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Electronic Health Record (EHR) Update: Public Input Sought for National Health Information Network and EHR Standard


New York, Jan 12, 2005

On November 15, 2004, the Office of the National Coordinator for Health Information Technology (ONCHIT) released a Request for Information (RFI) seeking public comment regarding how widespread interoperability of health information technologies and health information exchange can be achieved through a National Health Information Network (NHIN).

The National Coordinator position was created by an Executive Order signed by President Bush in April 2004, and is required to report on the implementation of a Framework for Strategic Action entitled: "The Decade of Health Information Technology: Delivering Consumer-centric and Information-rich Health Care" (the Framework). The Framework outlines an approach toward the nationwide implementation of interoperable health information technology in both the public and the private sectors, with four major goals:

  • inform clinical practice with use of EHRs
  • interconnect clinicians so that they can exchange health information using advanced and secure electronic communication
  • personalize care with consumer-based health records and better information for consumers
  • improve public health through advanced biosurveillance methods and streamlined collection of data for quality measurement and research

The RFI seeks input from health information technology organizations, healthcare providers, industry associations and other stakeholders on how these goals can be achieved, and is intended to inform policy discussions about possible methods by which widespread interoperability and health information exchange could be deployed and operated on a sustainable basis. The public comment period expires on January 18, 2005. [Download the RFI here.]

On December 3, 2004, the American Health Information Management Association (AHIMA), a member of the American National Standards Institute (ANSI), urged Department of Health and Human Services (HHS) Secretary Tommy Thompson to consider using undesignated and/or unspent discretionary funds in the HHS budget to provide funding to ONCHIT.

“Considering the importance of the health information technology issue and the progress generated over the last year, we were shocked and disappointed in Congress’ failure to provide the $50 million requested by the President to support health information technology efforts,” stated Linda Kloss, RHIA, CAE, executive vice president and CEO of AHIMA. “Restoration of funding to ONCHIT is essential to continue the momentum towards widespread adoption of standardized electronic health records and a national health information network.”

In January 2004, AHIMA released a series of electronic health record (EHR) practice standards to the healthcare industry. Practice standards include guidelines for the complete medical record in a hybrid environment, implementing electronic signatures, patient-provider e-mail communications, electronic data management, core data sets and speech recognition technology, and provide the industry with practical guidance for areas that play an integral role in the transition from paper to electronic health records.

AHIMA has supported the work of Health Level 7 (HL7) in developing a draft EHR standard for the health care industry. HL7 is a standards-developing organization that produces standards for clinical and administrative data. The Electronic Health Record Technical Committee (EHR TC) of HL7 is currently offering public comment periods for two sets of draft documents. The first, ending January 17, 2005, is for Conformance. The documents for review are the draft “Conformance Clause” and draft “How To Guide” for developing conformance criteria. The second, ending March 11, 2005, is for e-Prescribing. The documents for review include an overview and minimum function set list. These documents for public comment are part of the maturation cycle for the HL7 EHR System Functional Model DSTU. For information on comment submission or to download a copy of the model at no charge, visit http://www.hl7.org/ehr/downloads/.

Meanwhile, the six working groups of the International Organization for Standardization (ISO) Technical Committee 215, Health informatics, are working on standardization in the field of information for health, and Health Information and Communications Technology (ICT) to achieve compatibility and interoperability between independent systems. The group is developing a number of standards related to EHRs, including ISO 20514, EHR, definition, scope and context, and ISO 21549, Health informatics -- Patient healthcard data.

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