HHS adopts standards to speed health IT

Health and Human Services secretary Tommy Thompson wants his department to implement electronic health records ahead of the president’s 10-year goal. He has urged public and private officials to “press down on the accelerator” to transform health care through IT.

HHS and the Veterans Affairs and Defense departments are adopting 15 standards agreed to under the Consolidated Health Informatics initiative, a Quicksilver e-government project to enable electronic exchange of clinical health information across government.

“Health IT promises huge benefits, and we need to move quickly across many fronts to capture these benefits,” Thompson said at a recent health IT summit in Washington.

HHS is using its position as the largest health-care payer through Medicare and Medicaid to encourage providers to coordinate care and share patient information. The department is also funding grants for IT systems to reduce medical mistakes and improve the quality of care.

Errors, aging population

The Institute of Medicine, part of the government’s national academies for scientific research, has estimated that more than 44,000 Americans die each year from medical errors. And the aging of baby boomers is taxing the nation’s health care system, which lags at information exchange.

The standard terms and definitions would keep a patient’s electronic health records up to date, regardless of when and where the patient receives care. Medical language currently is informal and “variable by physician,” said Dr. David Brailer, the recently appointed national health IT coordinator.

With HHS support, the Health Level 7 standards-setting organization, an umbrella group of industry, academic, government and nonprofit groups, has developed standard definitions for demographic information, units of measure, immunizations and clinical encounters, plus a clinical document architecture for reports.

The College of American Pathologists produced a Systematized Nomenclature of Medicine Clinical Terms, or Snowmed CT, for laboratory results, procedures, anatomy and diagnosis. HHS has made Snowmed available to health care providers at no charge to promote adoption of the clinical terms.

Standard Laboratory Logical Observation Identifier Name Codes can encode test orders and drug label headers for electronic exchange. The Health Insurance Portability and Accountability Act, designed to protect the privacy of medical information, also specifies standard transactions and code sets for electronic exchange of health data.

Another standard combines a set of federal terminologies for medications. The Human Gene Nomenclature is a standard for exchanging information related to genes in biomedical research. And the Environmental Protection Agency’s substance registry system sets yet another standard for nonmedicinal chemicals in health care.

The HL7 standards organization, with HHS support, has drawn up a model and standards for electronic health records.

HHS, VA and DOD have already accepted the initial standards developed under the Consolidated Health Informatics for sharing X-rays, electronic laboratory results and electronic prescriptions.

HHS’ Agency for Healthcare Research and Quality will award $50 million in grants in September to help hospitals, especially small centers and those with no IT infrastructure, invest in information systems.

President Bush has requested another $50 million in fiscal 2005 for demonstration projects of local health information exchanges using the consolidated health standards.

Local health care exchanges would let a physician access information about care a patient has received from other providers in the same region. The local networks would communicate with one another in a dispersed national network of local and regional systems.

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