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Monday, July 20, 2009

ARRA: Short Term Tactics or Long Term Strategic Plan

Today I gave a brief presentation to a class covering "Key Standards in Health Informatics" at Northeastern University. While the capstone of my presentation was meant to be the HITSP Capabilities of IS 107, I spent far too much time on my "Brief History" slide to do the HITSP capabilities justice. However, I found that I really enjoyed putting the History slide together and presenting on it. The slide covers some key events over the past 10 years that help to formulate where we are today. My timeline is not complete, I'm missing key dates (e.g., the ONCHIT-1 through 4 RFP dates), and there are significant gaps in other areas, and I could go back even further if I hadn't placed a self imposed 1-decade limit on it. However, it's enough to fill a Slide at 12 point type, which argues that it is already too much. I reproduce the content of that slide below:

Nov 1999
IOM: To Err is Human: Building a Safer Health System
Nov 15, 2001
NCVHS: Information for Health: A Strategy for Building the National Health Information Infrastructure

Jul 18, 2003
HL7 EHR System Functional Model Draft Standard for Trial Use Begins

Jul 31, 2003
IOM: Key Capabilities of an Electronic Health Record System

Apr 27, 2004
EO 13335: Incentives for the Use of Health Information Technology and Establishing the Position of the National Health Information Technology Coordinator

Jul 2004
HL7 EHR System Functional Model Draft Standard for Trial Use Published

Jul 2004
CCHIT Formed by AHIMA, HIMSS and NAHIT (The Alliance)

Jul 21, 2004
The Decade of Health Information Technology: Delivering Consumer-centric and Information-rich Health Care

Nov 9, 2004
ONCHIT RFI: Development and Adoption of a National Health Information Network

Jan 17, 2005
13 Member Collaborative Response (AHIMA, AMIA, ANSI/HISB, CITL, CfH, eHealth, HIMSS, HL7, EHR(V)A, IHE, Internet2, Liberty Alliance, NAHIT)

Sep 13, 2005
American Health Information Community formed as Federal Advisory Committee

Sep 2005
ONCHIT-1 – ONCHIT-4 Awarded

Oct 2005
ANSI/HITSP Founded by ANSI, HIMSS, Booz Allen Hamilton, and the Advanced Technology Institute

Aug 22, 2006
EO 13410: Promoting Quality and Efficient Health Care in Federal Government Administered or Sponsored Health Care Programs

Oct 26, 2006
CCHIT Recognized as a Certifying Body

Jan 2008
HITSP Specifications Recognized

Jan 2009
HITSP Specifications Recognized

Feb 17, 2009
ARRA Passes

Jul 8, 2009
HITSP IS 107 EHR-Centric Release for Implementation

Jul 17, 2009
Meaningful Use Defined
Jul 21, 2009
Standards Committee Meets to Identify Standards for Meaningful Use

I spent a good 20 minutes on this slide showing how we got to meaningful use today. Going through this history you can see how
The IOM 8 functional areas are tied to the HL7 EHR Functional Model, CCHIT Certification Critiera, and the ARRA 8.
The National Health Information Infrastructure became the National Health Information Network
Programs such as CHI and HISB were rolled into ANSI/HITSP.
Executive Order 13335 and 13410 become keys points in ARRA and HITECH, to the point of using almost the same language.
You might find it instructive to go back through some of this historical material for yourself and see where we've been and how it's influenced (or failed to influence) where we are today, and more importantly, where we will be tomorrow. I reread various pieces of these documents today, and found the review to be very illuminating.


P.S. One of the students remarked during her presentation on ICD-10 that followed mine that "... the costs exceed $1B dollars, but that doesn't sound like so much after hearing Keith speak." I'm not sure what she meant, but I thought it significant enough editorially to include the comment here.

1 comment:

  1. Great historical perspective - thanks for providing this Keith