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Health IT committee has six months to define insurance enrollment standards

A look at key discussions from the April HIT Standards Committee meeting.

Even an area as wonky as healthcare information technology standards is influenced by the success of web platforms. During the April healthcare information technology (HIT) Standards Committee meeting, Dr. David Blumenthal, the National Coordinator for Health Information Technology, expressed a noble aspiration: make buying insurance as easy as buying a book on Amazon.com. And speaking earlier in the meeting, Dr. John Halamka, Co-Chair of the HIT Standards Committee, wondered: “What if we created a Facebook for electronic health records? I believe physicians will adopt e-prescribing more quickly when there’s a workflow. We have to afford flexibility for supporting things we don’t know about yet.”

Gov 2.0 Expo 2010While both physicians were speaking somewhat tongue-in-cheek, those metaphors for creating seamless ways for clinicians to share electronic health records (EHRs) easily and securely are now part of the national discussion around healthcare reform. And the urgency behind defining these standards was much in evidence at the HIT meeting.

“The Office of the National Coordinator was instructed to develop nationwide healthcare exchanges,” said Dr. Blumenthal. “We’re not waiting for private parties to come together. We have a mandate to lead this, to develop standards and implementation criteria, that, if political will exists, will support interoperability. We need to do it as fast as we can.”

Over the next few months, the HIT Standards Committee will work to define the following:

  • Content standards for administrative transactions, like enrollment and claims attachments that support of healthcare reform.
  • Vocabulary standards that encompass both the subsets and codesets that will be required to show meaningful use of HIT.
  • Transmission standards that support the NHIN Direct effort.
  • HIT privacy and security provisions that extend previous work on consent standards and patient engagement.
  • Harmonization frameworks that allow these elements to work together smoothly

Halamka summarized the April HIT Standards Committee on his blog. He examined the committee’s new responsibility, born from the passage of the healthcare reform bill, that gives the group a deadline for comprehensive insurance plan enrollment standards support, as defined in the law:

Not later than 180 days after the date of enactment of this title, the Secretary, in consultation with the HIT Policy Committee and the HIT Standards Committee, shall develop interoperable and secure standards and protocols that facilitate enrollment of individuals in Federal and State health and human services programs, as determined by the Secretary.

This assignment adds to a heavy workload for the committee. Wrote Halamka:

As David Blumenthal described it, the intent of this provision is to make signing up for insurance as easy as using an ATM card. All the supportive transactions including identity documentation, eligibility checking, and matching identity among diverse databases needs to be specified over the next 6 months. To do this, it is clear that the Policy and Standards Committees will need to work together. Doug Fridsma and ONC was charged with recommending a process, a structure, and a framework for us to do this work.

The details of this responsibility are further described in this newsletter on healthcare reform and HIT. That date will come well head of the 2011 deadline for meaningful use standards.

The HIT Standards Committee April meeting also included an update from the Implementation Workgroup on their work to make toolkits, accelerators, and best practices available via the web. While White House CTO Aneesh Chopra was unable to join the meeting, his notion of “implementation toolkits” — a set of resources for smaller physician practices — saw some discussion. The need for a standards repository was also discussed. As Halamka explained on his blog, the Implementation Workgroup will align their efforts with the Tools and Standards Repository RFP.

Other topics areas of the April HIT Standards Committee meeting were ably-chronicled by Dr. Halamka, including links to the relevant presentations.

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