NCVHS Testimony about Meaningful Use

Yesterday, I attended the NCVHS public hearing about meaningful use. Here's the agenda and my presentation.

I've described the importance of meaningful use in prior blog posts.

Much depends on the definition of meaningful use, including the characteristics of the EHRs which will qualify for stimulus dollars, the kind of interoperability we'll implement regionally/nationally, and the policies that will be required to support health information exchange.

My specific testimony included an overview of the interoperability needed for quality.

I highlighted the work of the NQF Health Information Technology Expert Panel (HITEP) which selected 84 metrics supported by 35 data types as an initial minimum dataset for quality measurement in 13 care processes. HITEP II will meet next week to further refine this work into a core minimum Quality Data Set (QDS).

I also highlighted the work done in Massachusetts on data exchange including the Massachusetts eHealth Collaborative Quality Data Warehouse.

My summary of the day, based on the testimony of 25 folks is

1. The country must rollout EHRs with baseline functionality that at a minimum includes e-prescribing, automated lab workflow, clinical summary exchange, and quality data reporting.

2. Health Information Exchanges will evolve locally based on business cases in communities. The services offered may include e-prescribing, diagnostic test results delivery, quality data warehousing, data normalization into common formats and vocabularies, and "convening services" to create data use agreements for the community.

3. Quality warehouses are needed to provide caregivers with rapid feedback and serve as population health registries. They will often be local based on the political feasibility of co-mingling data.

4. Standards will continue to evolve, but existing standards wrapped in a service oriented architecture using a common data transport approach are good enough. We should use clinical data preferentially over administrative data for quality reporting, population health analysis, and PHRs.

5. Policies in support of this technology will continue to evolve locally. Although there should some common national policies, regional variation must be allowed.

Several of my colleagues will testify today. I'll update this blog entry after their testimony.