The September HIT Standards Committee meeting

The September HIT Standards Committee focused on image exchange, scenario-based certification, the Food and Drug Administration Safety and Innovation Act (FDASIA), and an important discussion about setting standards priorities for FY14.

This was Farzad Mostashari's last meeting. He shared his worries and offered us advice:

  • Do not slow  implementation of FY14 standards. We've worked too hard to get this far
  • Offering more time for Meaningful Use Stage 2 attestation may be appropriate
  • New standards are coming but we can make progress today. Do not let the perfect be the enemy of the good
  • We need to create the standards and interoperability that people want, have value, and are appropriate for purpose

We began the meeting with a presentation by Jamie Ferguson about the image sharing testimony we've heard thus far. They key points are that different standards are needed for view/download/transmit use cases, evolving DICOM standards such as Web Access to DICOM Objects (WADO RS) and STore Over the Web (STOW RS) may meet many of these needs, and other countries have models we should study (such as Scotland).

We next heard an update on scenario based testing from Scott Purnell-Sanders. The current approach to certification breaks up clinician workflow into discrete scripts which many not demonstrate usability in actual clinical practice. The notion that an EHR should be certified based on a seamless clinical workflow, supporting the functions required for meaningful use, is a real improvement in certification design.

Jodi Daniel provided a policy update, focusing on FDASIA. The FDASIA Working Group, chaired by David Bates, did a remarkable job outlining a framework that balances innovation and risk reduction.

The remainder of the meeting was devoted to an FY14 Standards Workplan discussion by Doug Fridsma which reviewed an activities matrix listing current HITSC priorities, S&I framework initiatives in progress/planned, and HL7 ballots in progress. They key question for the HIT Standards Committee is how to balance scope, time, and resources over the next year to deliver those key standards needed to support national priorities: Care Coordination, Improving Quality, Engaging Patients/Family, and Population Health. Using the matrix, we will prioritize the most important and most urgent projects over the next few weeks.