Public wants open health records standards

HHS Report On Responses TO NHIN RFI

Public input on development of nationwide electronic health records called for an Internet-based, decentralized architecture and a software framework of open standards and policies, the Department of Health and Human Services said today.

HHS released results of its request for public comment on the National Health Information Network (NHIN) and health records exchanges in the United States. The report follows a project announcement from the Markle Foundation, which will use the Internet as the core of a pilot e-health records exchange network.

HHS received more than 500 responses to its NHIN request for information (RFI) released this January. "These ideas provide invaluable first specs for a plan that will transform health care in America," said Mike Leavitt, HHS secretary.

David Brailer, National Coordinator for Health Information Technology, said in an interview that all the responses supported using the Internet as the NHIN's backbone. Brailer said that respondents also agreed with other issues he has been pushing, including the need for a standards-based system.

"The responses from the RFI yielded one of the richest and most descriptive collection of thoughts on interoperability and health information exchange that has likely ever been assembled" in the United States, Brailer said in a statement.

HHS said that the report does not evaluate the merits of any one proposal. But officials said it does show significant support for important concepts, including joint public/private public development of the NHIN with oversight by a body of government and private stakeholders.

Responses also indicated that the NHIN needs to be patient-centric, with sufficient safeguards to protect the privacy of personal health information.

The report states that main challenges include better and more refined standards, and funding for development, operation and access to the system.

Health officials received responses that covered more than 5,000 pages. More than 17 departments and agencies took part in evaluating the information, including representatives from the Defense Department and the Department of Veterans Affairs, which have been developing e-health records systems.

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