The Implementation Workgroup Starter Kit

On March 8, the Implementation Workgroup of the HIT Standards Committee held a day of hearings as part of the effort to create an "Implementation Starter Kit" which accelerates EHR adoption and interoperability.

The goals of the hearing were to

* Describe challenges and successes that may be instructive to others.

* Provide advice to help others with implementation.

* Contribute tools and technologies that can be made available to the public and private sector, such as roadmaps, blueprints.

Here are the top 10 lessons learned from those hearings

1. Provide emerging HIE guidelines to assist providers. The Nationwide Healthcare Information Network (NHIN effort) is posting a implementation guide that will include: policy, “trusted relationship”, standards, services, and four use cases.

2. Disseminate knowledge of tools and utilities. The National Cancer Institute (NCI) is providing software developer kits with vocabularies and metadata, vendor utilities, and specification documents. The National Institute of Standards and Technology (NIST) is providing conformance testing tools.

3. Communicate details of all available funding sources i.e.

Regional extension centers (RECs) $643 million

Health Information Exchange $564 million

Workforce Training Programs $118 million

Beacon Communities $235 million

Strategic Health Advanced Research Projects (SHARP) $60 million

Nationwide Health Information Network/Standards and Certification $64.3 million

4. Focus on workflow challenges such as clinician friendly approaches to workflow redesign, change management, and training.

5. Lengthen the current implementation timelines in key challenging areas such as reporting of quality data.

6. Develop standards for data exchange that ensure that the data will be trusted such as rich metadata (who created the data, for what purpose in what workflow), further definition of the transport layer, and message routing standards. Exporting the data is easy, but how do we trust the inbound data into our systems from an external source (i.e., HIE)? What data should be in a PHR? What is the interplay between the state privacy laws and interoperability?

7. Drive collaboration between the software vendors to advance ARRA. Host an EMR software vendor summit to create synergies between vendors.

8. Create detailed implementation guidance for interoperability standards. Additional standards will be required for some use cases such as HIEs communicating with other HIEs.

9. Leverage open source models, where practical, such as the work of the Veterans Administration.

10. Innovate to improve speed of adoption. New business models and innovation are required. Utilize disruptive innovation to accelerate the road to adoption of meaningful use.

Tomorrow, the HIT Standards Committee will hear the report from the Implementation Workgroup and I'll post those materials, as well as a full summary of the meeting.