D.C. Bar HIT Overview

Yesterday, I attended a DC Bar Health Information Technology (HIT) Overview. The speakers were Mark Mantooth, an HHS attorney with the Office of the National Coordinator, Dr. Bill Braithwaite of the e-health Initiative, and Ben Butler, a partner with Crowell & Moring.

Mr. Mantooth reviewed the many HHS initiatives underway, and he described how the initiatives interact. Of particular interest to me was his discussion of the work of the American Health Information Community because the OPM Director sits on that FACA committee. The Community has four workgroups — BioSurveillance, Chronic Care, Consumer Empowerment, and Electronic Health Records. The OPM Director is the co-chair of the Consumer Empowerment workgroup.

Each of the workgroups has established a “breakthough objective” upon which they are focusing their attention. All of the breakthroughs involve making recommendations to the Community so that within one year the objective can be achieved. The workgroups are preparing the recommendations now and draft letters to the HHS Secretary are posted on the website.

Bio-surveillance — Essential ambulatory care and emergency department visit, utilization, and lab result data from electronically enabled health care delivery and public health systems can be transmitted in standardized and anonymized format to authorized public health agencies within 24 hours.

Chronic care — Widespread use of secure messaging, as appropriate, is fostered as a means of communication between clinicians and patients about care delivery.

Consumer Empowerment — A pre-populated, consumer-directed and secure electronic registration summary is made available to targeted populations and a widely available pre-populated medication history linked to the registration summary is deployed.

Electronic Health Records — Standardized, widely available and secure solutions for accessing current and historical laboratory results and interpretations is deployed for clinical care by authorized parties.

Dr. Braithwaite spoke primarily about regional health information organizations (RHIOs which he wants to call RHINOs — similar to Hippos with HIPPA) and the Connecting for Health Initiative. In April 2006, Connecting for Health, a Markle Foundation project, released a common framework for a national health information network. The framework would link frequently interacting health care providers into SNOs which would be connected into a national health information network using a SNO-Bridge and a Record Locator service. I am no technology expert but the framework clearly looks like a step in the right direction to me.

Dr. Braithwaite also mentioned a peer-reviewed study titled “Systematic Review: Impact of Health Information Technology on Quality, Efficiency, and Costs of Medical Care” to be published in the May 16, 2006 issue of the Annals of Internal Medicine. The study draws the following sobering conclusions:
“This review suggests several important future directions in the field. First, additional studies need to evaluate commercially developed systems in community settings, and additional funding for such work may be needed. Second, more information is needed regarding the organizational change, workflow redesign, human factors, and project management issues involved with realizing benefits from health information technology. Third, a high priority must be the development of uniform standards for the reporting of research on implementation of health information technology, similar to the Consolidated Standards of Reporting Trials (CONSORT) statements for randomized, controlled trials and the Quality of Reporting of Meta-analyses (QUORUM) statement for meta-analyses. Finally, additional work is needed on interoperability and consumer health technologies, such as the personal health record. “The advantages of health information technology over paper records are readily discernible. However, without better information, stakeholders interested in promoting or considering adoption may not be able to determine what benefits to expect from health information technology use, how best to implement the system in order to maximize the value derived from their investment, or how to direct policy aimed at improving the quality and efficiency delivered by the health care sector as a whole.”Ben Butler provided the attendees with excellent guidance on various privacy/security and intellectual property issues.