ONC to pilot test PCAST recommendations

The Office of the National Coordinator for Health Information Technology at HHS will sponsor a pair of pilot projects this fall to test recommendations on how to begin to implement health information exchange proposals made by the President's Council of Advisors on Science and Technology.

ONC chief Dr. Farzad Mostashari discussed the pilots in a post to Health IT Buzz, the official ONC blog.

In December, the PCAST issued a report criticizing HHS for not pushing harder to promote health information exchange. It called on HHS to coordinate development of a universal language for health information exchange based on a web-friendly, XML-like programming language. And it specified the use of meta-data tagging applied to discrete data elements in a patient's medical record to improve search capabilities for care and medical research as well as to create the technical capacity for patients to be able to track and control the movement of their sensitive medical information. The ONC has been scrambling ever since to shift its health IT policy apparatus to accommodate the PCAST while not dropping the ball on any one of a plethora of federal health IT policy initiatives mandated earlier by the American Recovery and Reinvestment Act of 2009.

One pilot described by Mostashari is called the query health initiative. It aims “to define and deliver the standards and services for distributed population health queries from certified electronic health records and community records originating in the routine course of patient care,” the Mostashari post said. “Ultimately, this initiative will enable population analyses to inform both clinical and payment strategies for their health systems and practices.”

The other pilot, a data segmentation initiative, is being planned by ONC's chief privacy officer and ONC's office of standards and interoperability, Mostashari said. This pilot will look at standards needed for sharing patient-identifiable medical records while using meta-data tagging of “privacy attributes,” he said. “This initiative will develop use cases that define the current need for data protection services, such as a patient's directive not to disclose substance abuse records” in accordance with a federal privacy rule, 42 CFR Part 2, protecting the privacy rights of patients receiving drug or alcohol abuse treatment through federally funded programs.

Mostashari also said the Indiana Health Information Exchange, an Indianapolis-based health information organization, is working on a challenge grant initiative through the Regenstrief Institute at Indiana University on approaches “to capture, index and search on key metadata, parsing information from patient summary care records. This will allow more detailed query at the data element level. The initiative is also developing a user interface allowing patients to have more granular control over the management and sharing of their health information,” Mostashari said.