Committee studies public health, research

Panel ponders changes for electronic health recods

The eligibility for $17 billion in economic stimulus law money for health information technology should include requirements for collecting and exchanging electronic public health data and research health data, several members of a federal advisory committee said today.

The Health IT Policy Committee, which met for the first time today, also discussed the possibility of setting out a foundation of principles that vendors must apply to allow for patients' ownership and patients' access to their electronic health records (EHRs).

“If we are looking at health IT as being transformational, then we need to think about patient ownership and control. We may need to set fundamental principles,” said committee member Dr. Neil Calman, who is also president of the Institute for Family Health.

The policy committee made no formal recommendations today. Members are planning to volunteer for several work groups in the next few weeks before reconvening.

The committee was created by Congress to advise the Health and Human Services Department (HHS) as the department distributes $17 billion in incentive payments to doctors and hospitals that purchase health IT systems and demonstrate “meaningful use” of those systems. HHS’ Office of the National Coordinator of Health IT also will spend $2 billion in stimulus money to set up an infrastructure for electronic exchange of patient health data.

The panel will submit recommendations to the national health IT coordinator, Dr. David Blumenthal, who also chairs the committee. “The committee makes recommendations to me,” Blumenthal said. “There is a certain awkwardness and ambiguity in that.” The committee expects to name a vice chair who will formally present the recommendations to Blumenthal.

Congress has mandated that the policy committee consider several issues, including privacy and security of patients’ EHRs, technical standards for EHRs, certifying health IT products that meet the standards, creating the infrastructure to exchange health data electronically, and workforce and training needs for adoption of electronic records, Blumenthal said.

The committee also will recommend a definition of “meaningful use” under the law, and HHS will release an interim regulation on that use by the end of the year, Blumenthal said.

The committee also may choose to deal with other areas related to health care quality and health care access, including public health, health research needs and biosurveillance, Blumenthal said.

The recent swine influenza outbreak has put additional emphasis on the need for public health data surveillance to identify how and where a new disease is spreading, he said. “Biosurveillance has been rising in importance on the list of priorities for this committee and for the government as a whole,” Blumenthal said.

“All of it [patient data] should be available to public health for disease surveillance,” Calman said.

Committee member Adam Clark, director of health policy at the Lance Armstrong Foundation, suggested that eligibility for health IT subsidies also should include a requirement to make data available for research purposes. “Health IT needs to support research and science,” he said.

Committee member Gayle Harrell, a former Florida state representative, said the committee must build privacy and security requirements into the standards from the beginning. “Privacy and security cannot be incremental, they need to be foundational,” she said.

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