1. 1 Consolidated Health Informatics Public Health Data Standards Consortium March 17, 2004

2. 2 Topics to discuss today … Overview of Consolidated Health Informatics –CHI history and strategy –CHI in the Electronic Health Care Data Environment CHI standards process –Approach –Portfolio overview– adopted, in-progress & upcoming –Implementation action plans Present and Future –Accomplishments –What follows in CY 2004?

3. 3 CHI History and Goals One of the 24 Quicksilver eGovernment Initiatives… –To enable the sharing of health information in a secure environment to improve health –To establish Federal health information interoperability standards as the basis for electronic health data transfer in all activities and projects and among all Federal agencies. –Lead and influence in sync with industry FOR MORE INFO... See the Government-to-Business portfolio at the www.egov.gov web sitewww.egov.gov

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5. 5 CHI Strategy CHI is part of the President’s eGov Portfolio Goal - adopt existing clinical vocabulary & messaging standards to enable interoperability in the federal health care enterprise Agencies will build standards into individual IT architecture to deploy in new systems and major system upgrades “Tipping point” for industry – industry seeks federal lead Policies preserve individual partner agency business rules Complementary to HIPAA

6. 6 Health Insurance Portability & Accountability ActConsolidated Health Informatics HIPAA Privacy Final (Modification) 08/02 HIPAA Security Final 02/03 Messaging Standards HL7, IEEE, DICOM, etc. Transaction Code Sets Final 08/2000 Employer ID Final 05/2002 Provider ID Proposed Rule 05/1998 Plan ID Future Medications Vocabulary Nursing Vocabulary Physicals Vocabulary Laboratory Vocabulary Interventions Vocabulary Modifications Final Rule 02/2003 Attachments Rule Future Immunizations Vocabulary The Electronic Healthcare Data Environment Administrative >>>>>>>>>>>Clinical

7. 7 Supporting Partners SSA, EPA, Commerce/NIST, NASA, & more… Managing Partner HHS Lead Partners VA, DOD, HHS CHI Federal Participation Federal Enterprise-wide Governance Structure: CHI Council

8. 8 Standards Adoption Process Form SME teams Define scope Identify candidate terminologies Deploy Teams Coordinate outreach Evaluate terminologies Assess deployment Analysis and Feedback Technical presentation to CHI Council Department/ agency review and feedback CHI Council establishes consensus Council Consensus Government- wide policy rollout Agency / department- specific implementation via architecture Standards Adoption Preliminary Reports To NCVHS Final Reports To NCVHS

9. 9 Communication with Industry In partnership with the National Committee on Vital and Health Statistics http://www.ncvhs.hhs.gov/ –To clarify the “range” of a clinical domain – what meanings are included –To clarify the choices we have –To align public and private industry work to the extent possible

10. 10 CHI Team Process Form Team Define Scope Identify Candidate Terminologies Evaluate Candidates Assess Current Federal and Non-Federal Deployment Make Recommendation to Council

11. 11 Range of Possible Recommendations Perfect terminology; needs only “evergreening” to maintain Imperfect terminology; must define weaknesses and actions needed to fix No solution at this time – recommend development of a solution – with whom would the government work to develop that vocabulary?

12. 12 Standards Announced March 2003 1.LOINC: Laboratory Result Names 2.HL7 Messaging Standards: Includes scheduling, medical record/image management, patient administration, observation reporting, financial management, patient care 3.NCPDP: Includes retail pharmacy transactions 4.IEEE 1073 Messaging Standards: Connectivity 5.DICOM Messaging Standards: Includes Image Information to Workstations

13. 13 Recommendations under Review Lab Results Contents Demographics Units Immunizations Medications Interventions and Procedures (A. Lab, B. Non-lab) Diagnosis/Problem List Anatomy/Physiology Nursing Billing/Financial Medical Devices and Supplies Encounters Disability Population Health Text-Based Reports History and Physical Multimedia Genes and Proteins Chemicals

14. 14 CHI Accomplishments Defined target portfolio (24 domains) “Rolled out” first five standards Teams 6-24 produced working reports and recommendations Presented all recommendations to HHS CAHIT, HHS CIO Council and HHS Data Council Formed strong relationship with NCVHS Standards & Security Subcommittee to obtain input from private sector

15. 15 What Follows in CY 2004? Roll-out adopted standards for remainder of portfolio OMB “graduates” eGov Initiatives by September 2004 CHI and Federal Health Architecture (FHA) partner to integrate work Phase II planning sessions underway

16. 16 Discussion Questions? Suggestions? FOR MORE INFO... Government-to-Business portfolio at www.egov.govwww.egov.gov