美国如火如荼的互联互通运动--让人羡慕

claude · 发表于 2006-9-1 06:03:28

<h2>HIMSS Reports: Systemic Interoperability Commission Releases Report to Congress and Administration</h2>(Washington, D.C. - October 25, 2005) - In a public forum in Washington, D.C. on Tuesday, Oct. 25, the Commission on Systemic Interoperability presented its <a href="http://endingthedocumentgame.gov/" target="_blank">final report</a> to the leadership of the Senate and House of Representatives. The Commission, which was established through the Medicare Modernization Act of 2003, began public hearings in January 2005 and met the statutory requirement of a report within 12 months. The Commissioners, including HIMSS Regional Health Information Organization Task Force Chairman, C. Martin Harris, M.D. of the Cleveland Clinic Foundation, focused on three major themes and 14 recommendations.The report is directed to the citizen at large. It aims to educate and motivate individuals to see the seemingly technical topic of interoperability as important to them and as something they can understand and take action on. It uses short, first person testimonies, to present key concepts, such as the need to have your medical record available in times of crisis when you need to quickly provide key medical facts. It also uses everyday examples of other technologies, such as cell phones, that have seen widespread adoption in the past few years.The associated website (<a href="http://endingthedocumentgame.gov/" target="_blank">http://endingthedocumentgame.gov/</a>) provides a rich media experience including video clips, interviews, transcripts, and easy access to the highlights of the report as well as the complete text of the full report (264 pages, 17 megabytes). In the appendices of the report the commission cites a project from the University of Maryland, Center for Health Information & Decision Support (CHIDS) hat is currently tracking major HIT projects around the United States and its territories. HIMSS is partnering with the CHIDS to provide an interactive web based version of the map that will be available by mid-December 2005.The report uses the example of an interoperable medication record for all Americans by 2010 to focus on a specific, achievable, high-value goal. They lay out 4 major phases:<ul><li>2005: A portrait of today's state-of-the-art electronic medical record system / No Interoperability / A small number of physicians use electronic medical record systems in their own practices with limited capability for electronic prescribing information to be sent directly to pharmacy and the ability for their patients to access some of that information from a secure website. </li><li>2006: Smart Personal Medication Record / Stage 1: Limited Interoperability / A personal health/medication record maintained by the individual about their medications, conditions, allergies and adverse reactions. Set up by the individual on one of many available secure websites. This now includes information for non-prescription medications and on medications from all the individual's providers. </li><li>2008: Electronic Dispensing Record / Stage Two: Increased Interoperability / Medicines are now recorded automatically based on pharmacy dispensing and existing prescription claim messages. </li><li>2010: and Beyond: Interoperable Medication Record / Stage Three: Complete Interoperability / The single-practice electronic medical record of 2005 has been retrofitted to use the standard drug names recognized by all systems. Over the last five years, all of an individual's providers have adopted standards-based e-prescribing systems. Providers and pharmacies instantly update each other on every change in medication information and prescriptions in real time. Finally, e-prescribing and dispensing are connected. </li></ul>Consistent with the vision established by President Bush for the widespread use of electronic health information systems, the Commission抯 recommendations focusing on medications presents a practical but impactful area to focus our nation抯 efforts as we progress towards a comprehensive health information solution.Overview of the Three Major ThemesThe Commission organized its recommendations into the following themes:<ul><li>Adoption challenges of getting clinicians and consumers to use healthcare information technology to improve the quality and effectiveness of care. The Commission recommends using the power of regulation and legislation to adopt incentives and reforms that encourage use of healthcare IT. The Commission calls on the Department (DHHS) of Health and Human Services, and the Departments of Labor and Commerce, to identify workforce needs and possible solutions. </li><li>Interoperability of healthcare data in a way that the data is accessible and consistent in its meaning whenever and wherever approved access is needed. Consistent with the goals and targeted efforts of the American Health Information Community (AHIC), the Commission recommends product certification, interoperable data standards, and standard product identifiers and vocabulary. The Commission recommends that the AHIC should make an interoperable drug record for every American by 2010 a priority. </li><li>Connectivity between networks for seamless sharing of healthcare information. The Commission recommends Congress authorize DHHS to develop a national standard for patient authentication and identity that respects privacy considerations while enabling the creation of a complete medical picture of every person even when various aspects of their complete medical history is maintained by different healthcare organizations. The Commission also calls for a federal privacy standard that makes the Health Insurance Portability and Accountability Act (HIPAA) preemptive of state privacy laws; encourages criminal sanctions for privacy violations, and recommends the development of consumer protections against unauthorized access or release of their healthcare data. Finally, the Commission recommends the rapid move to fund and develop the National Health Information Network. </li></ul>Commission抯 14 RecommendationsThe Commission抯 14 recommendations within each of the three themes listed above are as follows:To advance progress of the adoption of health information technology, the following actions should be taken:<ol><li>Adoption Incentives. The Department of Health and Human Services (HHS) should implement, or seek authorization from Congress as necessary to implement, financial and other incentives for participation in a standards-based healthcare information network. These incentives should be directed toward individuals and organizations including healthcare providers, medical institutions, purchasers, and health plans. Incentives should include broad-based approaches such as pay-for-performance, as well as targeted approaches that include grants directed at small, safety net, and financially challenged providers. These incentives should begin to be implemented within two years. Employers and other private-sector healthcare payers who will benefit from the adoption of interoperable healthcare information systems should be encouraged to provide similar incentives. </li><li>Regulatory Reforms. The Secretary of HHS should act with urgency to revise or eliminate regulations that prevent healthcare entities, networks, hospitals, and clinicians from working together to create and adopt interoperable healthcare information systems, while promoting competition and maintaining reasonable protections against inurement and kickbacks. To ensure that healthcare providers can be confident in the legality of their actions, the Secretary should clearly state in the regulations those actions that are permissible and should direct the Centers for Medicare and Medicaid Services and the Office of the Inspector General to provide effective guidance to accelerate legally compliant activities that advance adoption of healthcare information technology. This effort should begin with 42 U.S.C. 1395nn, known as the Physician Self-Referral or Stark Law, and 42 U.S.C. 1320a-7b, known as the Federal Anti-Kickback Law, and regulations issued pursuant to those laws. </li><li>Reporting on Adoption Gaps. To ensure that the benefits of healthcare information technology are equally available to all the nation抯 citizens, HHS should monitor and annually issue a public report on gaps in the adoption and effective implementation of interoperable healthcare information technology systems across all sectors of the nation抯 health system. The report should specifically identify types of gaps and should propose public and private sector policies to address and close those gaps. </li><li>Workforce Needs and Impacts. The Departments of Labor and Commerce, in concert with HHS, should identify and quantify deficiencies in healthcare workforce knowledge and skills that must be addressed in order to secure maximum benefit from healthcare information technology. The effects of healthcare information technology on the use of labor and the upward mobility of workers in the healthcare system should also be considered. Based on these findings, these Departments should create a plan to meet such workforce needs and better estimate the financial impact of workforce changes that occur as a result of effectively adopting healthcare information technology. </li><li>

ublic Awareness. HHS should develop and execute a public awareness campaign that helps educate consumers, providers, and other interested constituencies of the benefits of using interoperable health information technology and the steps they can take to realize those benefits. HHS should implement the campaign in conjunction with the Department of Commerce and other government and private-sector organizations. </li></ol>To advance progress of the interoperability of health information technology, the following actions should be taken:<ol><li>

roduct Certification. Purchasers of healthcare information technology products must have a reliable source of information about the interoperability, functionality, and security of these products; and vendors must be able to compete by differentiating their products beyond minimum standards. HHS should support a single, voluntary, private-public process to certify that products meet minimum standards. To ensure continual improvement in the products available to the healthcare community, the scope of certification activities should aggressively be expanded to include additional healthcare information technology products, and the minimum performance specifications should be augmented over time as technology and standards progress. </li><li>Data Standards. HHS, advised by the American Health Information Community (AHIC) and in consultation with the National Committee for Vital and Health Statistics (NCVHS), should ensure broad acceptance, effective implementation, and ongoing maintenance of a complete set of interoperable, non-overlapping data standards that function to assure data in one part of the health system is, when authorized, available and meaningful across the complete range of clinical, administrative, payment system, public health, and research settings. Additionally, AHIC should build upon the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to develop national standards for authentication, authorization, and security that will permit the necessary infrastructure for consumers?confident adoption of healthcare information technology. </li><li>Standard Product Identifiers and Vocabulary. Standardizing data at the point of its creation will greatly accelerate the creation of an interoperable healthcare information network. HHS should work with manufacturers of drugs, devices, and test kits to achieve standardized identifiers and vocabulary in labels and packaging, and in all data outputs of devices and test kits. </li><li>Drug Records. Interoperable healthcare information technology will ensure that all providers have access, when authorized, to their patients?medication records and will establish a robust capability for post-marketing surveillance of drugs. AHIC should, in its early activities, take a phased approach to developing a fully interoperable drug record for every American by 2010. </li></ol>To advance progress of the connectivity of health information technology, the following actions should be taken:<ol><li>

atient Authentication Standard. Correctly aggregating and exchanging information about a specific person is essential and requires a uniform mechanism for authenticating the patient抯 identity. Congress should authorize HHS to develop a national standard for determining patient authentication and identity. </li><li>Federal Privacy Standard. Congress should authorize the Secretary of HHS to develop a uniform federal health information privacy standard for the nation, based on HIPAA and pre-empting state privacy laws, which anticipates and enables interoperability across the nation. </li><li>Nationwide Health Information Network. A national healthcare information network is part of the critical infrastructure of national security. Therefore, HHS and its relevant agencies should coordinate and seek Congressional approval to coordinate, as necessary, with the Department of Homeland Security (DHS) and other cabinet Departments to ensure the nationwide health information network is created and receives funding commensurate with its contributions to the safety and security of the American public. </li><li>Criminal Sanctions for Privacy Violations. To augment the protections provided by HIPAA, Congress should authorize Federal criminal sanctions against individuals who intentionally access protected data without authorization. </li><li>Consumer Protections. Patients should be protected from the consequences of unauthorized access to or release of their healthcare information. Therefore HHS should study and recommend to Congress actions to prohibit discrimination based on data obtained in that way. </li></ol>

claude · 发表于 2006-9-1 12:04:04

没有评论，看来英文这狗东西不好玩。

		自动登录	找回密码
密码			欢迎注册