HHS' road map for improving the electronic exchange of health data omits a prescriptive route to its destination. That's a good thing, according to the Healthcare Information and Management Systems Society, the health IT industry's largest trade group. Other parts of the plan are cause for concern, HIMSS says.
The Chicago-based trade group generally praised HHS' Office of the National Coordinator for Health Information Technology for taking a balanced approach in the road map. But the organization is taking issue with the feds' call to use technology to give patients and providers tools for so-called “granular” consent management in information exchange.
HIMSS also spilled an announcement planned for its annual convention in Chicago next week, informing the Office of the National Coordinator for Health Information Technology it will be launching a voluntary interoperability testing and certification program for electronic health-record systems, health information exchanges and health information service providers.
In its formal response to the federal interoperability plan, HIMSS said the new testing program will build upon the work of Integrating the Healthcare Enterprise USA, the U.S. subsidiary of a not-for-profit organization to promote interoperability co-founded by HIMSS and the Radiological Society of North America in 1997.
“This takes testing to the next level, into the certification process,” said Joyce Sensmeier, vice president of informatics at HIMSS and president of IHE USA. Some customers have technology in the process of being certified in a pilot test of the program and “some have made it all the way through,” Sensmeier said. “Sunday, we'll have full disclosure who's in it.”
Participants will be tested against criteria for moving data via the federally developed Direct protocol that sends or “pushes” a message between two organizations and via more complex “query-based” transactions needed to find and pull records from providers over the proposed Nationwide Health Information Exchange.
The ONC released its 166-page plan, “Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap,” in January. The plan calls for achieving nationwide interoperability of a core data set of patient information by the end of 2017. The public comment period on the plan ended Friday.
“Overall, we're supportive of the plan,” said Tom Leary, vice president, government relations for HIMSS. “From a governance perspective, finding a balance between government driving and being a partner, we know that ONC tried to strike the right balance and make sure they understand and the general public understands we're working with the other organizations to drive that collaboration to achieve some real success.”
Leary said the road map gives the industry an opportunity to identify and achieve milestones. However, many of the timelines laid out in the road map are too aggressive and need to be re-evaluated, according to HIMSS.
In its 31-page response (PDF) to the ONC plan, HIMSS also opposed what it called the introduction of the concepts of “basic choice” and “granular choice” for privacy and consent management, which HIMSS said “can only serve to inject confusion among healthcare stakeholders in terms of what they are required to do (or not do).”
“HIMSS does not see the benefit of, nor is in favor of, the introduction of the concepts of 'basic' and 'granular' choice, particularly in view of these concepts being contradictory and inconsistent with applicable law.”
But the idea of using technology to tag and isolate data elements for privacy is not new.
In 2012, the Veterans Affairs Department in collaboration with HHS' Substance Abuse and Mental Health Services Administration demonstrated the technology in response to a call by the President's Council of Advisors on Science and Technology to use what's called "meta-data tagging" to enhance privacy and promote research. There have been multiple, federally promoted pilots since and several instances where the technology has been put into regular use.
The technology could be useful to providers who have to deal with patient information from behavioral health providers, which is covered by a more stringent federal privacy rule than the Health Insurance Portability and Accountability Act privacy rule that's more familiar to healthcare organizations.
Data segmentation for privacy also could come in handy segregating data under a 2009 HIPAA amendment that enables patients to block the movement of their healthcare information to their insurance company if the patient pays for the treatment out of pocket.