ONC is now accepting applications for potential membership for the new FDASIA Workgroup of the HITPC until March 8, 2013 The Food and Drug Administration Safety Innovation Act (FDASIA) Workgroup is charged with providing expert input on issues and concepts identified by the Food and Drug Administration (FDA), Office of the National Coordinator for Health IT (ONC), and the Federal Communications Commission (FCC) to in order to inform the development of a report on an appropriate, risk-based regulatory framework pertaining to health information technology including mobile medical applications that promotes innovation, protects patient safety, and avoids regulatory duplication. FDASIA indicated that if a workgroup was formed, it should be geographically diverse and include representatives of patients, consumers, health care providers, startup companies, health plans or other third-party payers, venture capital investors, information technology vendors, health information technology vendors, small businesses, purchasers, employers, and other stakeholders with relevant experience. If you are interested in being considered for membership on the workgroup, please register at ONC's Workgroup Application Database. The three agencies will review the applications received by March 8, 2013. Anticipated Focus Areas: Throughout the report's development, the three agencies expect to seek input from the HITPC through this workgroup on various topics associated with what constitutes a risk-based regulatory framework for health IT that can also promote innovation, protect patient safety and avoid regulatory duplication. The FDASIA Workgroup is expected to build on prior work such as the Institute of Medicine (IOM) report, Health IT and Patient Safety: Building Safer Systems for Better Care and ONC's Health IT Patient Safety Action and Surveillance Plan; FDA's mobile medical applications guidance and Medical Device Data Systems Rule; FCC's National Broadband plan and other relevant work. Specifically the three agencies will seek input on issues relevant to the report, which include:
· Types of risk that may be posed by health IT that impact patient safety, the likelihood that these risks will be realized, and the impact of these considerations on a risk-based approach;
· Factors or approaches that could be included in a risk-based regulatory approach for health IT to promote innovation and protect patient safety; and
· Approaches to avoid duplicative or overlapping regulatory requirements.
All FDASIA Workgroup meetings and documents discussed at such meetings will be publicly available and will offer opportunities for public comments.
Background: Section 618 of the 2012 FDASIA charges the Secretary of Health and Human Services (the Secretary) (acting through the Commissioner of the Food and Drug Administration (i.e., FDA), in consultation with the National Coordinator for Health Information Technology (i.e., ONC) and the Chairman of the Federal Communications Commission (i.e., FCC) to publish a report by January 2014 that expresses "a proposed strategy and recommendations on an appropriate, risk-based regulatory framework pertaining to health information technology including mobile medical applications, that promotes innovation, protects patient safety, and avoids regulatory duplication." |
Showing posts with label HITPC. Show all posts
Showing posts with label HITPC. Show all posts
Thursday, February 21, 2013
ONC is now accepting applications for membership in new FDA SIA Workgroup of the HITPC

Friday, April 8, 2011
What to do about ONC meetings next week if the US Government Shuts down
Just got this via e-mail today (because Monday the mail might not go thru). In summary, if the Gov't shuts down, FACAs will not meet -- read the entire message below the line for details.
I have not been able to confirm what would happen to ONC S & I activities. Because those are led by contractors rather than ONC employees, it isn't at all clear what will happen, and few of them are answering Skype/e-mail/twitter right now (just before 5:00 EST).
If a shutdown does happen, I will use any extra time (note, I said extra, because it was never free) to make progress on other fronts that have been postponed by government activities ;-)
If I learn more, I'll update this post.
Update: According to one source: All is still on: Contractors work at risk, and from another: Purely federal folks will not be on calls, but contractors are allowed to work at their own discretion.
-- Keith
If a shutdown does happen, I will use any extra time (note, I said extra, because it was never free) to make progress on other fronts that have been postponed by government activities ;-)
If I learn more, I'll update this post.
Update: According to one source: All is still on: Contractors work at risk, and from another: Purely federal folks will not be on calls, but contractors are allowed to work at their own discretion.
Oh well, so much for work put on hold ;-(
-- Keith
Dear FACA members,
As you may know, we face a possible government shut down as of midnight tonight, April 8. In case we do shut down, there will be no federal government activity including any FACA meetings or calls. I, and others at ONC, will be prohibited from conducting any of our duties while the government is closed. Once funding is available, we will return to work. IF THERE IS NO SHUT DOWN, THE MEETINGS WILL CONTINUE AS PLANNED.
Assuming we are shut down: If there is a FACA Workgroup conference call and we are shut down, that call will not take place. However, if we find out the day before the call is scheduled, please assume that the call will take place. For example, the Information Exchange Workgroup has a call scheduled for Friday, April 15; if we are back at work on Thursday, April 14, that call will take place.
The situation is a little different if there is an in-person meeting, such as the HIT Policy Committee on April 13 in Washington, DC. If we know by noon the day before (in this case, noon on April 12), you may assume the meeting will take place.
Travel: if you travel on the morning of April 12 for the HITPC but find after noon that the meeting is cancelled, we will be able to cover your costs since the funds are from FY10 money. Also, if you find that the notification of the meeting occurring is short, you may wish to call into the meeting and we can arrange that.
Since we will know more at midnight tonight (but I cannot come into work this weekend if we are furloughed), I will email you all on Monday morning, April 11, with final instructions. I hope any shutdown is not lengthy, but if it does stretch more than next week, please watch the news. I will send you an email as soon as I am able. Please call or email me if you have questions. I will be available until about 11:30 am/ET on Monday, April 11 (Not over weekend if we are shut down). Thank you for your patience and understanding. Judy
FACA Schedule – April 11 through April 22
In-person Meetings in Washington (will be held if Government open by noon the day before):
April 13, HIT Policy Committee meeting
April 20, HIT Standards Meeting
April 21, Certification/Adopting Workgroup meeting (I am also sending this information to panelists)
Workgroup calls (will be held if Government is opened the day before):
April 12, Quality Measures WG
April 14, Vocabulary Task Force
April 15, Information Exchange WG
April 18, Privacy & Security Tiger Team and Clinical Quality WG
April 19, Business Rules Tiger Team/Enrollment WG
April 22, Clinical Operations WG
Judith Sparrow
Office of the National Coordinator for HIT
Dept of Health and Human Services
Washington, DC

Thursday, September 30, 2010
Provider Directories
This isn't a topic I would usually write on, but given other absences, I got tapped to sit in on the HIT Policy Committee Information Exchange Workgroup deliberations and testimony on Provider Directories. I missed the first panel's testimony because my flight was delayed for policy reasons (the crew needed sleep, a good policy). Of course that delay due to policy also put me in the middle of rush-hour DC traffic and rain, so a 40 minute drive from Dulles took an hour and 40 minutes.
There was quite a bit of lively discussion, and you can access all the written testimony here, including mine. [Note: That link will get stale, so if you are looking at this after October 2, look here under September 30th, and at that point you should also get the oral testimony and Q&A]. I spent three hours carving up my written testimony down to 4.5 minutes of oral remarks which I rehearsed 3 times yesterday, and then just wound up using that as notes for what I wound up saying unrehearsed because of what I'd heard during the day.
Now, for my OWN thoughts on this meeting, and I do mean my own, because as always, the comments on this blog represent my own opinions and not those of my employer or the standards organizations that I may represent.
There are two orthoganal axes by which I could characterized the MANY different kinds of directories discussed:
1. Who/What is using the Directory to Communicate
2. What purpose the communication is used for.
On the who/what: It's mostly either human-to-human, or computer-to-computer. Very different use cases, with very different requirements.
On the purpose, it's either for treatment (e.g., ePrescribing, referral, results delivery, or other communication of clinical data to providers), payment (another very big swath), or for operations (quality management...) [which also was not discussed very much at all, although I did allude to it briefly].
Doing this math, this is a 2x3 grid, so I can identify at least 6 different kinds of directories. For the most part, the testimony used two different terms: Yellow Pages, and routing. By the end of the meeting, both terms had been questioned as to what they were, and in part because sometimes they referred to one of the 6 I identified, and other times, a different one. MOSTLY, but not always, yellow pages fell into the human-to-human category, and were principally addressed in payment. CAQH's work on the Uniform Provider Directory (did I get that right), or UPD was mentioned numerous times throughout the day, as were several directories used by CMS. The "Routing" directory fell into the computer-to-computer column, about 50/50 split in treatment/payment.
CDC had a very interesting use case for directories, which was communications of information TO providers, like a public address system used to let everyone know about public health alerts. I've been working with some folks to TRY to turn that sort of use on it's head, because the number of sources (and thus need for directory updates), for alerts much smaller than the consumer audience for them. That use case was interesting because they need good recall (as many provider addresses as they can get), but precision is not as vital.
I also heard repeatedly that the need was for "ROUTING" directories, and not yellow pages. Since I was at the very end of the line, I couldn't correct that terminology soon enough. It's not about routing. It IS about getting access to the services needed to support computer-to-computer communciation, which includes authentication, policy support (certifcates), and end-point discovery. All this talk about Web 2.0 and we are still thinking about policy for routing messages. That really needs to change.
I heard a number of dings on HL7, but in reality, most I heard were due to the fact some in the room didn't understand it (e.g., OBX structures), and others HAVE not chosen to implement or contstrain it appropriately.
At least one thing everyone agreed on was that we need standards for core directory content. That's actually pretty easy, because you can just examine key fields in standards like HL7, NCPDP, and X12, and requirements of them in selected guides (e.g., CAQH/CORE or HL7 V2 guides for ELR, Immuniziation, or CCD) to see what that common set should be. To avoid argument about whether it is core or not, I propose a very simple rule. If a non-technical person can recognize the content as being the same thing in two or more of the standards, then it is a candidate for the core set. If it appears in all, then it is certainly a core component. A lot of stuff won't show up, but that should be OK, because this SHOULD be an Iterative process. How do begin a journey of a million steps? By taking the first one.
I was amazed by the continual references to the Internet as if that appeared by magic overnight, rather than being developed over the course of the last 5 decades, and in commerce, really only the last two. The web didn't happen overnight, and not all of these problems will be solved overnight either. Most of those Internet standards we laud are on their 4th and 5th iteration.
A number of commenters reported that there WERE NO standards for this. I pointed out that in fact there are, and by the way, this problem is not one experienced just in healthcare.
The other part that folks seem to agree upon is that this cannot be centrally controlled, and that the technology should support federation (Hey, look at what those internet guys came up with!).
Walter Suarez summed it up very well. There is a LOT to take in, and we need to be focused. I'd go even further, use the 2 axes I described, and prioritize the bunch, then pick the two with the biggest ROI. Because, as I pointed out over lunch, good policy has to be implementable, and implementable also means sustainable. We cannot afford to execute on every good idea without understanding both the benfits and costs.
Oh, and by the way, if this is focused on meaningful use, I'd tend towards treatment and operations (quality), rather than payment, and computer-to-computer, but you know, that is just MY reading of the policies behind Meaningful Use.
So much for not writing today, I'm exhausted but have another 25 minutes before my flight boards. Next up, an analysis of the ISDS work I posted on between tweets and panels.
There was quite a bit of lively discussion, and you can access all the written testimony here, including mine. [Note: That link will get stale, so if you are looking at this after October 2, look here under September 30th, and at that point you should also get the oral testimony and Q&A]. I spent three hours carving up my written testimony down to 4.5 minutes of oral remarks which I rehearsed 3 times yesterday, and then just wound up using that as notes for what I wound up saying unrehearsed because of what I'd heard during the day.
Now, for my OWN thoughts on this meeting, and I do mean my own, because as always, the comments on this blog represent my own opinions and not those of my employer or the standards organizations that I may represent.
There are two orthoganal axes by which I could characterized the MANY different kinds of directories discussed:
1. Who/What is using the Directory to Communicate
2. What purpose the communication is used for.
On the who/what: It's mostly either human-to-human, or computer-to-computer. Very different use cases, with very different requirements.
On the purpose, it's either for treatment (e.g., ePrescribing, referral, results delivery, or other communication of clinical data to providers), payment (another very big swath), or for operations (quality management...) [which also was not discussed very much at all, although I did allude to it briefly].
Doing this math, this is a 2x3 grid, so I can identify at least 6 different kinds of directories. For the most part, the testimony used two different terms: Yellow Pages, and routing. By the end of the meeting, both terms had been questioned as to what they were, and in part because sometimes they referred to one of the 6 I identified, and other times, a different one. MOSTLY, but not always, yellow pages fell into the human-to-human category, and were principally addressed in payment. CAQH's work on the Uniform Provider Directory (did I get that right), or UPD was mentioned numerous times throughout the day, as were several directories used by CMS. The "Routing" directory fell into the computer-to-computer column, about 50/50 split in treatment/payment.
CDC had a very interesting use case for directories, which was communications of information TO providers, like a public address system used to let everyone know about public health alerts. I've been working with some folks to TRY to turn that sort of use on it's head, because the number of sources (and thus need for directory updates), for alerts much smaller than the consumer audience for them. That use case was interesting because they need good recall (as many provider addresses as they can get), but precision is not as vital.
I also heard repeatedly that the need was for "ROUTING" directories, and not yellow pages. Since I was at the very end of the line, I couldn't correct that terminology soon enough. It's not about routing. It IS about getting access to the services needed to support computer-to-computer communciation, which includes authentication, policy support (certifcates), and end-point discovery. All this talk about Web 2.0 and we are still thinking about policy for routing messages. That really needs to change.
I heard a number of dings on HL7, but in reality, most I heard were due to the fact some in the room didn't understand it (e.g., OBX structures), and others HAVE not chosen to implement or contstrain it appropriately.
At least one thing everyone agreed on was that we need standards for core directory content. That's actually pretty easy, because you can just examine key fields in standards like HL7, NCPDP, and X12, and requirements of them in selected guides (e.g., CAQH/CORE or HL7 V2 guides for ELR, Immuniziation, or CCD) to see what that common set should be. To avoid argument about whether it is core or not, I propose a very simple rule. If a non-technical person can recognize the content as being the same thing in two or more of the standards, then it is a candidate for the core set. If it appears in all, then it is certainly a core component. A lot of stuff won't show up, but that should be OK, because this SHOULD be an Iterative process. How do begin a journey of a million steps? By taking the first one.
I was amazed by the continual references to the Internet as if that appeared by magic overnight, rather than being developed over the course of the last 5 decades, and in commerce, really only the last two. The web didn't happen overnight, and not all of these problems will be solved overnight either. Most of those Internet standards we laud are on their 4th and 5th iteration.
A number of commenters reported that there WERE NO standards for this. I pointed out that in fact there are, and by the way, this problem is not one experienced just in healthcare.
The other part that folks seem to agree upon is that this cannot be centrally controlled, and that the technology should support federation (Hey, look at what those internet guys came up with!).
Walter Suarez summed it up very well. There is a LOT to take in, and we need to be focused. I'd go even further, use the 2 axes I described, and prioritize the bunch, then pick the two with the biggest ROI. Because, as I pointed out over lunch, good policy has to be implementable, and implementable also means sustainable. We cannot afford to execute on every good idea without understanding both the benfits and costs.
Oh, and by the way, if this is focused on meaningful use, I'd tend towards treatment and operations (quality), rather than payment, and computer-to-computer, but you know, that is just MY reading of the policies behind Meaningful Use.
So much for not writing today, I'm exhausted but have another 25 minutes before my flight boards. Next up, an analysis of the ISDS work I posted on between tweets and panels.

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