Feds push standards for health care IT

The U.S. Department of Health and Human Services this week announced a pair of initiatives to kick-start development of a standardized electronic medical records system that could be used nationwide. But some top health care companies said it could take years for the envisioned technology to be broadly adopted.

HHS said it has licensed a medical terminology database that was developed by the Northfield, Ill.-based College of American Pathologists and plans to make the technology available without charge throughout the U.S. health care industry.

The agency has also commissioned a unit of the National Academy of Sciences in Washington to design a model electronic patient record that likewise would be offered at no cost for use by companies.

Kaiser Permanente Health Plan Inc. already uses the terminology database chosen by HHS and views the technology as a fundamental component for ensuring that data can be exchanged among the various medical systems in a hospital, said Dr. Louise Liang, senior vice president of clinical support systems at the Oakland, Calif.-based health maintenance organization.

No Overnight Solution

Liang said Kaiser plans to incorporate the database into a new automated medical records system that it’s developing with software from Epic Systems Corp. at a cost of $1.8 billion. “It’s one of the first things we asked (Epic) about,” she said.

The availability of the terminology database in the public domain also should help spur adoption by other health care providers, Liang said. But she predicted that widespread deployment will take as long as five years. “I’m on the pessimistic side,” Liang said.

“This is not going to happen overnight,” agreed Nancy Brown, senior vice president of strategic planning at McKesson Corp.’s Information Solutions division. She said the vendors of medical systems technology will have to link the database to back-end servers and then provide access to the information via middleware. For its part, San Francisco-based McKesson plans over the next two years to gradually add the technology to the systems that it sells, according to Brown.

The database developed by the College of American Pathologists includes uniform terminology and descriptions for more than 340,000 medical concepts; the collection is formally known as the Systematized Nomenclature of Medicine Clinical Terms.

In addition to releasing the database to health care companies, the government plans to use it within HHS as well as the U.S. Department of Defense and the Department of Veterans Affairs.

The licensing agreement for the technology will be administered by the Bethesda, Md.-based National Library of Medicine (NLM), which is part of HHS. Dr. William Hole, a research medical officer at the NLM, said the database won’t be made available to health care organizations until year’s end because of the need to convert the files into an electronic meta-thesaurus that the HHS unit distributes for use by systems developers.

Meanwhile, HHS said it expects to make the proposed model electronic patient record available to health care companies next year. The model record is being designed by the National Academy of Sciences’ Institute of Medicine and will be submitted for evaluation by Health Level Seven Inc., a health care standards development organization in Ann Arbor, Mich.

Carla Smith, executive vice president of the Healthcare Information and Management Systems Society in Chicago, said she views the two HHS initiatives as “significant steps” toward creating a common infrastructure for automating medical records.

Smith noted that there currently is no such thing as a standard definition of clinical terminology in the health care industry. For example, some doctors use the term “heart attack” on medical charts, while others refer to the attacks as “myocardial infarctions,” she said.

The standards situation is even worse when it comes to the structure of electronic medical records, Smith added.

HHS Secretary Tommy Thompson said in a statement that the agency is looking to help health care companies catch up to industries like financial services in exchanging data electronically — a move that he claimed would improve patient care while reducing medical errors and costs. “Banks and other financial institutions all across the country can talk to each other electronically, which has streamlined customer transactions and reduced errors,” he said. “We want to do the same thing for the American health care system.”

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