Consolidated Health Informatics (CHI) Briefing to HITSP Panel

Transcription

1 Document Number: HITSP 06 N 55 Rev. Date: March 8, 2006 Consolidated Health Informatics (CHI) Briefing to HITSP Panel March 13, 2006

2 CHI Overview Background Strategy Adoption Process Federal Governance Adoption Process Industry Contribution Standards Criteria Accomplishments Questions 1

3 CHI Background One of the 24 Quicksilver egovernment Initiatives To enable the sharing of health information in a secure environment to improve health, decrease medical related errors and decrease health care costs To establish Federal health information interoperability standards as the basis for electronic health data transfer in all activities and projects and among all Federal agencies. Influence and support industry efforts Standards Recommendations 4 Messaging Standards (2003) 23 Vocabulary Standards (2003/4) 10 Additional Standards Efforts (2005/6) 2

4 3 CHI Strategy Develop rigorous process to identify, evaluate and adopt clinical vocabulary & messaging standards to enable interoperability in the federal healthcare enterprise Gain insight and industry endorsement. Become Tipping point for private healthcare environment Use agency partnership and consensus not regulation very successful to-date Work closely with domain experts to identify and assess options Agencies will build standards into individual IT architecture to deploy in new systems and major system upgrades Adopt existing standards from Standards Development Organizations /Agencies Use budgets to enforce and implement standards Establish an evergreening process to assure long-term viability

5 CHI Adoption Process Federal Enterprise-Wide Governance Structure: CHI Council/WG NCVHS Managing Partner HHS CHI Work Groups Lead Partners VA, DOD, HHS Supporting Partners NIST, SSA, EPA, DHS, DOJ & more Current CHI Membership: approximately 300 members 4

6 CHI Adoption Process Identify and Prioritize Needs Prioritize standards Determine approach Deploy Teams Form SME teams Define scope Identify candidate terminologies Analysis and Feedback Coordinate outreach Evaluate terminologies Assess deployment Council Consensus Technical presentation to CHI Council/WG Department/ agency review and feedback CHI Council/WG establishes consensus Standards Adoption NCVHS Adoption Notice OMB/HHS public websites Federal Registry Governmentwide policy rollout planning Preliminary Reports To NCVHS Final Reports To NCVHS 5

7 CHI Industry Contribution National Committee on Vital and Health Statistics (NCVHS) Adoption Process Contribution NCVHS serves as the forum for communicating CHI recommendations to, and obtaining feedback from the private sector NCVHS endorsed the CHI standards Membership Organizations Kaiser Permanente Medical Records Institute University of Pittsburgh MC Health Systems Physician Patient Partnerships for Health Humana Beth Israel Deaconess Medical Center University of Utah College of Medicine University of Louisville School of Medicine University of Pennsylvania School of Medicine BCBS of NC Health Policy R&D The Urban Institute Booz-Allen & Hamilton University of Kansas School of Nursing Palo Alto Medical Foundation The Johns Hopkins University Bloomberg School of Public Health Input Expound the range of a clinical domain Clarify the choices available Align the public and private industry work 6

8 CHI Standards Criteria Candidate Terminology Criteria Maintained by official Standards Development Organizations (SDOs) ANSI, ISO and Federal Government approved Low Barriers for use Freely available Accessible State of the Standard Maturity: implementable, evergreening, conditional/full Subject Matter Experts Responsibility Identify Scope for each standard Scan environment for potential candidates Evaluate each standard against evaluation criteria Develop consensus Present recommendation 7

9 8 Standards Adoption Example Identify Team / SME LAB Tests--- LOINC Recommendation DOD VA HHS CMS CDC NIH Identify Scope / Identify Candidates Evaluate Options LOINC SNOMED CPT Present Preliminary Recommendation to NCVHS ve/ltornm_full_public.pdf Additional Review Report Revision NCVHS Approval Letter HHS Website Federal Registry Final Report Presented and Adopted

10 CHI Accomplishments 35 Standards Adoption Reports 27 Adopted Standards 8 Recommendations In Progress Implementation Guideline Development Standards Gap Analysis Report 4 Adopted Messaging Standards 1. Clinical Standards- HL7 : Includes scheduling, medical record/image management, patient administration, observation reporting, financial management, patient care 2. Pharmacy Standards - NCPDP: Includes retail pharmacy transactions 3. Connectivity Standards- IEEE 1073: Includes medical device messaging 4. Imaging Standards DICOM : Includes image information to workstations 9

11 10 CHI Accomplishments 23 Adopted Vocabulary Standards 1. Laboratory Result Names LOINC 2. Interventions & Procedures, Laboratory Test Order Names - LOINC 3. Laboratory Result Contents - SNOMED CT 4. Interventions and Procedures, Non-Laboratory SNOMED CT 5. Medications: Special Populations - HL7 6. Medications: Drug Classifications - NDF RT 7. Medications: Structured Product Labeling Sections- LOINC 8. Medications: Drug Product- FDA NDC 9. Medications: Package - FDA/CDER 10. Medications: Active Ingredients FDA UNII Codes 11. Medications: Clinical Drug - RxNORM 12. Medications: Manufactured Dosage Form FDA/CDER 13. Diagnosis and Problem Lists - SNOMED CT 14. Nursing - SNOMED CT 15. Demographics - HL7 16. Billing / Financial - HIPAA 17. Clinical Encounters - HL7 18. Immunizations - HL7 19. Text Based Reports - HL7 CDA 20. Anatomy - SNOMED CT /HL7 /NCI Thesaurus 21. Units - HL7 22. Chemicals - EPA SRS 23. Genes - HUGN for Genes

12 CHI Accomplishments 7 Non Adopted Standards Reports 1. Disability (*) 2. History and Physical 3. Medical Devices and Supplies (*) 4. Multimedia (*) 5. Population Health 6. Physiology 7. Proteins Reports contains recommendations for follow-up work Continuing Work Groups (*) 1 Additional New Standards Work Group 1. Allergy 11

13 CHI Standards Graphic 12

14 CHI Collaboration Collaboration Activities USHIK registry Developed by CMS Production system deployment planned cadsr system Could function as front end portal for USHIK NIST HCSL initiative Current link to CHI references Office of the National Coordinator for Health Information Technology (ONC) Support the Standards Harmonization efforts 13

15 Questions? For further information please contact: Vish Sankaran, HHS - FHA PMO Vish.Sankaran@hhs.gov Beth Halley, MITRE- CHI Facilitator ehalley@mitre.org