HIT advisory committees: Know data provenance, embrace standards and APIs for interoperability

The path to interoperability of health information has been a long one and will continue to be so, but healthcare organizations, IT vendors and government can take steps now to move forward on that journey, members of two federal advisory committees said this week.

In a joint meeting of the Health IT Standards Committee and Health IT Privacy Committee Tuesday, HIT Standards Committee member David McCallie Jr., MD, director of the Cerner Medical Informatics Institute, advised moving beyond a “document-centric world.” As he put it, “Don’t just move CDAs around,” referring to Health Level Seven International's Clinical Document Architecture standard.

John Halamka, MD, MS, vice chair of the HIT Standards Committee, discussed the importance of data stewardship. “Know data provenance so people can decide whether data is trustworthy,” said Halamka, CIO of Beth Israel Deaconess Medical Center in Boston.

Florida state Rep. Gayle Harrell, MA, a member of the HIT Policy Committee, reminded the panels and the public about an oft-overlooked provision of HIPAA. “Individuals have a right to access their health information,” said Harrell, a Republican from Stuart, Fla.

Harrell then was asked if HIPAA was adequate for safeguarding patient privacy to convey trust in electronic health information. “HIPAA is what we have,” she responded. “We need to advance interoperability within the framework that we have.”

Other panelists made a variety of points:

• Consent is an ongoing process, not just individual permissions, so it makes sense to do away with standing consent forms on paper in favor of electronic queries that ask for patient consent each time new data is created.
• There will not be a “natural arbiter” of privacy decisions.
• One standard will not meet all needs, but federal officials and technology developers should work with as few as possible.
• Restful application programming interfaces (APIs) will advance interoperability, which is why the Office of the National Coordinator for Health IT called for more APIs in its 10-year interoperability roadmap, published last month.