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Presidential Initiatives

Consolidated Health Informatics

Program Manager
Vish Sankaran, FHA Program Manager  (Program managed as component of FHA)

Managing Partner

Department of Health and Human Services (HHS)

Description

Adopts a portfolio of existing health information interoperability standards (health vocabulary and messaging) enabling all agencies in the federal health enterprise to “speak the same language” based on common enterprise-wide business and information technology architectures.

Progress to Date
  • Government-wide health IT governance council established
  • Portfolio of 24 target domains for data and messaging standards identified
  • Partnered with 23 federal agencies/departments who use health data for agreements to build adopted standards into their health IT architecture
  • Messaging and terminology standards adopted for 20 domains, yielding 11 sets of standards to be used in federal IT architectures
  • Domains that did not have standards ready or mature enough to adopt produced follow-up recommendations
  • Regular meetings with industry to prevent major incompatibilities in partnership with the National Committee on Vital and Health Statistics
  • Defined change management role for the initiative's merger into Federal Health Architecture (FHA)
  • CHI goals incorporated into the FHA and activities coordinated through the Office of the National Coordinator for Health Information Technology (ONC) http://www.hhs.gov/healthit/
  • CHI standards were presented to the Health Information Technology Standards Panel, and the American Health Information Community, for incorporation into national health interoperability standards harmonization process.

Next Steps
  • As of October 1, 2006, the FHA program will be operating under a new strategic framework. This framework does not contain a separate CHI initiative, and rather, involves FHA partners directly in the national standards harmonization process. Through this approach, Federal government systems and processes will be fully aligned with the President’s Health IT goals and objectives of interoperability, improved quality of care, and increased efficiency.

Exhibit 300

Not available - included as component of FHA LoB exhibit 300

 

Previous Accomplishments:

Standards Announced on March 21, 2003

On March 21, 2003, the Departments of Health and Human Services, Defense, and Veterans Affairs announced the first set of uniform standards for the electronic exchange of clinical health information to be adopted across the Federal government.

The standards included:

  • Health Level 7 (HL7) messaging standards to ensure that each federal agency can share information that will improve coordinated care for patients such as entries of orders, scheduling appointments and tests and better coordination of the admittance, discharge and transfer of patients.
  • National Council on Prescription Drug Programs (NCDCP) standards for ordering drugs from retail pharmacies to standardize information between health care providers and the pharmacies. These standards already have been adopted under the Health Insurance Portability and Accountability Act (HIPAA) of 1996, and ensures that parts of the three federal departments that aren’t covered by HIPAA will also use the same standards.
  • The Institute of Electrical and Electronics Engineers 1073 (IEEE1073) series of standards that allow for health care providers to plug medical devices into information and computer systems that allow health care providers to monitor information from an ICU or through telehealth services on Indian reservations, and in other circumstances.
  • Digital Imaging Communications in Medicine (DICOM) standards that enable images and associated diagnostic information to be retrieved and transferred from various manufacturers’ devices as well as medical staff workstations.
  • Laboratory Logical Observation Identifier name Codes (LOINC) to standardize the electronic exchange of clinical laboratory results.

Full Reports:

  1. Laboratory Result Names - adopted
  2. Messaging Standards: Includes scheduling, medical record/image management, patient administration, observation reporting, financial management, patient care - adopted
  3. Messaging Standards: Includes retail pharmacy transactions - adopted
  4. Messaging Standards: Connectivity - adopted
  5. Messaging Standards: Includes Image Information to Workstations - adopted

Standards Announced on May 6, 2004:

On May 6, 2004, the Departments of Health and Human Services, Defense, and Veterans Affairs announced the adoption of 15 additional standards agreed to by the CHI initiative to allow for electronic exchange of clinical information across the federal government. The 15 new standards build on the existing set of five standards adopted by HHS in March 2003 and complete the first phase of the CHI initiative. The new standards agreed to by federal agencies will be used as agencies develop and implement new information technology systems.

The specific standards were:

  • Health Level 7 (HL7) vocabulary standards for demographic information, units of measure, immunizations, and clinical encounters, and HL7’s Clinical Document Architecture standard for text based reports. (Five standards)
  • The College of American Pathologists Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) for laboratory result contents, non-laboratory interventions and procedures, anatomy, diagnosis and problems, and nursing. HHS is making SNOMED-CT available for use in the U.S. at no charge to users. (Five standards)
  • Laboratory Logical Observation Identifier Name Codes (LOINC) to standardize the electronic exchange of laboratory test orders and drug label section headers. (One standard.)
  • The Health Insurance Portability and Accountability Act (HIPAA) transactions and code sets for electronic exchange of health related information to perform billing or administrative functions. These are the same standards now required under HIPAA for health plans, health care clearinghouses and those health care providers who engage in certain electronic transactions. (One standard.)
  • A set of federal terminologies related to medications, including the Food and Drug Administration’s names and codes for ingredients, manufactured dosage forms, drug products and medication packages, the National Library of Medicine’s RxNORM for describing clinical drugs, and the Veterans Administration’s National Drug File Reference Terminology (NDF-RT) for specific drug classifications. (One standard.)
  • The Human Gene Nomenclature (HUGN) for exchanging information regarding the role of genes in biomedical research in the federal health sector. (One standard.)
  • The Environmental Protection Agency’s Substance Registry System for non-medicinal chemicals of importance to health care. (One standard.)

Link to Executive Summaries

Full Reports:

  1. Medications: Summary report including Special Populations and Drug Classifications - adopted
  2. Medications: Structured Product Labeling Sections - adopted
  3. Medications: Drug Product - adopted
  4. Medications: Package - adopted
  5. Medications: Active Ingredients - adopted
  6. Medications: Clinical Drug - adopted
  7. Medications: Manufactured Dosage Form - adopted
  8. Anatomy - adopted
  9. Billing / Financial - adopted
  10. Chemicals - adopted
  11. Clinical Encounters - adopted
  12. Demographics - adopted
  13. Diagnosis and Problem Lists - adopted
  14. Genes and Proteins - adopted
  15. Immunizations - adopted
  16. Interventions & Procedures Laboratory Test Order Names - adopted
  17. Interventions and Procedures, non-Laboratory - adopted
  18. Laboratory Result Contents - adopted
  19. Nursing - adopted
  20. Text Based Reports - adopted
  21. Units - adopted

No standard ready to be adopted. Report contains recommendations for follow-up work.

  1. Disability
  2. History and Physical
  3. Medical Devices and Supplies
  4. Multimedia
  5. Population Health
Consolidated Health Informatics Federal Partner Departments & Agencies As of November 2003
Department-Level Agency-Level
Veterans Affairs Veterans Health Administration
Defense  
Health & Human Services Office of the Secretary
Health & Human Services Centers for Medicare & Medicaid Services
Health & Human Services Centers for Disease Control & Prevention
Health & Human Services Indian Health Service
Health & Human Services National Institutes of Health
Health & Human Services National Library of Medicine
Health & Human Services Agency for Health Research & Quality
Health & Human Services Administration for Children & Families
Health & Human Services Health Resources & Services Administration
Health & Human Services Substance Abuse & Mental Health Services Administration
Social Security Administration  
General Services Administration  
Office of Management & Budget  
Environmental Protection Agency  
Department of Energy Los Alamos National Laboratories
  National Institute of Standards & Technology
  US Agency for International Development
State  
Education  
Justice