- The Health IT Advisory Committee (HITAC) has cancelled its monthly meeting, scheduled for Jan. 23, due to the US government shutdown, reported Politico.
HITAC was established in 2017 under the 21st Century Cures Act to provide recommendations to HHS’s Office of the National Coordinator for Health Information Technology (ONC) on policies, standards, implementation specifications, and certification criteria related to interoperable health IT infrastructure.
HITAC replaces the Health Information Technology Policy Committee and the Health Information Technology Standards Committee.
Four task forces operate under the HITAC umbrella: Trusted Exchange Framework Task Force, US Core Data for Interoperability Task Force, Interoperability Standards Priorities Task Force, and the Annual Report Workgroup. A meeting of the workgroup scheduled for Jan. 10 was also cancelled.
In April, HITAC approved and submitted nine recommendations to ONC on how to improve interoperability of the health IT infrastructure. The recommendations were developed by the US Core Data for Interoperability Task Force.
The task force identified common causes that prevent health data from being shared: data does not exist; data exists but is not collected at all or in part; data is collected, but there are no semantic standards for normalizing the data; data is collected and there are appropriate semantic standards, but they are not broadly applied; data is collected and semantic standards are applied, but inconsistent standards application inhibits interoperability; and detailed and reliable workflows to share the data outside of the originating organization have not been set up.
To address these causes the task force laid out nine recommendations:
1) Establish a six-stage maturation process through which data classes would be promoted, each with objective characteristics for promotion
Stage 1 would identify data objects and classes of value to any stakeholder. The end user would assign value to interoperable data because it contributes to clinical or business need.
Stage 2 addresses two issues: creating data classes with broad value and defining and specifying data objects to support interoperability.
Stage 3 would test data classes in pilot scenarios as part of specific use cases to enable end users and developers to identify issues with definitions, semantic, and transport standards and workflow prior to broader deployment.
Stage 4 would test rigorously the data class in several product settings, identify issues requiring resolution prior to national deployment, and ensure the vendor community has enough advanced notice that data classes in this stage are up for release for national adoption.
Stage 5 is designed to put industry officially on notice that a data class has completed testing and is a priority for national deployment at scale.
Stage 6 would recognize data classes that have attained widespread adoption nationally as the final state in the US Core Data for Interoperability (USCDI) process.
2) Expand the USCDI as each data class completes Stages 1 to 4 without a predetermined timeline
Among other steps, the task force recommended that ONC establish an open process for proposing data items or data classes for consideration without restrictions on what is proposed or who can propose it.
3) Establish an annual publishing cycle for the USCDI (Reference Edition) with periodic bulletins as data objects/data classes progress from one stage to the next
The USCDI Reference Edition should include the most relevant information for each data class in each stage. It should strike a balance in the amount of information provided and could include summary statistics for the USCDI in general and how it changed over the course of the year.
4) Incorporate public feedback at each stage
The task force proposed a two-month public comment period following the annual publication of the USCDI Reference Edition.
5) Test USCDI process by addressing critical Trusted Exchange Framework requirements
The task force recommended that two data classes be created for the framework, use cases for six permitted uses for the framework be developed, the effectiveness of the recognized coordinating entity in promoting the voice of the patient be measured, and current data classes in the USCDI be reviewed against the criteria proposed in the recommendations.
6) Ensure the voice of the patient is represented and heard
The task force noted that the current regulatory and practice environment is shifting towards person-centered care, making it more important that the patient perspective be represented when designing tools and processes to advance interoperability.
7) Support the process of data object object harmonization as a condition for data class advancement
The task force said it is essential to the USCDI process that ONC support data object object harmonization with enough resources to enable harmonization to occur at each stage.
8) Data class management
Although it did not provide recommendations for data class management, the task force identified the following needs: processes to modify established USCDI data classes, to remove or retire data classes, and to create and advance data classes in response to a public emergency.
9) Governance structure for USCDI
The task force recommended that ONC acts as the steward for the USCDI to ensure data classes move through the USCDI process. ONC should facilitate work groups when appropriate and help identify and educate stakeholders regarding how to effectively engage with the USCDI, the task force concluded.