WASHINGTON – The Office of the National Coordinator for Health IT will focus in 2011 on activities that will enable healthcare providers to perform complex exchanges of information and on the technical foundation to support secure sharing.

ONC is considering a set of tasks it needs to undertake "in short order" to make it possible for Stage 2 meaningful use to have a more robust exchange of information, said David Blumenthal, MD, national health IT coordinator, at the Jan. 12 meeting of the Health IT Standards Committee .

Those activities are centered around standards and certification criteria, privacy and security protections, governance of exchange. They will also focus on the assurances the public will need that the organizations exchanging information have accomplished the conditions that foster trust and interoperability, he said.

Sense of urgency

Blumenthal also highlighted the importance of getting Stage 2 of meaningful use requirements right.  With that, interoperability and all its associated issues will "flow to the top of the agenda," he said.

"In part, we feel a sense of urgency because we fear if we don't lay the groundwork for that soon that we may not be able to do it later on," he said.

That means having a comprehensive policy around privacy and security, as well as making sure that standards are in place that will assure that willing providers can technically exchange information. Then, having the community and national resources, organizations, rules, regulations and systems of governance that allow for solving problems when they arise. 

Through the use of standards, ONC has set its sights on increasing transactions for electronic prescribing, on public health, on consumer participation in exchange of their information, and on providers being able to send patient care summaries to each other for referrals and transitions of care, said Dr. Farzad Mostashari, ONC's deputy national coordinator for programs and policy.

"These are all meaningful use actions that require someone on the other end to also hold up their end of the bargain," he said. "We need to make it as seamless and easy and low cost as possible."

ONC will re-sharpen its focus on improving healthcare outcomes associated with health IT, the "what's it for, our North Star," he said. This means a renewed emphasis on clinical decision support and on bringing it into institutions beyond the few early adopter and benchmark hospitals, and rapidly improving how it is deployed and effectively used.

"We all know that clinical decision support inexpertly applied can lead to alert fatigue and dissatisfaction, just as much as appropriately implemented it can lead to dramatic improvements in quality and safety," he said.

Also in 2011, ONC will expand its activities around usability of electronic health record systems, such as having measures or benchmarks by which vendors can prove the usability of their products and being transparent about it to their customers.