The Security Scrutinizer with Howard Anderson

EHR Interoperability: Next Steps

Is a Universal Exchange Language the Missing Link?
EHR Interoperability: Next Steps

Meanwhile, federal authorities are accepting comments on the report about secure health information exchange from the President's Council of Advisors on Science and Technology through Jan. 19. So you don't have much time left to make your opinion known to the Office of the National Coordinator for Health IT.

The new workgroup's primary task, according to ONC, is to "synthesize and analyze the public comments and input into the PCAST Report relative to implications on current and future ONC work." Translated, that means the group will weigh comments and try to figure out if any of the council's recommendations, such as using XML to tag specific data elements within EHRs with relevant privacy protections, should be implemented.

Some critics already are saying that adding tough additional requirements for a universal exchange language to the next phases of the HITECH EHR incentive program qualifications is unwise. 

As we reported earlier this week, many security experts are less than enamored with the council's recommendations. Some say the panel's call for creation of a universal exchange language based on XML to ease the secure exchange of data is overly simplistic and impractical.

Instead, they call for focusing on further development of existing standards and related implementation efforts, including Health Level Seven and IHE, or Integrating the Healthcare Enterprise, among many others.

The council called for aggressive action by federal regulators. It endorsed requiring use of the new universal exchange language to qualify for future stages of the HITECH Act electronic health record incentive program. And that's a tall order.

We'll have to wait and see if the newly formed workgroup sees the universal exchange language as a practical solution that can be implemented in a hurry, and whether the Department of Health and Human Services ultimately agrees.

New HITECH Requirement?

But some critics already are saying that adding tough additional requirements for a universal exchange language to the next phases of the HITECH EHR incentive program qualifications is unwise.

Hospitals and clinics scrambling to qualify for the Medicare and Medicaid incentives already "have their hands full with the systems implementations that they currently have going on," says Joyce Sensmeier, vice president for informatics at the Healthcare Information and Management Systems Society (See the recent interview: Critiquing EHR Interoperability Plan.

Mark Segal, vice president, government and industry affairs at GE Healthcare IT, an EHR vendor, says requiring the use of a newly developed universal exchange exchange language for Stage 2 or 3 of the incentive program is unrealistic because "it's a fundamental change in course."

For its part, the presidential council says: "Achieving the full potential of health information technology will require the development and adoption of a robust information-sharing infrastructure to facilitate the exchange of data among institutions." Such an infrastructure, based on its vision of a universal exchange language built on XML, would, according to the council, "allow health data to follow patients wherever they are, with appropriate privacy protection and patient control, while giving patients' various doctors a more complete picture of those patients' medical conditions and needs."

But Health Level Seven and many other organizations have been working for decades on the clinical system interoperability issue, as well as standard vocabularies for EHR content. And to quote a lyric, "It don't come easy."

The presidential council's report has effectively put the spotlight on the issue of how to securely exchange EHRs and other information while maintaining privacy. We'll be watching closely to see whether its recommendations lead to new HITECH requirements, new regulations or revitalized long-term standards development efforts.

About the Author

Howard Anderson

Howard Anderson

Former News Editor, ISMG

Anderson was news editor of Information Security Media Group and founding editor of HealthcareInfoSecurity and DataBreachToday. He has more than 40 years of journalism experience, with a focus on healthcare information technology issues. Before launching HealthcareInfoSecurity, he served as founding editor of Health Data Management magazine, where he worked for 17 years, and he served in leadership roles at several other healthcare magazines and newspapers.

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