 |
 |
 |
 |
| |
|||||
|
|
|
Home > News & Events > MITRE Publications > The MITRE Digest > | |||||||||||||||||||
Healthcare IT Standards to Bring Order to Medical Records February 2008
Imagine you're rushed to a hospital emergency room, unconscious, due to a severe allergic reaction. All the relevant details about your allergy are contained in your primary care doctor's files—but your doctor's electronic medical records system is not compatible with the system the hospital uses. Without quick access to this data, the emergency room staff wastes valuable time making a diagnosis. This scenario, and others like it, unfolds countless times a day across the U.S., resulting in needless risk and patient deaths each year. The Institute of Medicine and the Centers for Disease Control and Prevention estimate that medical errors kill more Americans each year than motor vehicle accidents or breast cancer. But there's hope for improvement. Standardizing the data exchange tools, software programs, and systems used by doctor's offices, hospitals, and insurance companies, among others, will allow for the fast, accurate exchange of patient records, emerging medical research data, disease outbreak updates, prescription data, and other critical health care information. This evolution will improve levels of care and lessen risks for patients nationwide. MITRE health information technology (IT) experts are at work on an ambitious healthcare IT standards effort that aims to integrate systems and clinical knowledge by helping the federal government create a seamless, secure healthcare informatics system. We are working with private sector organizations and federal agencies, including the Department of Health and Human Services (HHS), the Veterans Administration, and the Department of Defense, to lay the groundwork for a nationwide electronic infrastructure for the secure exchange of medical data. A step in the right direction—an evaluation tool developed by MITRE and one of our partners—will be available soon. (See "Launching LAIKA to Improve Testing" on this page.) We are also working to establish technical standards for such a system, in the hopes that the federal government "can be the tipping point for the rest of the healthcare industry in promoting and adopting the new standards," says Beth Halley, a MITRE principal healthcare consultant and registered nurse involved in the project. In addition, MITRE scientists and analysts are focused on identifying areas where new health IT standards are needed, refining existing standards, and guiding the implementation of the standards within federal government systems. "One key goal for us is to help various federal agencies identify their own needs and cross-agency needs throughout the whole standards lifecycle," Halley explains. Solutions Must Include Everyone Besides the government, any solution also will have to meet the needs of the different parties who have a stake in the outcome. "Physicians are concerned about interoperability, and patients are concerned about accuracy and privacy," says Lisa Tompkins, a MITRE multi-discipline systems engineer who serves as liaison between the Healthcare Information Technology Standards Panel (HITSP) and the 28 federal agencies that have a stake in healthcare activities. "Because we don't sell products, we're well positioned to provide an independent, third-party perspective on technologies in the healthcare space." Tompkins' work also includes support to a federal health interoperability architecture project and cross-agency initiatives including benefits eligibility determination. Under the system envisioned by the government, ultimately the consumer will manage his or her own data, which will provide an additional level of security and privacy. For example, Tompkins says, one day such standards will allow doctors and patients to manage prescriptions electronically, cutting down on errors and increasing convenience for patients. Putting a System Back on Track The American healthcare system faces challenges that are epic in scope: U.S. per capita healthcare spending exceeded that of all industrial countries in 2001, yet the nation ranked 22nd in life expectancy for both sexes. Even these lackluster results are a significant drain on public resources, given that the federal government pays 57 percent of all healthcare costs. Informatics solutions such as those in progress at MITRE are aimed at addressing both the human and monetary costs of the healthcare system's shortcomings. MITRE took on this work in response to a 2004 federal directive that called for widespread adoption of technologies allowing for interoperable electronic health records within 10 years. This same directive enabled the establishment of the Office of the National Coordinator for Health Information Technology (ONC) and the Federal Health Architecture initiative, both within HHS. The FHA, which is managed by the ONC, will create a nationwide electronic health data infrastructure and ensure that federal agencies can easily exchange health data among themselves, with state and local governments, and with private sector health care organizations. ONC convened the HITSP—of which MITRE is a founding member—to bring together government and non-government stakeholders to develop, prototype, and evaluate the standards process for healthcare software applications, particularly electronic health records. This panel is also assisting in the development of the U.S. Nationwide Health Information Network, addressing issues of privacy and security. The network is expected to form part of the overall electronic health data infrastructure envisioned by the government. Improving Performance for Medical Devices and Diagnostic Tools Health IT standards cover a range of things, some physical and some virtual. For instance, there are standards in the works for medical devices and tools such as EKGs, as well as for the electronic filing of disability claims. In the latter case, MITRE is working with the Social Security Administration on a plan to transform the disability claims system, which up until recently has been paper-based. The process encompasses planning for standardizing not only the format of the electronic claims forms, but also the terminology used in them, Halley says. The issue of standardizing medical terminology is also important when it comes to pharmaceuticals, she adds. MITRE works with the Food and Drug Administration, National Library of Medicine, and the National Cancer Institute to provide "terminology services support" for standardizing the medical terms collected in a comprehensive medical database known as SNOMED, or Systematized Nomenclature of Medicine. SNOMED covers most areas of clinical information such as diseases, medical
procedures, and pharmaceutical data. It allows for a consistent way to
index, store, retrieve, and aggregate clinical data across varying medical
specialties and sites of care. It also is used in organizing the content
of medical records, reducing variations in the way medical data is captured,
encoded, and used in clinical care and research. The benefits of implementing unified standards for the electronic exchange of health information include early detection of infectious disease outbreaks, improved tracking of chronic disease management efforts, and improved ability to evaluate healthcare services based on the comparison of anonymous price and quality information. "Health IT standards benefit everyone in the health system, from clinicians and diagnosticians to payers and the ultimate customer—the patient," says Rob Jensen, MITRE's executive director of healthcare. "For all of us, as potential patients, MITRE's support to this endeavor is truly in our collective public interest."
—by Maria S. Lee Related Information Articles and News
Websites |
||||||||||||||||||||
| Page last updated: February 12, 2008 | Top of page |
Solutions That Make a Difference.® |
|
|
