hit standards committee
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HIT Standards CommitteeHIT Standards Committee
Clinical Operations WorkgroupReport on Gaps and Next StepsReport on Gaps and Next Steps
Jamie FergusonKaiser Permanente
John HalamkaHarvard Medical School
October 14, 2009
2
Scope Of Gaps For Discussion
• Criteria for certification
• Gaps for Health Information Exchange (HIE)– Standards for inter-HIE communications– Coordination of EHRs with HIEs and clinical ancillaries
“coordination of all systems that must communicate with HIEs”
• Clarification of 2011 measures
• Gaps in specific domains, e.g., administrative vs. labs
3
Gaps: Clarification Of 2011 MU Measures
• High cost imaging with structured indications– Needs definitions
• Patient access to EHR– Minimum content requirements– Direct access vs. PHR copies
• Patient-specific educational materials– Needs clarification
4
Gaps: Vocabulary
• National SNOMED CT maps to ICD9 and ICD10• RxNorm
– Cross-maps to existing codes– Complete federal medication terminology set w/ NDF-RT, SPL
• LOINC– Complete set of order codes including panels and profiles– Identify comparable test results e.g. for trending– LOINC/SNOMED boundary and relationship
• UCUM guidance and testing• Standards to distribute code sets and updates• Maintenance and management processes for subsets
5
Gaps: Other Gaps
• Administrative– Operating rules for 5010– Updates to electronic claim attachments– Explore how all documents in the CDA family can be used
• Clinical Lab Order Messaging
• Quality Reporting Architecture– Implementation guidance for architectural alternatives– QRDA and e-Measure guidance
6
Next Steps
• Resolve identified gaps
• Launch Vocabulary Sub-Workgroup
• Develop additional and/or revised recommendations for 2013 to support 2013 policy objectives and measures
• Integrate with and support testing efforts
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