United States Healthcare Informatics Standards Harmonization

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United States Healthcare Informatics Standards
Harmonization

• MOU/MG
• 16-17 October 2006

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Objectives

• Describe the importance of the standard
  harmonization process
• Discuss the relationship of standards
  harmonization to the US National Health
  Information Network
• Report on the current state of progress with the
  standards harmonization process

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Sponsorship

• The Office of the National Coordinator for Health
  Information Technology (ONC) and the American
  Health Information Community (AHIC) provided
  HITSP oversight and guidance
• The Panel is sponsored by the American National
  Standards Institute (ANSI).
• Funding for the Panel is being provided via the
  ONCHIT1 contract award from the U.S. Department
  of Health and Human Services (HHS).

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Standards HarmonizationOne element of
Interoperability
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Four Major Goals

• Inform Clinical Practice
• Interconnect Clinicians
• Personalize Care
• Improve Population Health

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AHIC to HITSP

• AHIC community selects breakthrough areas to be
  worked across ONC Contracts
• HITSP charters Technical Committees to address
  each break through
• Identify a pool of standards for each area
• Identify gaps and overlaps for a specific content
• Make recommendations for resolutions of G O
• Develop instructions to use selected standards
• Test the interoperability specifications

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Membership

• Membership in the HITSP is open to all
  stakeholders and groups within any of the
  following categories and members are encouraged
  to participate
• Standards Development Organizations (SDOs) whose
  processes are accredited by ANSI and create
  standards in health informatics and
  implementation of Electronic Health Record (EHR)
  systems
• Non-SDO Stakeholder Organizations
• Clinicians, Providers, Vendors that develop,
  market, install, and support health IT products,
  Healthcare purchasers or employers, Healthcare
  payers or health insurance companies, Public
  health professionals, National organizations with
  a broad representation of stakeholders with an
  interest in healthcare information technology
  standards, Clinical and health-services
  researchers
• Governmental Bodies Federal, state, and local
  agencies
• Consumers Consumers and organizations with an
  interest in health information technology
  standards

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HITSP Committees

• Technical
• Biosurveillance
• EHR
• Consumer Empowerment
• Chronic Care

• Coordinating
• International
• Readiness Criteria
• Inventory of Standards Inventories

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Committee Use Cases

• Consumer Empowerment
• Gain wide adoption of a personal health record
  that is easy-to-use, portable, longitudinal,
  affordable, and consumer-centered.
• Bio-surveillanceImplement real-time nationwide
  public health event monitoring and support rapid
  response management across public health and care
  delivery communities and other authorized
  government agencies.
• Electronic Health Record (EHR)Support the
  implementation of a certified and interoperable
  EHR, that minimizes integration issues for
  providers and other healthcare delivery systems.
  

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Use Case Definition

• Each Use Case includes applicability and business
  needs in a sequence of actions
• Experienced by the patient
• Performed by the Clinician
• Supported by Health Information Technology
• Standards are used for facilitating
  interoperability

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Use Case Criteria

• Pragmatic
• Value
• Measurable
• Comprehensive
• Meets US government needs
• Population and public health

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Base Standard

• A standard capable of fulfilling a discrete
  function within a single category produced and
  maintained by a single standards organization.
• Per HITSP definition the term standard refers,
  but is not limited to
• Specifications
• Implementation Guides
• Code Sets
• Terminologies
• Integration Profiles

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Composite Standard

• Grouping of coordinated base standards, often
  from multiple standards organizations, maintained
  by a single organization. In HITSP, it can serve
  as a component, transaction or transaction
  package functional requirements.

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Categories for Standards

• Information Model (Context)
• Information Exchange
• Content / Terminology
• Security and Privacy
• Identifier Standards for Entities
• Functionality and Process (Workflow)
• Other

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Standards Requirements

• Pool of standards is required for each Use Case
  developed
• Each action and actor needs to be supported by
  standards
• All gaps and overlaps would be addressed by each
  Technical committee
• Standards would be categorized using a taxonomy
  and selected using Readiness Criteria
• Interoperability Specifications would be used to
  complete the interoperability of the standards

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Readiness Criteria as Filters

• Suitability
• Compatibility
• Costs
• Life Cycle Maturity

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Limitations

• Architecturally neutral, in order to be
  applicable to various organizational scenarios
• Not intended as functional specifications (do
  not represent stakeholder requirements)
• A first attempt at promoting interoperability are
  limited to testers with standards implementation
  experience

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The HITSP process
Harmonization Process Steps
I Submit Request for Business Driven
Interoperability Specification to the HITSP
II HITSP Processes Request
III HITSP Committees Define the Pool of
Standards for the Request
V HITSP Approves or Disapproves the Work of the
Committees
IV HITSP Committees and Industry Harmonize
Overlaps and Fill Gaps
VI Develop Interoperability Specifications for
Approved Requests
VII Interoperability Specifications are
Disseminated and Maintained
Published Artifacts
Formalized Forums
Agreements, Criteria, Other Tools
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For Additional Information

• www.ansi.org/standards_activities
• www.hitsp.org
• www.gcn.com/forum/qna_forum/40276-2.html
• www.himss.org/ASP/ContentRedirector.asp?ContentId
  65351

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Audrey E. Dickerson RN, MS Manager, Standard
Initiatives ISO/TC 215 Health Informatics,
Secretary US TAG for ISO/TC 215 Health
Informatics, Administrator HIMSS 230 East Ohio
Street, Suite 500 Chicago, Illinois 60611 TEL
01-1-312-915-9233 FAX [phone] adicker
son_at_himss.org www.himss.org