Universal language for health IT standards urged

Achieving the full potential of health IT will require an information-sharing infrastructure that facilitates data exchange among institutions, according to a report released by the President’s Council of Advisers on Science and Technology (PCAST). The council is a presidentially appointed group consisting of academia, non-governmental organizations and industry members.

That infrastucture would allow health data to follow patients wherever they are, with appropriate privacy protection and patient control, while giving doctors a more complete picture of patients’ medical conditions and needs, according to the report.

The PCAST report calls on the federal government to facilitate the widespread adoption of a “universal exchange language” that allows for the transfer of relevant pieces of health data while maximizing privacy.

PCAST recommended that the Office of the National Coordinator for Health IT (ONC) and the Centers for Medicare & Medicaid Services (CMS) develop guidelines to spur adoption of an exchange language for use by health IT systems. “That would facilitate a transition from traditional EHRs to a more medically useful and secure system in which individual bits of healthcare data are tagged with privacy and security specifications,” PCAST stated.

The best way to manage and store data for advanced data-analytical techniques is to break them down into the smallest individual pieces that make sense to exchange or aggregate, according to the report. The pieces, “tagged data elements,” are accompanied by “metadata tags” that describe the attributes, provenance, and security and privacy protections of the data, according to PCAST.

A key advantage of the tagged data element approach is that it allows a more sophisticated privacy model—one in which privacy rules, policies and applicable patient preferences are bound to each separate tagged data element and are enforced both by technology and by law, according to the organization. “Also addressing a widespread privacy concern, such a system would not require the creation or assignment of universal patient identifiers, nor would it require the creation of any centralized federal database of patients’ health information,” the report added.

The report called on ONC and CMS to move rapidly to implement its recommendations by creating appropriate definitions in the meaningful use standards for health IT, which under law must be achieved in stages by 2013 and 2015.

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