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National Interoperability Standards and USHIK

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When I think of all the HITSP products. My brain hurts so many 'constructs' ... Pinochle: 48 cards, all higher than an 8, duplicated. Poker: all 52 cards ... – PowerPoint PPT presentation

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Title: National Interoperability Standards and USHIK


1
National Interoperability Standards and USHIK
  • Public Health Data Consortiums 2009 Annual
    Meeting
  • J. Michael Fitzmaurice, Ph.D.
  • Agency for Healthcare Research and Quality
  • November 12, 2009

2
Does anything exist?
  • Cogito, Ergo Sum
  • Rene Descartes

3
When I think of all the HITSP products
  • My brain hurtsso many constructs
  • How do I grasp the power of what HITSP has done?
  • USHIK.ahrq.gov

4
USHIKa National Metadata Registry
US Health Information Knowledgebase
AHRQ-USHIK
4
5
USHIKa National Metadata Registry
  • AHRQ-USHIK is an AHRQ-funded and managed metadata
    registry of
  • Data elements endorsed, accepted, and recognized
    by the HHS Secretary for federal agencies use
  • An organized collection of data elements and
    their characteristics (metadata)ISO/IEC 11179
  • USHIK contains data elements from National
    Interoperability Standards for
  • HIPAA transactions
  • Consolidated Health Informatics Domains
  • Health Information Technology Standards Panel
    (HITSP)

6
AHRQ-USHIK
  • Mission To represent AHRQ with excellent service
  • Specific Goal To be an organized set of
    repositories that coordinates the data elements
    and their metadata from health data standards
    that the HHS Secretary has endorsed, accepted,
    and recognized, including ARRA data elements,
    plus AHRQs patient safety elements
  • Why To improve the uniformity, accuracy, and
    computerization of health data for researchers
    and decision makers, including providers,
    patients, plans, and payers
  • Improves clinical and administrative data used
    for research
  • Speeds applications of research tools developed
    from these data

7
Bridge Normal Deck of 52 Cards
  • Data element name(1 of 52) 4 of spades
  • Attributes (Metadata)
  • Definition playing card
  • Number 4
  • Suit spades
  • Odd/even even
  • Picture card No
  • Authority You, or Hoyle
  • Version or date effective 12-14-1917
  • Bridge deck member Yes
  • Pinochle deck member No
  • Euchre deck member No
  • Poker deck member Yes

8
Card Metadata Registry
  • Each game master is the authority for its games
    cards
  • The same card can be used in different games
  • The same metadata about a card can be reused many
    times, in a metadata registry
  • Bridge all 52 cards
  • Euchre 24 cards, all higher than an 8
  • Pinochle 48 cards, all higher than an 8,
    duplicated
  • Poker all 52 cards
  • In total, it would take 176 cards for each of you
    to display the cards for your games with separate
    decks

9
What cards are needed to play?
Bridge
Pinochle
Euchre
Poker
Deck of 52 CARDS
Not 176
10
AHRQ-USHIK Data Element
  • Data Element Gender code
  • Attributes (Metadata)
  • Definition For eligibility, id gender of
    the individual member
  • Context NCPDP Data Dictionary
  • Registration. Authority NCPDP
  • Effective date 2001-11-27
  • Data type Numeric extended
  • Represent. Layout X(1)
  • Value Domain Gender, coded_VD
  • Codes M (male), F (female), U (unknown)

11
Comparison Matrix Aids in Harmonizing Data
Elements
www.USHIK.org
12
What data elements are needed for ARRA
meaningful use?
AHRQ Patient Safety
X12N
NCPDP
HL7
HITSP
USHIK
13
Do the data elements in my EHR fit HITSP
specifications?
X12N
NCPDP
HL7
HITSP
Are My EHR data defined the same as HITSPs?
USHIK
14
How does each authority express gender?
X12N
NCPDP
HL7
HITSP
USHIK
Gender
15
ARRA Incentive Payments to Providers
  • American Recovery and Reinvestment Act of 2009
    (Feb. 17, 2009) provides
  • Up to 44,000 starting in 2011 through 2015 for
    Meaningful Use of Certified EHRs by eligible
    Providers
  • Meaningful Use --- so that patients will get
    value
  • Certified --- to reduce market risk to EHR
    purchasers about the EHRs capabilities for them
    to engage in Meaningful Use activities

16
Simple Hypothetical Diagram
Standards Recommendations for Meaningful Use and
8 other areas
ARRA
Health providers
HHS Secretary
CMS/ONC
ONC
Meaningful use definition
HITSP
HIT Policy
HIT Standards
17
Simple Hypothetical Diagram
ARRA
Federal Agencies
HHS Secretary
ONC
ONC
HITSP Other bodies
CCHIT Other bodies
HIT Policy
HIT Standards
18
Simple Hypothetical Diagram
AHRQ USHIK
ARRA
Federal Agencies
HHS Secretary
ONC
ONC
CCHIT Other bodies
HITSP Other bodies
HIT Policy
HIT Standards
19
Simple Hypothetical Diagram
AHRQ USHIK
ARRA
Federal Agencies
HHS Secretary
ONC
ONC
CCHIT Other bodies
HITSP Other bodies
HIT Policy
HIT Standards
20
Federal Agencies
  • As required by ARRA, when federal agencies
    implement, acquire, or upgrade HI systems for
    exchanging personal health information, they must
    use systems that meet standards adopted by the
    HHS Secretary under ARRA.
  • Federal agencies are similarly bound by Executive
    Order 13410 (Aug. 2006) to use standards
    recognized by the HHS Secretary.

21
Federal Agencies must use these Standards per
ARRA
  • a) SPENDING ON HEALTH INFORMATION TECHNOLOGY
    SYSTEMS.As each agency implements, acquires,
    or upgrades health information technology systems
    used for the direct exchange of individually
    identifiable health information between agencies
    and with non-Federal entities, it shall utilize,
    where available, health information technology
    systems and products that meet standards and
    implementation specifications adopted under
    ARRA ...
  • (b) FEDERAL INFORMATION COLLECTION
    ACTIVITIES.With respect to a standard or
    implementation specification adopted under ARRA
    , the President shall take measures to ensure
    that Federal activities involving the broad
    collection and submission of health information
    are consistent with such standard or
    implementation specification, respectively,
    within three years after the date of such
    adoption.

22
Vendors of Certified EHR Systems
  • The standards and certification criteria are
    forthcoming in the Federal Register by December
    31, 2009, as mandated by ARRA.

23
ushik.ahrq.gov promotes
  • One-stop shopping for HITSP data elements
  • Reduced resources for implementing HITSP
    standards
  • And for reporting patient safety events in
    hospitals
  • Defined authorities for data elements meanings
  • Uniformity of certified EHR content
  • Movement toward identical data elements
  • Reconciling inconsistencies within and among
    HITSP documents and SDO standards
  • Making available data information from other
    sources in USHIK for HITSP comparisons and
    choices
  • Federal agency and private sector comparisons of
    their program and product data needs with HITSP
    data elements

24
Whats New in USHIK
  • As of July 15, 2009, every HITSP-specified data
    element is in USHIK and linked to every HITSP
    construct (document) in which it appears
  • Developing new, faster data loader
  • Updating SDO information X12, NCPDP, HL7
  • X12 data elements are being updated in USHIK
  • 4010 in the USHIK staging server now
  • 4050 and 5010 generic elements developed next
    week for loading the following week Thank you,
    Steve Bass

25
Whats New in USHIK
  • X12 is taking responsibility for properly
    loading its data elements into USHIK HITSP
    should reference them there
  • NCPDP and HL7 are proposed to follow
  • USHIK has a preliminary view of HITSPs
    Capabilities and Services Collaborations
  • Within IS 07 EHR Centric Context with links to
    capabilities, service collaborations, all
    constructs, data elements, value sets
  • Not official, but presented for improving
    understanding and obtaining user comments

26
Whats New in USHIK
  • AHRQ has recently funded USHIK to
  • Develop a State All-Payer Data (SAPD) Metadata
    Portal
  • Develop a Meaningful Use Metadata Measure (MUMM)
    Metadata Analysis and Portal (with Abt
    Associates, Inc.)
  • Continue developing AHRQs Patient Safety Common
    Formats Portal
  • Put HITSP T66 compliant web services in place for
    external queries of/by USHIK
  • AHRQ and VA will continue their USHIK
    partnershipHITSP data elements ? Quality Measure
    domain

27
Where is Value?
  • Publishing in one place the data elements from
    the standards processes ONC has developed
  • Being a source for what is required by the
    Presidents and HHS Secretarys Interoperability
    StandardsFederal Agencies, Federal Contracts
  • Supporting federal and private sector efforts to
    match their programs and products data elements
    with those of Federal Interoperability Standards

28
Finale
  • See the HITSP Portal Information Models at
  • Ushik.ahrq.gov
  • See also CDCs PHIN VADS for public health data
    value set information at
  • Phinvads.cdc.gov

29
National Interoperability Standards and USHIK
  • Public Health Data Consortiums 2009 Annual
    Meeting
  • J. Michael Fitzmaurice, Ph.D.
  • Agency for Healthcare Research and Quality
  • November 12, 2009

30
USHIK Metadata Registry Contents, data elements
from
  • IEEE Medical Device Communications Industry
    Group (IEEE/ISO 11073)
  • DoD Military Health System
  • NCVHS
  • Clinical Care Classification (Nursing Taxonomy)
  • HITSP
  • AHRQ Patient Safety Events
  • Other sources
  • X12
  • ASTM
  • NCPDP SCRIPT, Batch, Data Dictionary
  • American Dental Association
  • HIPAA
  • HL7
  • MHS Functional Area Model
  • Public Health Care Data Standards  
  • LOINC
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