Agencies set e-gov health standards

The federal government has taken the lead in adopting standards for exchanging electronic health information in hopes that the rest of the health community will follow suit.

The departments of Health and Human Services, Veterans Affairs and Defense announced this week the first five of 24 health informatics standards, dictating how, for example, patient prescription information and lab results are shared. The standards are part of the Consolidated Health Informatics (CHI) initiative, one of the president's 24 e-government initiatives.

"It enables us to share information we need appropriately to understand what's happening to a patient," said Jared Adair, project manager for the CHI initiative. "It is a very important step for the federal government to be taking the leadership in."

A CHI council, with members from several agencies, determined the target areas to be standardized and examined the standards used in the health care industry. From there, they decided which standards made sense for all agencies, with the intention of making them national standards.

"We're swimming in the mainstream of what those standards should be," said Gary Christopherson, senior adviser to the VA undersecretary for health.

Standards will improve patient safety, reduce error rates and save administrative costs. Currently, agencies use different coding systems.

"Either we moved paper or we didn't get data at all or spent of lot of money to get a solution to tie the systems together," said Robert Kolodner, deputy chief information officer for health at the VA.

The idea, Adair said, is that by establishing standards, agencies can build them into the technology architecture, so when it comes time for changes and upgrades, software and hardware companies can follow the standards.

Previous data that does not conform to the standards will likely remain in its native form, because converting high volumes of information can be costly, Kolodner said.

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Health data framework

As part of the Consolidated Health Informatics e-government initiative, agencies have introduced the first five of 24 standards for exchanging health information electronically:

* Health Level 7 messaging standard to ensure that each agency can share information such as order entries, scheduled appointments and tests, and admittance, discharge and transfer of patients.

* National Council for Prescription Drug Programs standards for ordering drugs. The standards were adopted under the Health Insurance Portability and Accountability Act of 1996, and the new announcement will ensure that parts of the three agencies not covered by the act use the same standards.

* IEEE 1073 standards to enable providers to connect medical devices to information systems.

* Digital Imaging Communications in Medicine standards to enable images and diagnostic information to be retrieved using various devices.

* Logical Observation Identifier Names and Codes to standardize the exchange of clinical results.

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