the adoption of HIT and the development of means for health information exchange to assure the critical mass of users necessary to create a self-sustaining system of interoperable HIT. Finally, working to improve the efficiency of public and population health programs is clearly a government responsibility.

“The Health IT Strategic Framework enumerates critical government roles in the pursuit of a health system that uses information to empower individuals and to improve the health of the population.”

Premable to Strategic Framework (Selected sections)
“The proposed Federal HIT strategies are grouped into four Themes:
1) Meaningful Use of Health Information Technology,
2) Policy and Technical Infrastructure,
3) Privacy and Security, and
4) Learning Health System.

“Themes 1, 2 and 3 focus on establishing the foundation and infrastructure to support a learning health system and Theme 4 focuses on leveraging these resources to create a learning system. These themes are interrelated and must work together to achieve the vision set forth in this Framework.

“Theme 1 focusing on Meaningful Use describes steps towards using HIT to improve care and support a learning health system.

“Themes 2 and 3 focus on the infrastructure for HIT.

“Theme 2 focuses on Policy and Technology infrastructure that is necessary to support Meaningful Use as well as the learning health system for broader HIT i.e. not only EHR but also health information exchange, and other HIT components.

“Theme 3 addresses Privacy and Security issues and challenges related to broader HIT as well.

“Finally, Theme 4 focuses on leveraging these resources to create a learning health system. 

“Each Theme… includes a goal, guiding principles, objectives and strategies. The ONC strategic plan will include specific tactics and measures for each Theme.”

Referenced Documents
The (2008) ONC-Coordinated Federal Health IT Strategic Plan: 2008-2012 (pdf)
Dated: June 3, 2008

Nationwide Privacy and Security Framework for
Electronic Exchange of Individually Identifiable Health Information (pdf)
Dated: December 15, 2008. Still considered the benchmark document, the framework describes eight principles that “are expected to guide the actions of all health care-related persons and entities that participate in a network for the purpose of electronic exchange of individually identifiable health information. These principles are not intended to apply to individuals with respect to their own individually identifiable health information.”

ONC Releases Whitepaper on Consumer Consent Options for Electronic HIE

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ONC Releases Whitepaper on Consumer Consent Options for Electronic Health Information Exchange
Emailed from ONC on March 24, 2010
“The whitepaper examines issues regarding whether, to what extent, and how individuals should have the ability to exercise control over their health information in an electronic health information exchange environment.  It looks at existing approaches and details policy options, considerations, and analysis.  This whitepaper will serve as input to, and be reviewed by, the HIT Policy Committee’s Privacy and Security Workgroup as it prepares to make recommendations related to consumer consent in an electronic health information exchange environment.  The whitepaper is the first in a series of privacy and security reports developed by George Washington University under contract with ONC.”

Privacy and Security Whitepaper Series
Consumer Consent Options for Electronic Health Information Exchange: Policy Considerations and Analysis

  • Cover Page and Executive Summary [PDF - 40 KB]
  • Consumer Consent Options — Complete Whitepaper [PDF - 735 KB]
  • Appendix A: State Model Table [PDF - 73 KB]
  • Appendix B: State Law Table [PDF - 62 KB]
  • Appendix C: Other Countries [PDF - 60 KB]

    • Privacy and Security and Health Information Technology
    Excerpted from ONC on March 24, 2010.
    “Electronic health information exchange promises an array of potential benefits for individuals and the U.S. health care system through improved clinical care and reduced cost. At the same time, this environment also poses new challenges and opportunities for protecting individually identifiable health information. In health care, accurate and complete information about individuals is critical to providing high quality, coordinated care. If individuals and other participants in a network lack trust in electronic exchange of information due to perceived or actual risks to individually identifiable health information or the accuracy and completeness of such information, it may affect their willingness to disclose necessary health information and could have life-threatening consequences. Coordinated attention at the Federal and State levels is needed both to develop and implement appropriate privacy and security policies. Only by engaging all stakeholders, particularly consumers, can health information be protected and electronically exchanged in a manner that respects variations in individuals’ views on privacy and access.”

    (The section above labelled “Privacy and Security Whitepaper Series” contains the links to the first White Paper. ONC shared additional resources shown below.)

    Other Resources

    HIT Standards Committee Mtg: Consumer Permissions, Consent Mgmt- March 24, 2010

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    HIT Standards Committee–Consumer Permissions, Consent Management
    March 24, 2010
    9:00 a.m. to 2:15 p.m. [Eastern Time]
    Below agenda, key points are excerpted from Privacy and Security Workgroup about consumer permissions and consent management, including schedule for educational sessions.

    A G E N D A (pdf)
    Washington, DC

    9:00 a.m. CALL TO ORDER – Judy Sparrow
    Office of the National Coordinator for Health Information Technology
    9:05 a.m. Opening Remarks – David Blumenthal, MD, MPP
    National Coordinator for Health Information Technology
    9:15 a.m. Review of the Agenda – John Halamka, Vice Chair
    9:20 a.m. Priority Setting & Synchronization with the HIT Policy Committee
    John Halamka, Vice Chair
    9:45 a.m. Implementation Workgroup Report on Implementation Starter Kit Hearing
    Aneesh Chopra, Chair
    Liz Johnson, Workgroup member
    Cris Ross, Workgroup member
    10:30 a.m. NHIN Direct Interoperability Framework
    Doug Fridsma, Office of the National Coordinator
    11:15 a.m. Clinical Operations Workgroup/Vocabulary Task Force Update
    Jamie Ferguson, Chair
    11:45 a.m. Clinical Quality Workgroup Update
    Janet Corrigan, Chair
    Floyd Eisenberg, Workgroup member
    12:15 p.m. LUNCH
    1:00 p.m. Privacy & Security Workgroup Update (PPT)
    Dixie Baker, Chair
    Steve Findlay, Co-Chair
    1:30 p.m. Report on Certification NPRM (PPT)
    Carol Bean, Office of the National Coordinator
    Steven Posnack, Office of the National Coordinator
    2:00 p.m. Public Comment
    2:15 p.m. Adjourn

    To Participate
    Webconference
    Audio:
    You may listen in via computer or telephone.
    US toll free:   1-877-705-6006
    International Direct:  1-201-689-8557
    Confirmation Code: HIT Committee Meeting  

    Key Notes Excerpted from
    Privacy and Security Workgroup Slides
    Focus on Consumer Permissions, Consent Mgmt
    PPT Slides
    Progress
    –Updated IFR Review to incorporate comments from the HIT Standards Committee – submitted to HITSC Chairs
    –Supporting HIT Policy Committee’s Privacy and Security Policy Workgroup, and aligning our standards efforts to their priorities
              Consent management
              Review of existing security policy inherent in HIPAA Security Rule
    –Launching educational sessions on standards activities around consent management

    Consumer Health Permissions
    –Privacy Consent (or Consent Directive) – Consumer’s written or verbal permission to collect, use, and/or disclose individually identifiable health information (IIHI)
    –Privacy Authorization – A signed, written document that contains all of the elements required by the HIPAA Privacy Rule and that gives a covered entity permission to use or disclose specified IIHI for specified purposes
    –Informed Consent – Consumer’s written permission to perform a specific medical procedure, or to participate in a specific research study or clinical trial, that is given only after the consumer has been fully informed of the purposes, risks, benefits, confidentiality protections, and other relevant aspects of the activity

    Consent Management Today
    –Consumer permissions captured as manual signature on paper form
    –Paper forms filed in each organization who holds consumer’s private health information

    Consent Management Tomorrow
    –Consent/Authorization: Consumer digitally signs consent or authorization
    –Permissions and updates captured as part of health record
    –Permissions interpretable by humans & computers
    –Permissions cross-validated & translated into consent rules enforced by security access control mechanisms
    –Rules inexorably tied to information exchanged – updates propagated to all data instances throughout life cycle

    Standards Needed
    –Digital signatures
    –•Privacy policies •Data model & schema •Permission syntax & vocabulary
    –•Cross-validation of consumer permissions •Maintaining and retrieving permissions •Translating permissions into access-control rules •Enforcement and auditing of permission-related activities
    –•Exchanging permissions & access rules •Propagating permission revocations & modifications

    Educational Sessions Re: Standardization Efforts Relating to Consent Management
    •April 1, 2:00-4:00pm ET:  Organization for the Advancement of Structured Information Standards (OASIS) / International Security Trust and Privacy Alliance (ISTPA) Privacy Management Reference Model (PMRM); Speakers – John Sabo, Michael Willett
    •April 23, 2:00-4:00pm ET:  Integrating the Healthcare Enterprise (IHE) Basic Patient Privacy Consents (BPPC) Profile; Speaker – John Moehrke
    •[Schedule TBD]:  Health Level 7 (HL7) Version 3 Domain Analysis Model: Medical Records; Composite Privacy Consent Directive – Speaker (TBD)
    •[Schedule TBD]:  OASIS Cross-Enterprise Security and Privacy Authorization (XSPA) and eXtensible Access Control Markup Language (XACML) – Speaker (TBD)

    Which Medical Dictionary? Vocabulary Task Force Meets March 23

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    Vocabulary Task Force Meeting
    Clinical Operations Workgroup of  HIT Standards Committee
    March 23, 2010
    9:00am to 4:30pm EDT   Webconference/Audio (see access below)
    Meeting focuses on Best Practices and lessons learned from stakeholders in vocabulary infratructure as well as governance values for various vocabularies.

    Questions for Vocabulary Owners/Custodians
    1. What vocabulary subset or value set creation and distribution services do you provide?
    2. Who uses your services and what is the level of use?
    3. What, if any, additional services and capabilities are in active development?
    4. If applicable, what process is used to establish and revise any subsets or value sets that you distribute?
    5. Based on your experience, what advice would you offer regarding best practices and pitfalls to avoid?

    Questions for those involved in Governance Value Sets
    1. Who should determine which value sets are needed?
    2. Who should produce the value sets?
    3. Who should review and approve value sets?
    4. How should value sets be described, i.e., what is the minimum set of metadata needed?
    5. In what format(s) and via what mechanism should value sets be distributed?
    6. How and how frequently should value sets be updated, and how should updates be coordinated?
    7. What support services would promote and facilitate their use?
    8. What best practices/lessons learned have you learned, or what problems have you learned to avoid, regarding value set creation, maintenance, dissemination, and support services?
    9. Do you have other advice or comments on value sets and their relationship to meaningful use?
    10. What must the federal government do or not do with regard to the above, and/or what role should the federal government play?
    11. Some have expressed concerns about intellectual property with respect to the specific value sets (i.e., the effort and expertise required to create them), and regarding the specific codes used (i.e., value sets developer from proprietary code sets). How do you envision sharing value sets while accounting for these intellectual property issues?

  • Agenda [PDF - 415 KB]
  • Welcome, Purpose of the Meeting
              – Jamie Ferguson, Chair
  • Summary & Key Points from February Hearing
            – Jamie Ferguson, Chair
            – Betsy Humphreys, Co-Chair
  • Panel 1: Office of the National Coordinator, Interoperability Framework
    • Douglas Fridsma, MD
  • Panel 2:  Federal Provider Organizations
  • Panel 3:  Best Practices & Lessons Learned: Vocabulary Infrastructure
  • Panel 4:  Best Practices & Lessons Learned, con’t
  • Panel 5:  Level 1 Governance Value Set
    • Sharon Sprenger, The Joint Commission [PDF - 229 KB]
      “While The Joint Commission has its roots in hospital accreditation, over the years it has developed evaluation programs for a diverse array of health care settings. Today, The Joint Commission evaluates and accredits more than 17,000 health care organizations and programs in the United States, including ambulatory care, behavioral health services, durable medical equipment providers and suppliers, home care, hospices, hospitals and critical access hospitals, laboratories and long term care facilities.” –From Joint Commission Statement
    • Karen Kmetik, American Medical Association
    • Greg Pawlson, National Committee for Quality Assurance (NCQA) [invited]
    • Janet Corrigan, National Quality Forum (NQF)

    You may participate
    Webconference
    Audio:
    You may listen in via computer or telephone.
    US toll free:   1-877-705-2976
    International Direct:  1-201-689-8798

    “Safeguarding Health Information: Building Assurance through HIPAA Security”– Conference Sponsored by HHS/OCR and NIST

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    “Safeguarding Health Information: Building Assurance through HIPAA Security”– Conference Sponsored by HHS/OCR and NIST
    May 11-12, 2010
    Excerpts from NIST site on March 22, 2010
    Sponsors: Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) and National Institute of Standards and Technology (NIST).

    Audience:     “CIOs & Information Security Officers of HIPAA covered entities & business associates; others responsible for the security of electronic health info; HIT consultants & attorneys.”

    Purpose: “The HHS Office for Civil Rights (OCR) enforces the HIPAA Privacy Rule, which protects the privacy of individually identifiable health information; the HIPAA Security Rule, which sets national standards for the security of electronic protected health information; the confidentiality provisions of the Patient Safety Rule, which protect identifiable information being used to analyze patient safety events and improve patient safety; and, the Breach Notification regulations requiring HIPAA covered entities and their business associates to notify individuals when their health information is breached.”

    “NIST’s mission, as a non-regulatory federal agency within the U.S. Department of Commerce, is to promote U.S. innovation and industrial competitiveness by advancing measurement science, standards, and technology in ways that enhance economic security and improve our quality of life.”

    “This conference will provide a forum to discuss the current HIT security landscape, as well as practical strategies, tips, and techniques for implementing the requirements of the HIPAA Security Rule.”

    Topics: “Plenary sessions will discuss a variety of current and important HIT and HIPAA Security Rule topics, including updates on OCR’s administration and enforcement of the HIPAA Security Rule, risk assessments and contingency planning, logging and auditing in a healthcare context, security of health devices, and security considerations for mobile/wireless technologies and new media in healthcare, industry panels discussing breach notification rules and the state of compliance with the Security Rule and much more.”

    Location:
    Voice of America
    Wilbur Cohen Building, Auditorium
    330 Independence Avenue, SW
    Washington, DC 20237
    (Public Entrance on C Street, SW)

    Website:
    http://csrc.nist.gov/news_events/HIPAA-May2010_workshop/
    Agenda Draft
    Registration:     On-Line Registration
    Registration Fee: $75
    Registration closes on 05/04/2010
    Refund requests must be submitted in writing by 05/04/2010 

    Joseph Goedert, HealthDataManagement, broke story on March 19, 2010.

    HIT Policy and Standards Committees’ Recommendations for CMS Incentive Programs, ONC Implementation, Certification

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    HIT Policy Committee Recommendations — March 2010
    “The HIT Policy Committee has made recommendations to the National Coordinator on (1) the Centers for Medicare & Medicaid Services’ (CMS) Notice of Proposed Rulemaking regarding CMS’ incentive program for the meaningful use of EHRs; and (2) the Interim Final Rule (IFR) on Initial Set of Standards, Implementation Specifications, and Certification Criteria for EHRs. The recommendations, from the Meaningful Use, Certification/Adoption, Privacy & Security Policy, and Information Exchange Workgroups, were approved by the HIT Policy Committee at its February 2010 meeting. The HIT Policy Committee recommendations have been transmitted to the National Coordinator and to CMS.”

    HIT Standards Committee Recommendations–March 2010
    “The HIT Standards Committee has made recommendations to the National Coordinator on (1) the Centers for Medicare & Medicaid Services’ (CMS) Notice of Proposed Rulemaking regarding CMS’ incentive program for the meaningful use of EHRs; and (2) the Interim Final Rule (IFR) on Initial Set of Standards, Implementation Specifications, and Certification Criteria for EHRs. The recommendations, from the Clinical Operations, Clinical Quality, and Privacy & Security Workgroups, were approved by the HIT Standards Committee at its February 2010 meeting. The HIT Standards Committee recommendations have been transmitted to the National Coordinator.”

    Health IT Policy Commitee: March 17, 2010

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    Health IT Policy Commitee: March 17, 2010

    A G E N D A (see pdf version below)
    March 17, 20109
    9:00 a.m. to 12:45 p.m. [Eastern Time]
    Washington, DC

    9:00 a.m. CALL TO ORDER – Judy Sparrow
    Office of the National Coordinator for Health Information Technology
    9:05 a.m. Opening Remarks – David Blumenthal, MD, MPP
    National Coordinator for Health Information Technology
    9:15 a.m. Review of the Agenda – Paul Tang, Vice Chair of the Committee
    9:20 a.m. Strategic Plan Workgroup Update
    - Paul Tang, Chair, Strategic Plan Workgroup
    - Jodi Daniel, Co-Chair
    9:45 a.m. Certification/Adoption Workgroup Report on HIT Safety Hearing
    - Paul Egerman, Co-Chair
    - Mark Probst, Co-Chair
    10:30 a.m. NHIN Workgroup Report
    - David Lansky, Chair, NHIN Workgroup
    - Daniel Weitzner, Co-Chair, NHIN Workgroup
    - Farzad Mostashari, Office of the National Coordinator
    11:00 a.m. HIT Standards Committee Update [priority setting; synchronization]
    - Jonathan Perlin, Chair, HIT Standards Committee
    - John Halamka, Vice Chair, HIT Standards Committee
    - Janet Corrigan, Clinical Quality Workgroup
    - Jamie Ferguson, Chair, Clinical Operations Workgroup
    - Dixie Baker, Privacy & Security Workgroup
    - Aneesh Chopra, Chair, Implementation Workgroup
    12:00 p.m. Report on Certification NPRM
    - Carol Bean, Office of the National Coordinator
    - Steve Posnack, Office of the National Coordinator
    12:15 p.m. Remarks on the NPRM Comments Received & Process
    - Tony Trenkle, Centers for Medicare & Medicaid Services (CMS)
    12:30 p.m. Clinical Laboratory Improvement Amendments (CLIA)
    - Jessica Kahn, Centers for Medicare & Medicaid Services (CMS)
    12:45 p.m. Public Comment
    1:00 p.m. Adjourn

    Agenda [PDF - 400 KB]

  • Strategic Plan Workgroup Update [PPT - 1.26 MB]

  • Certification/Adoption Workgroup Report on HIT Safety Hearing [PPT - 1.18 MB]

  • NHIN Workgroup Report [PPT - 1.11 MB]
  • HIT Standards Committee Update [PPT - 118 KB]
  • Report on Certification NPRM [PPT - 542 KB]
  • Clinical Laboratory Improvement Amendments (CLIA) [PPT - 1.21 MB]To participate:
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    • NIST Launches Health IT Standards and Testing site

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    NIST Launches Health IT Standards and Testing site
    http://healthcare.nist.gov
    On February 26, 2010, the National Institute of Standards and Technology (NIST) launched the NIST Health IT Standards and Testing web site. Excerpts from the new site: ”This site provides information about the key health IT testing initiatives underway. It provides an overview of the Health IT Standards Testing Infrastructure,

    NIST HIT Standards and Testing

    NIST HIT Standards and Testing

    information and access to the test methods to meet meaningful use technical requirements and standards, access to the Health IT Implementation Testing and Support website, as well as educational material on conformance and interoperability testing.”

    This program is overseen by the NIST Information Technology Laboratory (ITL).

    The site is dividied into four major sections:
    1. Health IT Testing Infrastructure
    2. Meaningful Use Test Methods
    3. What is Conformance Testing
    4. Health IT Testing and Support  

    1. Health IT Testing Infrastructure
    “NIST is responsible for leading the development of the core health IT testing infrastructure that will provide a scalable, multi-partner, automated, remote capability for current and future testing needs.  

    “The objective of the Health IT Standards Testing Infrastructure Project is to harmonize the efforts of healthcare standards test development and delivery to meet the demands for conformance and interoperability within the healthcare domain. This is accomplished by working in collaboration with health IT stakeholders such as vendors, implementers, standards organizations and certification bodies to establish a testing infrastructure…”  

    Project Stakeholders
    “NIST will work with stakeholders to establish and utilize a testing infrastructure that will help ensure that the health information of Americans is exchanged safely, securely, reliably, and only to appropriate sources, and that the standards used are appropriate, consistent, and effective. The stakeholder landscape is outlined as follows:” 

    NIST Stakeholders

    NIST Stakeholders

     HITSP, SDOs, NHIN contribute standards and specifications. HIT vendors, system implementers, NHIN participants, and 3rd party testing organizations conduct testing. Certification bodies perform certification.

    “The testing infrastructure is intended to centralize health IT testing resources to provide the U.S. healthcare IT industry and the Federal Government with a robust conformance and interoperability testing capability.”

    2. Meaningful Use Test Methods
    “In support of the health IT certification program, NIST is developing the conformance test methods (test procedures, test data, and test tools) to ensure compliance with the meaningful use technical requirements and standards.

    “In developing the test methods, NIST has conducted an analysis of the HHS/ONC Interim Final Rule (IFR) published in the Federal Register on January 13, 2010 including:
    –the functional and interoperable requirements
    –the referenced standards
    –the derived test requirements based on the functional and interoperable requirements and referenced standards
    –the test methods and test procedures which could be used to validate conformance with the derived test requirements
    –the assumptions which may influence the selection of a specific test method or the scope of testing”

    3. What is Conformance Testing
    “    NIST provides the necessary conformance tests, test tools and techniques to advance healthcare information technology standards that are complete and testable. As an introduction and overview into testing, the following articles provide details around healthcare information technology conformance and interoperability testing.”

    Articles on Conformance Testing

    4. Health IT Testing and Support
    “    The Health IT Implementation Testing and Support website provides health IT implementers with access to the tools and resources needed to support and test their implementation of standards-based health systems. The site provides information about the key initiatives that serve as the foundation for the nationwide health IT infrastructure. It provides an overview of the HITSP Interoperability Specifications and the standards that they reference; and provides access to the test resources that are available to support their implementations.

    “Visit the Health IT Implementation Testing and Support website for more information.”