Health IT standards, interoperability &

exchange of health information

Joseph W. Grubbs, Ph.D.

VP & Chief Information Architect

Binary Structures Corporation

Presentation agenda Highlight business drivers of health IT

standards, interoperability and health information exchange

Identify federal enabling legislation, agencies and programs framing the health IT agenda

Establish the purpose of health IT standards and how they support health information exchange

Provide an overview of the Commonwealth of Virginia’s adoption of health IT standards

Questions

Business drivers of health IT standards, interoperability & health information exchange

Patient access – Allow patients to become informed “co-producers” of their health and well-being

Enhanced care – Enable real-time collaboration among providers to foster high-quality health care

Quality improvement – Support health research and advances in clinical care and technology

Greater efficiency – Prevent fraud and reduce waste in legacy health record systems

Moving from this…

To this…

Federal enabling legislation American Recovery and Reinvestment Act

(Pub.L. 111–5) Title XIII. Health Information Technology for

Economic and Clinical Health (HITECH) Act

Patient Protection and Affordable Care Act (Pub.L. 111-148) Medicaid IT Architecture (MITA)

Framework 3.0

Federal agencies and programs

Centers for Medicare and Medicaid Services (CMS) MITA framework EHR incentives Meaningful use standards/attestation

Office of the National Coordinator (ONC) for Health IT, U.S. Dept. of Health & Human Services Meaningful use guidance EHR certification program Federal health IT strategic plan

Health information sharing

Source: http://www.harrisonhealthlink.com/img/sharedata.jpg

Health IT standards for exchange

Provide an architecture, vocabulary and shared terminology for the exchange of health information across disparate systems

Developed, “balloted” and implemented by health care professionals to ensure relevance and usability in practice

Promulgated, published and maintained by independent standards development organizations (SDOs) for global adoption

Primary health IT standards Health Level 7 (HL7) Clinical Document

Architecture – XML-based code standard for structuring clinical documents

Logical Observation Identifiers Names and Codes (LOINC) – Standardized database of laboratory codes and observations

Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT) – Systematically organized medical terminology and codes

ASC X12 (ANSI) – Standards for health care (payer) claims and payments

SDO harmonization efforts

Source: http://library.ahima.org/xpedio/groups/public/documents/graphic/bok1_043987.jpg

Health IT standardization in Virginia

Virginia’s Health Information Technology Standards Advisory Committee (HITSAC) § 2.2-2699.7, Code of Virginia Advises the CIO of the Commonwealth and the

Secretaries of Technology and Health & Human Resources on health IT standards and technology

To date, advocated adoption of 125 health IT standards, including

Health Level 7 (HL7) Clinical Document Architecture Logical Observation Identifiers Names and Codes (LOINC) Systematized Nomenclature of Medicine (SNOMED) ASC X12 for health claims and payments

HITSAC has “raised the standard”

Commonwealth of Virginia’s Enterprise Information Architecture (EIA) Strategy

Commonwealth Data Standardization Final Plan (Item 427, 2012 & 2013 Appropriation Acts) Standardization of all “citizen-centric” data Adoption of standards for other enterprise data

National Information Exchange Model (NIEM) across domains of state government

Cross Sector Digital Identity Initiative (CSDII)/ National Strategy for Trusted Identities in Cyberspace (NSTIC) – E-authentication and identity management for patient and provider access

Questions?

Joseph W. Grubbs, Ph.D.,

VP & Chief Information Architect

Binary Structures Corporation

+1.804.467.7729

joeg@binarystructures.com