1

Consolidated Health InformaticsConsolidated Health Informatics

Public Health Data Standards Consortium

March 17, 2004

2

Topics to discuss todayTopics 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

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 site

4

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

Health Insurance Portability & Accountability Act

Consolidated Health Informatics

HIPAA Privacy Final (Modification) 08/02

HIPAA Security Final 02/03

Messaging StandardsHL7, IEEE, DICOM, etc.

TransactionCode Sets

Final 08/2000 Employer IDFinal 05/2002

Provider IDProposed

Rule 05/1998Plan IDFuture

MedicationsVocabulary

NursingVocabulary

PhysicalsVocabulary

LaboratoryVocabulary

InterventionsVocabulary

ModificationsFinal Rule02/2003

AttachmentsRule

Future

ImmunizationsVocabulary

The Electronic Healthcare Data Environment

Administrative<<<<<<<<<<<<….>>>>>>>>>>>>Clinical

7

Supporting PartnersSSA, EPA,

Commerce/NIST, NASA, & more…

Managing Partner

HHS

Lead PartnersVA, DOD, HHS

CHI Federal Participation

Federal Enterprise-wide Governance Structure: CHI Council

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

StandardsAdoption

Preliminary Reports To NCVHS

Final ReportsTo NCVHS

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

CHI Team Process

• Form Team

• Define Scope

• Identify Candidate Terminologies

• Evaluate Candidates

• Assess Current Federal and Non-Federal Deployment

• Make Recommendation to Council

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

Standards Announced March 2003

1. LOINC: Laboratory Result Names2. HL7 Messaging Standards: Includes scheduling,

medical record/image management, patient administration, observation reporting, financial management, patient care

3. NCPDP: Includes retail pharmacy transactions4. IEEE 1073 Messaging Standards: Connectivity5. DICOM Messaging Standards: Includes Image

Information to Workstations

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

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

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

Discussion

Questions?

Suggestions?

FOR MORE INFO...

Government-to-Business portfolio at www.egov.gov