May 21, 2010 - Advocacy Corner

Stronger Privacy Safeguards and MU Timing Among HIT Policy Committee Themes. . Meeting earlier this week, the HIT Policy Committee heard recommendations from five of its workgroups. Issues raised include concerns around the “intermediary“ in information exchange and questions on the adequacy of HIPAA in safeguarding privacy for Meaningful use. No mention was made, however, of the fact that HITECH specifically stated that HIPAA was sufficient for purposes of electronic health records. Specific workgroup recommendations included encryption for one-to-one exchanges of patient information between health care providers for treatment purposes with or without a facilitator.

Both vendor and provider representatives expressed concern with the overall compressed timeframe of Meaningful Use and the Stage II Criteria preliminary schedule. Before release of Stage II criteria, HHS will likely issue an RFI in the second quarter of 2011 to gather feedback from stakeholders. More immediate feedback is planned through hearings this summer on Health Disparities (June 4), Care Coordination (date TBA), and Population and Public Health (date TBA) with resulting findings presented to the Policy Committee in October. In addition, the Meaningful Use Workgroup recommended that HHS release an RFI in November 2010 for public comment on these recommendations. This input, data on real world implementations and ONC policy guidance would then be presented to the National Coordinator in the second quarter of 2011.

The Information Exchange Workgroup report drew a number of comments, which echo the concern of many CHIME members regarding 50 different states adding standards on top of national standards. Mechanisms for a regional approach to coordination were suggested as a way to address patient care occurring across state lines. Also recommended was a communication channel to the HIT Policy Committee for State HIT coordinators. To broaden input, the Workgroup suggested adding representatives from the public health community, public health laboratories, and state Medicaid directors.

Continuing a practice begun in 2004 by the National Coordinator to articulate long-term health IT goals, the Strategic Plan Workgroup presented a framework that addressed policy and technical infrastructure, privacy and security, meaningful use, and a learning health system. While a useful document for looking at ONC’s long term vision, reaction was mixed with one Committee member urging the Office to provide a “Human Readable” version that could be used with consumers and the general public to explain the value of EHRs to patient health.

Given the ongoing high level of workgroup activity and related federal health IT activity, such as the new HHS panel to focus on enrollment in federal health programs as mandated by HITECH, there was a request to ONC for staffing support to summarize and integrate various workgroup findings and related work. It was noted this was would be helpful as a way to best coordinate and align the work of respective groups. More to come on May 26 when the HIT Standards Committee meets to review and adopt certain recommendations from those mentioned above. For May 19 handouts and a subsequent transcript of this meeting, please click here (scroll down to May 19 transcript, to be posted next week).

ONC Deputy to Address StateNet CIOs during NHIT Week. Dr. Farzad Mostashari, Deputy National Coordinator for Policy and Programs with ONC, will kick-off the first in-person meeting of StateNet Coordinators on June 16. Intended as a dialog on issues central to state-level information exchange, CIOs are encouraged to share their views on such issues as interoperability, inter-state functionality, sustainability, eMPI, and privacy and security. StateNet is forming workgroups to identify and create best practices around these and similar issues.

The meeting will be held from 1 – 3:30 pm at the Ronald Reagan Building and International Trade Center. There is no c ost to attend, but registration is required. Please RSVP online by June 10. For more information on other National Health IT Week events, please visit the CHIME website.

NHIN Direct Focus of June Webinar. While the Nationwide Health Information Network (NHIN) remains the ultimate goal for exchanging health information, the economic, political and technical issues pose barriers and require time to resolve. In the interim, ONC has launched NHIN “light” or NHIN Direct to “enable simple, direct, scalable transport over the Internet to be used for secure and meaningful exchange between known participants in support of meaningful use.”

Begun in March, NHIN Direct is intended to enable one-to-one exchange, such as physician-to-physician, physician-to-patient, or hospital-to-physician, for example. Designed as an open, transparent collaborative process, NHIN Directs uses wikis, blogs, open source and open content. To learn about the implications for CIOs, join us June 22, 11:00 am for a CHIME College Live Webinar with Dr. Doug Fridsma, Acting Director of the ONC Office of Interoperability and Standards. Watch for registration details. In the meantime, please see http://nhindirect.org for more information on NHIN Direct.