The President's Information Technology Advisory Committee has released a list of draft recommendations calling for broad federal support for healthcare IT.
Topping the list is a recommendation that the government should do a cost-benefit study of using Snomed Clinical Terms as an alternative to switching to International Classification of Diseases-10-Clinical Modifications coding systems in the proposed upgrade from the ICD-9 code set currently used.
In November, the National Committee on Vital and Health Statistics voted to recommend that HHS adopt ICD-10 to replace several of the decades-old ICD-9 code sets as the new transactions and codes sets under the Health Insurance Portability and Accountability Act of 1996. A RAND Corp. study for the committee estimated the industrywide cost of upgrading to ICD-10 at $425 million to $1.5 billion, but the Blue Cross and Blue Shield Association put the price tag as high as $14 billion.
Snomed International, which developed Snomed CT, is a division of the American College of Pathologists.
William Braithwaite, M.D., a staffer for the advisory committee and a former HHS senior advisor on healthcare information policy, said Snomed is a much more descriptive code for recording clinical terms than even the upgraded ICD-10 code set.
Money would be better spent switching to a more precise code, he said.
"The thought is that we're trying to support the electronic health record and clinical decision-making," Braithwaite said. "You can't do that unless the clinical concepts are recorded in a way that are computable and comparable."
Braithwaite said jumping to Snomed would be "taking a 10-year leap, but let's not waste the billions of dollars."
The presidential advisory committee also recommended that the federal government should increase its support for demonstration projects to estimate costs and benefits of the national health infrastructure initiative and electronic health records investments and practices. It also recommended the creation of differential payment structures in Medicare and other federal healthcare programs to fund quality- and cost-improvement programs using electronic transactions and EHRs.
The government also should increase support for the development of regional IT connectivity systems and settle on a single set of clinical and technical standards across all federal EHR systems, the committee said.
The report also calls for research and development work to improve the user interface of healthcare IT systems, for the creation of a unique patient identifier and for research into the legal implications of and impediments to sharing EHR systems among physicians, hospitals, labs and pharmacies.
The 24-member committee, created in 1991 to advise the president on technology matters and comprising academic and private-sector IT leaders, met Tuesday in Washington, D.C., and conducted a public airing and fine-tuning of the wish list, prepared by its subcommittee on healthcare delivery and information technology.
The subcommittee will hold a "town hall meeting" to gather public comment on the recommendations from 10 a.m. to noon May 21 at the Medical Records Institute's TEPR healthcare IT trade show in Fort Lauderdale, Fla., then vote and send a final list to the president in June. The meeting will be open to the public and will not require registration for the trade show.
A PDF version of the draft recommendations is available at itrd.gov.