Standards panel reaches EHR milestone

The Health IT Standards Committee has endorsed a single set of vocabulary standards for each area of quality reporting measures, an accomplishment that has been 10 years in the making. The domains include medications, labs and allergies.

The committee will recommend to the Office of the National Coordinator for Health IT to incorporate the vocabulary standards and implementation guides in certification criteria for electronic health records (EHRs) for stage 2 of meaningful use. 

[See also: Standards panel explores Stage 2 meaningful use]

Standards provide the common technical methods that can be installed in EHRs to support functions that improve care and help physicians and hospitals meet meaningful use. 

ONC has offered choices of vocabulary standards associated with some quality measures in stage one, according to Dr. John Halamka, committee co-chair and CIO of Beth Israel Deaconess Medical Center. 

“Today we have achieved something that some of us have been working on for a decade. For the first time in history, we will be declaring a single set of standards for each domain with one set of implementation guides,” Halamka said at the Aug. 17 committee meeting. “This is truly a momentous event.”

In categories where more work is needed, the committee will suggest that pilots be the next step.

[See also: Consumer trust 'essential enabler' to EHR adoption]

One criticism of Stage 1 where vocabulary standards are involved is the availability of choice. “Every time we say ‘or,’ we really mean ‘and.’ It creates a dizzying amount of mapping because vendors must support every variation,” Halamka said.

Fine-tuning proposals

Over the past month, the committee has fine tuned the proposals of two of its work groups to require a minimal number of vocabulary standards, primarily SNOMED-CT, LOINC or RxNorm. 

“For every category of vocabulary, they have chosen one standard,” Halamka said.

The Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT) is a standard medical vocabulary for use in electronic health records for sharing information across specialties and sites of care. The Logical Observation Identifiers Names and Codes (LOINC) is used for lab and clinical identifiers. And RxNorm is a standard for the names for clinical drugs and drug delivery devices produced by the National Library of Medicine.