A number of states use health and social program eligibility and enrollment data that are similar enough that they could be a foundation for sharing information by electronic health insurance exchanges, according to an analysis by the Office of the National Coordinator for Health IT.
Certain pieces of information that states collect, such as name, address and gender, are close enough in definition and format that they could be easily unified as common data elements, said Dr. Doug Fridsma, acting director of ONC's office of standards and interoperability.
Common data elements and technical standards are needed to share information across health and human service programs to support the development of state insurance exchanges in 2014, a requirement of this year's health reform legislation.
Under the law, the exchanges must electronically direct individuals to Medicaid services, high risk pools and other public and private health plans as millions more Americans become eligible for health insurance.
But the task will require a significant amount of back-end engineering by states to link the relevant databases. The federal government is trying to assist them by leading a push for common eligibility and enrolment data standards.
ONC examined data that 10 states collected for health and human services programs, including Medicaid and the Children's Health Insurance Programs, as part of the groundwork for coming up with enrollment standards. A panel of the Health IT Policy Committee is leading the effort.
"We tried to see to what degree data in other programs was the same or different, get more details about what information is collected for those data elements, and analyze the results," Fridsma said at a meeting Aug. 12 of the ONC's enrollment work group.
For instance, date of birth can also be written as birth date in a standard data format but it means the same. "It gives a sense where there are opportunities for harmonization and where we need to be explicit about the data elements and recognize that even if we call them the same thing, they may be slightly different," he said.
Other terms are more complicated to establish as common data elements because different states have various definitions for them. For example, address can mean home address, mailing address or postal address.
As a result, Fridsma proposed that the Health IT Standards Committee create a panel to harmonize selected existing enrollment data elements and that federal and state agencies collaborate to define what information should be exchanged.
To analyze the data that state programs gather, ONC used the National Information Exchange Model (NIEM), a technical approach to identify and develop information exchange standards.
Federal agencies developed NIEM to be able to share homeland security information quickly and securely across disparate jurisdictions.
In adapting the framework, ONC collected details for core enrollment data elements and examined if they could be mapped to existing standards such as Health Level 7 and X12, which handles many administrative transactions.
