Final Standards Rule

[Dennis Ballance]

The Health Information Technology Standards Committee, a federal advisory committee charged with setting the regulations for [human] health data standards in the US, has released their Final Standards Rule. This document (http://mycourses.med.harvard.edu/ec_res/nt/41804BCE-C157-4D3C-83CA-3D938EF1895D/standards.ppt) identifies the standards and implementation guides that have been included for each of a variety of content areas. Thanks to Dr. John Halamka, chair of the HIT Standards Committee, for putting this together. As you will see, many of the content areas don't apply in veterinary medicine, but some are relevant. Vet Med, of course, is not bound by this regulation, but (in my humble opinion) we will get a lot farther a lot faster if we adhere to it.

Enjoy!

--Dennis
Dennis Ballance, DVM
dennis....@vcaantech.com

Director of Health Technology Integration
VCA Antech
Office: (310) 571-6542 (internal: x 6542)
Cell: (408) 497-8295

[Michael K. Martin]

One thing to note that isn't obvious unless you really dig in the final
rules themselves is that the standards for code sets are minimum
versions. So the fact that the rule specifies LOINC 2.27 doesn't mean
you can't or shouldn't use the current release of LOINC, and so on. The
comments section explicitly calls out LOINC 2.3 as one of the code sets
that is already recognized as a valid upgrade.

Unfortunately, IMHO, the same is not true of the referenced standards
other than code sets. So your only choices for HL7 are 2.3.1 or 2.5.1.
For veterinary labs doing reporting to public health this may mean that
we will need to maintain older versions of things like laboratory
results messaging. My own health department actually preferred the 2.6
message to the 2.5.1 but I suspect now that 2.5.1 is set in stone we
might end up going back to the older message structure via either a new
message or a transformation in an interface engine.

Mike

--

Michael K. Martin, DVM, MPH, DACVPM
Clemson Livestock Poultry Health
PO Box 102406
Columbia, SC 29224-2406
email: mma...@clemson.edu
personal email: michael.mar...@gmail.com
phone: (803) 788-2260 ext 230
work cell: (803)312-1439 (no personal calls)
personal cell: (803)348-1879 (no work calls)
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Only two things are infinite, the universe and human
stupidity, and I'm not sure about the former.
ALBERT EINSTEIN

[Jeff Wilcke]

I think I'd treat the federal mandate as a stalking horse and not something to adhere to...  

I don't believe that the versions of most of the standards specified at this point are adequate to meet veterinary needs across a fairly wide spectrum of our profession.  So I'd be careful that we not "adhere" to something that might take us backwards but rather we should recognize that if we proceed with parallel development we will eventually align fully with the [human] health data standards when current and future versions allow.

-Jeff

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[Dennis Ballance]

Fair enough.  The challenge to using newer versions will be that we won't necessarily have access to the tools and resources that are developed on the human side, as they will be retrograde for us as well.  (Note - at this point that's only a theoretical risk.)

--Dennis

[Michael K. Martin]

Oh, of course.  I agree.  The only place we will have to "live with" these is where our business partners are restricted due to their need to comply with "Meaningful Use" to get their share of the pie. 

It is still valuable to see what works and what doesn't when it comes to dragging physician practices--kicking and screaming--into using standards.

Mike

[Jeff Wilcke]

Sadly yes, the risk is mostly theoretical. 

The "ahead of [human]" issue has been with us all along.  For a long time, we've had to use what was coming because existing inhibited our ability to be [veterinary] correct.

-J