AHRQ’s US Health Information Knowledgebase Health Information Technology Standards Panel J. Michael Fitzmaurice, Ph.D. Agency for Healthcare Research and Quality June 11, 2008

2 What is AHRQ-USHIK? A metadata registry that follows the ISO/IEC standard A metadata registry that follows the ISO/IEC standard A source for data elements from health data standards endorsed, adopted, recognized by the HHS Secretary for federal use A source for data elements from health data standards endorsed, adopted, recognized by the HHS Secretary for federal use A public domain web site managed by AHRQ A public domain web site managed by AHRQ

3 What does AHRQ-USHIK Contain? Health care data elements from Health care data elements from – HIPAA administration simplification transactions standards – Consolidated Health Informatics-Domains – President’s Interoperability Standards Biosurveillance Use Case Biosurveillance Use Case Quality Use Case Quality Use Case Selected data elements for comparison and program purposes Selected data elements for comparison and program purposes

4 What is AHRQ- USHIK currently doing? Supporting HITSP’s Committees Supporting HITSP’s Committees Supporting AHRQ’s Patient Safety Working Group Supporting AHRQ’s Patient Safety Working Group

5 What is AHRQ- USHIK currently doing? Supporting HITSP Supporting HITSP – Population Perspective TC (Floyd Eisenberg, Peter Elkins, Steve Steindel) Biosurveillance Use Case Biosurveillance Use Case Quality Use Case Quality Use Case Others Others – Care Delivery and Health Records Domain TC (Keith Boone) – HITSP Foundation Committee (Steve Wagner, Bob Dolin) Foundation Harmonization Subcommittee (Bob Dolin) Foundation Harmonization Subcommittee (Bob Dolin) Foundation Interoperability Exchange Sub. (Greg Suppola) Foundation Interoperability Exchange Sub. (Greg Suppola) – Other Perspective, Domain, and ad hoc committees

6 What is AHRQ- USHIK currently doing? How? By How? By – Working with other TC’s to determine the data elements contained within their Interoperability Specification's standards choices C32 document based on HL7’s CCA CCD C32 document based on HL7’s CCA CCD Will move to C48, C28, and C37 Will move to C48, C28, and C37 – Attending specific TC meetings and providing support on data element questions – Providing an orderly display of HITSP- recommended data elements for publication and use

7 What is AHRQ- USHIK currently doing? Supporting AHRQ’s Patient Safety Working Group (AHRQ, FDA, CDC, HIS, VA, DoD, HRSA, NIH, ONC) Supporting AHRQ’s Patient Safety Working Group (AHRQ, FDA, CDC, HIS, VA, DoD, HRSA, NIH, ONC) – Common formats project (AHRQ, FDA, CDC, IHS, VA, DoD) for PSO’s to report patient safety events – Pilot Testing at DoD, VA, IHS facilities Modifying common formats and, hence, USHIK data element contents as a results of the tests (May, July 2008) Modifying common formats and, hence, USHIK data element contents as a results of the tests (May, July 2008) – Patient Safety Event data elements publication July-August 2008 for release for public comment (with NQF) July-August 2008 for release for public comment (with NQF) NQF will compile and synthesize public comments NQF will compile and synthesize public comments

8 What is already being done to USHIK? Make USHIK web site compatible with requirements of: Make USHIK web site compatible with requirements of: – AHRQ – HHS – Section 508 compliance Load the Patient Safety PSE data elements and link to USHIK’s information model display Load the Patient Safety PSE data elements and link to USHIK’s information model display Load C32 spreadsheet data elements into USHIK Load C32 spreadsheet data elements into USHIK – Establish authority for these elements ONC ONC SDO’s SDO’s Work with the SDO’s to update their data elements for the HIPAA and CHI domains (basis for HITSP comparisons) Work with the SDO’s to update their data elements for the HIPAA and CHI domains (basis for HITSP comparisons)

9 What is needed? Speed up the loading of additional HITSP data elements into USHIK Speed up the loading of additional HITSP data elements into USHIK Make further modifications to make USHIK web site useful for federal agencies and private sector users Make further modifications to make USHIK web site useful for federal agencies and private sector users – To put their data elements into USHIK form Manual Manual Technical assistance Technical assistance – To compare their data elements internally and with those of the Federal Interoperability Standards Add representation and support at HITSP TC meetings Add representation and support at HITSP TC meetings Obtain faster ONC and SDO validation of HITSP data elements Obtain faster ONC and SDO validation of HITSP data elements Support the entry of IHE data elements for HITSP IS use Support the entry of IHE data elements for HITSP IS use

10 Where is Value? Publishing in one place the data elements from the standards processes ONC has developed Publishing in one place the data elements from the standards processes ONC has developed Being a source for what is required by the President’s and HHS Secretary’s Interoperability Standards—Federal Agencies, Federal Contracts Being a source for what is required by the President’s and HHS Secretary’s Interoperability Standards—Federal Agencies, Federal Contracts Supporting private sector efforts to match their products’ data elements with those of Federal Interoperability Standards Supporting private sector efforts to match their products’ data elements with those of Federal Interoperability Standards

11 Biosurveillance Technical Committee  The USHIK team developed a table that consolidates each of the data elements referenced in the Biosurveillance Interoperability Specification  Representatives from the USHIK team attended the Committee’s weekly teleconference and regular face to face meetings to provide ad hoc data element identification support.  Scenario: An implementer wants to view a list of all the data elements identified for the Biosurveillance Interoperability Specification

12 Foundations Committee  Representatives from the USHIK team attend the Committee’s weekly teleconferences for both Harmonization and Medication Terminology harmonization.  USHIK published each of the harmonized value sets developed by the Foundations Committee.  Scenario: A committee member wants to review all of the harmonized value sets to date

13 Care Delivery and Health Records Domain Committee  Representatives from the USHIK team attend the Committee’s weekly teleconferences as well as regular face to face meetings to provide ad hoc data element identification support.  The USHIK team is playing an integral role in the Committee’s effort to harmonize value sets across all of the HITSP Technical Committees  Scenario: The committee would like to review a demographic data element chosen for Biosurveillance to determine if the value is suitable and should be used for a current use case

AHRQ’s US Health Information Knowledgebase Health Information Technology Standards Panel J. Michael Fitzmaurice, Ph.D. Agency for Healthcare Research and Quality June 11, 2008