A National Cancer Institute registry service that will allow patients, federal health researchers and healthcare providers to access its data is just the first of a slew of examples that the Obama administration hopes will spur meaningful use of health IT.
"We're looking for success stories and where we can help to accelerate adoption," said Aneesh Chopra, the White House chief technology officer. "The standards for meaningful use are not new " some organizations have been engaging in meaningful use for some time."
Speaking at a March 8 meeting of the committee's implementation workgroup, Chopra cited NCI's open source Patient Outcomes Data Service as an example of innovation in the public sector that providers and vendors should know about.
Based on terminology and standards of NCI's Cancer Biomedical Informatics Grid (caBIG), the service could be commercially adopted as a means of patient engagement and data exchange, he said.
The cancer registry service enables physicians to collect and share information about cancer diagnoses, treatment and clinical outcomes of individual patients, as well as the outcomes of all of their patients in the aggregate, said Dr. Ken Buetow, director of the NCI's Center for Bioinformatics and Information Technology.
"The concept here is that we have some chunks of data that people can use right away," he said. "It also provides a utility for vendors to have a module that has to be implemented that can be bolted on to EHRs."
Another instance of support being developed to accelerate meaningful use is ONC's NHIN Direct, a streamlined version of the standards and services of the nationwide health information network that would enable providers to exchange data securely through the Internet.
ONC wants to broaden participants in the NHIN, which primarily serves health information exchanges, large providers and government agencies, said Dr. Doug Fridsma, director of ONC's Office of Interoperability and Standards.
States could be an enabling organization through their health information exchange, he said. For example, NHIN Direct services could assist a rural community provider by taking information in simple text format and communicate quality reporting to the Centers for Medicare and Medicaid Services.
ONC has an accelerated schedule in which to develop technical definitions on which to build standards and services through collaboration in its wikis and blogs, Fridsma said.
"We intend by May to have draft implementation specifications, and by the end of September we will have a final set of implementation specifications to support this exchange," Fridsma told the workgroup.
Turning to the private sector, Chopra said the healthcare industry is rife with examples of the meaningful use that could be taken up directly by providers or used as a basis of further commercial development and innovation.
One example cited in the workgroup discussions was the Truman Medical Center, a safety net acute care hospital system in Kansas City, Mo., which has deployed Cerner Corp.'s electronic health record.
Anticipating meaningful use requirements, Truman has already incorporated evidence-based decision support tools into its nursing workflow; begun the first phase of the roll out of computerized physician order entry, e-prescribing and documentation in its outpatient clinics; and imaging paper documents so physicians can review and sign them without having to locate a paper chart, said Mitzi Cardenas, the Truman CIO.
Truman, like other safety net providers, has faced difficulty finding capital for an electronic health record as uncompensated care has skyrocketed. Last year, however, its CEO made setting up a complete EHR a top priority and that message has filtered through the organization, she said.
Truman also worked with Cerner to determine how to collect the right data efficiently for quality reports and to provide value to the hospital, Cardenas said. Tools embedded in the daily clinician workflow generate quality reports and are produced frequently enough so the provider can respond to changes in the patient's condition based on the medical evidence.
Chopra said he expects that the Office of the National Coordinator will post pointers on its blog about where to find information about similar tools and experiences from providers and their vendors who have already deployed electronic health records in productive and innovative ways.
