HITSP takes a look ahead at standards harmonization

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Last year HITSP (Healthcare Information Technology Standards Panel) put forward 30 new health IT standards within its priority focus areas for 2006 which included consumer empowerment, electronic health records, and biosurveillance. This comprised 12,000 working hours on the part of HITSP, and according to John D. Halamka, MD, Chair HITSP, speaking at HIMSS 2007 in New Orleans today, the panel expects that the same amount of work will be done in 2007 as well.

HITSP is representative of 260 industry stakeholders and works under the guidance of federal advisory body American Health Information Community (AHIC), which is a part of HHS (U.S. Department of Health & Human Services). AHIC sets HITSP’ priorities and provides it with basic healthcare use cases – essentially instances where harmonization of various standards within the industry would greatly benefit care.

With the priorities in place in 2006, HITSP then went about “whittling down all the candidate standards” and finding gaps where standards are needed, said Halamka.

After HITSP did the bulk of its work the standards were then handed back to AHIC, followed by a public comment period. The standards and interoperability specifications were then accepted by the National Coordinator for Health Information Technology (ONC) last month for further review with planned implementation and adoption by the Federal government as part of its procurement process by Jan. 2008.

This elaborate process exists because while HITSP feels does great work, the implementation of the standards must be tested in the industry to assure that is it both “sane” and “implementable,” said Halamka.

Some of the panel’s key achievements in 2006 include:

  • Resolving the differences between CCR (Continuity of Care Record) v. CDA (Clinical Document Architecture), which resulted in the CCD (continuity of care document) approval. This wasn’t an instance of deciding a winner, he said, but rather taking the best of both worlds; and
  • Resolving differences between HL7 2.4 and 2.5, by incorporating ELINCS (EHR-Lab Interoperability and Connectivity Standards) which will be maintained by HL7. An HL7 v. 2.51 version of ELINCS will be unveiled by 2007.

AHIC has already handed down to HITSP its main priorities for 2007 which will be hammered out from now to October when the standards and interoperability specifications will be again delivered to the national coordinator through a similar process.

The 2007 priorities include:

  • Harmonization of privacy and security standards;
  • Emergency Responder – a transportable record to enable emergency providers to care for you with the aid of essential medical details. This could be applied to mass casualty events or for individuals, he said;
  • Person Health Records – an enormous amount of activity has taken place in this realm, with numerous companies signing on to PHR initiatives for employees. The companies include heavy hitters such as Intel and Walmart. There is also a number of private companies putting PHR products out on the market, or planning to. These must all be resolve so they can work together. HITSP’ task is to get a handle on all of this activity and to develop standards;
  • Medication Management – “We have to now harmonize standards for medication management for the country. This one is difficult because there are so many stakeholders,” said Halamka; and
  • Quality – HITSP will aim to harmonize all of the quality efforts taking place in the industry.