The NCVHS Executive Subcommittee held a conference call on Thursday, April 24, 2003, from 11:00 a.m. to 1:00 p.m. to discuss NCVHS organizational issues and to plan the June 24-25 full Committee meeting.
Executive Subcommittee Members
John Lumpkin, M.D., M.P.H., Chair
Simon Cohn, M.D., M.P.H.
Robert Hungate
Vickie Mays, Ph.D., M.S.P.H.
Mark Rothstein, J.D.
Staff and Liaisons
Marjorie Greenberg, Executive Secretary (NCHS)
Jacquelyn Adler (NCHS)
Audrey Burwell (OMH)
Mary Jo Deering, Ph.D. (OPHS)
Stan Edinger, Ph.D. (AHRQ)
Dale Hitchcock (ASPE)
Debbie Jackson (NCHS)
Katherine Jones (NCHS)
Stephanie Kaminsky (OCR)
Steve Steindel, Ph.D. (CDC) liaison
Karen Trudel (CMS)
Absent:
James Scanlon, Executive Staff Director (ASPE)
Judith Berek (CMS) liaison
Virginia Cain, Ph.D. (NIH) liaison
J. Michael Fitzmaurice, Ph.D. (AHRQ) liaison
Ed Sondik, Ph.D. (NCHS) liaison
Discussion Topics:
Dr. Lumpkin indicated that he attended a town meeting on March 21 when DHHS Secretary Thompson announced adoption of certain Clinical Data Standards for exchange of information among federal agencies. The Secretary endorsed CHI and was very enthusiastic about it. Although the Committee was not specifically mentioned, the Committee's ideas were embraced and supported, and Dr. Lumpkin was a featured speaker. There will be a lot of pressure on the Standards and Security Subcommittee from Federal colleagues to expedite the PMRI terminology recommendations.
Discussion ensued regarding considerations for handling overlapping issues within and among subcommittees and workgroups. Mr. Hungate expressed the need to have more contact with the Subcommittee on Privacy and the Standards and Security Subcommittee. He suggested that it might be feasible to have a liaison participant from each subcommittee represented at the various meetings. Dr. Mays indicated that issues related to the Subcommittee on Populations belong to lots of people and we need to figure out how to work across the group. Issues that overlap tend to fall between the cracks. Committee members who agree to be on two or more subcommittees will serve the liaison role. The Subcommittee on Privacy and the Standards and Security Subcommittee are considering holding joint hearings. This approach will facilitate some of the concerns regarding overlap. We will do some comprehensive planning at the summer Executive Subcommittee Meeting and look at the overlap issues to determine how they should be handled. It was suggested that there should be some tracking of issues and assignments given to people. Mrs. Greenberg indicated that it was constructive and useful that the Workgroup on Quality, during their meeting, decided to bring a report to the full Committee in June for discussion, with a final report for approval possibly in September. We should engage the members who are not participating in various workgroups to identify concerns and provide input into the resolution process. We should also engage the full Committee on key issues that are relevant to the subcommittees.
Corresponding Members - It was discussed briefly that corresponding members are not official members of the various subcommittees or workgroups, but will obtain all information and materials pertaining the subcommittee's work to be kept informed. This mechanism will remain in place for now.
Establishing a Quality Subcommittee - In considering whether we should establish a Quality Subcommittee from the Workgroup, Mr. Hungate indicated that we should wait and see what scope of work will emerge for the Workgroup after the report has been produced. It was decided that there is no urgency to make a decision now.
Incorporating Population Issues throughout the Committee - Perhaps in September or November we will have a formal discussion about this with the full Committee. Most of the population issues have been initiated through presentations to the full Committee. Dr. Lumpkin noted that in determining how to address population health issues within the framework of the full Committee, we'll probably discover overarching issues for further consideration and exploration. There will be no panel presentation on population health at the June meeting. We will consider having Susan Kanaan pull together the themes discussed at the various meetings and have this information available for the summer Executive Subcommittee Retreat.
Executive Subcommittee Retreat - we will be polling the members and staff for a date in either late July or early August for the retreat. The location has not yet been determined. Minutes and Lead Staff Responsibilities - Mrs. Greenberg discussed the problems associated with the subcommittee meeting minutes not being finalized properly or timely. She reminded everyone that all sessions are transcribed and that the transcripts serve an important function for informing the public, members, and staff. However, we are having a very difficult time in getting the minutes finalized. One of the problems was that they needed to be more succinct. We have addressed this concern with the contractor, and they will be summarizing the minutes, making them less onerous to review. Our preference is that the lead staff review and make necessary edits to the minutes before they are distributed to participants for comments and then adjudicate the comments. Dr. Cohn suggested that one solution might be to make the minutes six pages as opposed to thirty. Mrs. Greenberg indicated that the more comprehensive minutes will assure that we have sufficient detail so we can discard the transcripts at the appropriate time. She further explained that the NCVHS Team Staff do not have that level of technical expertise or political involvement to adjudicate the edits. The plea was made for the NCVHS Lead Staff to take the responsibility more seriously. Dr. Mays suggested that the transcripts should be cleaned-up a little better and the quality should be improved. Our goal is to have timely, reasonably concise minutes. We will work with the contractor to improve the transcripts, shorten the minutes, and turn them around quickly. The Chairs and lead staff are asked to increase their efforts in finalizing the minutes. If the chair does not reply or sign the minutes in a timely fashion, Dr. Lumpkin has agreed to sign the minutes for expediency.
Broadcasting Conflict - There is a conflict with broadcasting capabilities for the May meetings which is why we try not to hold overlapping meetings. The Subcommittee on Standards and Security is scheduled to meet May 20-22. The Subcommittee on Populations has since scheduled a meeting for May 22-23 in Los Angeles. We cannot broadcast both meetings on May 22. Dr. Lumpkin suggested that both meetings should be able to broadcast two days each. Dr. Cohn indicated that it would be okay if there is no broadcasting capability for the Standards and Security Subcommittee on May 22.
It was confirmed that the meeting will be held at the Humphrey Building. We will also have our dinner/social on the evening of June 24th.
We will have the usual updates from the Department during the morning of June 24th. We will also get feedback from OCR staff regarding enforcement of the Privacy Rule (including insight concerning any complaints received by OCR to date). Jared Adair will give an update on Consolidated Health Informatics and the Clinical Data Standards Adoption.
International Harmonization of Standards - we will have a brief introduction to the issue for the Subcommittee on Standards and Security to explore further. Dr. Steindel indicated that CDC is considering when or how to get involved in these issues. Maybe Mike Fitzmaurice might be able to give an overview on this issue as well. We will check to see if he is willing to make a presentation. Claudia Tessier might be a possible presenter on the issue. Dr. Cohn would prefer someone to give a broad overview, including WHO, and indicated that Claudia is more versed on the SDO level. It would be nice to get an overview of what's going on and what OMB would like us to do. Maybe someone from the Data Council or Katherine Wallman, Chief Statistician at OMB, might be able to give some high level overview. People at NIST handling circular 119 might also be a good possibility.
Status of Health Tracking Initiative - The Committee should be following the issues related to summary health measures. We will consider planning a presentation for the September meeting. Marjorie reported that she received a copy of a WHO publication, Summary Measures of Population Health and that she can obtain additional copies if members have an interest.
Status Report from Quality Workgroup - The Workgroup will give an overview of the report that might come to the September full Committee as an action item. The overview will brief the Committee on what has been accomplished by the Workgroup and future directions for the Quality Workgroup and raise discussion questions.
Status of Subcommittee on Populations Report on Collection and Use of Health Data in Racial and Ethnic Populations - Dr. Mays reported that the Subcommittee may be able to present a draft report by the June meeting.
The Standards and Security Subcommittee may have a letter about the HIPAA Privacy Procedural Enforcement interim rule, which was published for public comment on May 15. WEDI is asking the Department for support around some of the contingency planning pieces, and a response is needed from the Secretary by mid-June (letter from WEDI was cc'd to NCVHS). Dr. Cohn noted that the responses may not be substantive if they are done after the May hearings. If there is an action item after the May hearings, we will follow-up with a conference call and solicit changes through E-mail. Contingency planning will probably need twenty minutes on the agenda. Regarding PMRI terminology, more time may be needed to report out to the Committee, but Dr. Cohn will not know until after the May meeting.
NHII will not have an action item, but will have a working session on the first day. The Congressional staff input on the NHII will be discussed. Given that Senator Frist has submitted the draft Bill, Mary Jo will arrange a presentation at the full Committee. Debbie will work with Mary Jo on when to have the presentation.
The Subcommittee on Privacy and Confidentiality and the Workgroup on Quality will both have their working sessions on the morning of June 25th.
Gallup Survey Results - Mrs. Greenberg will provide feedback on June 25th regarding the GSA Federal Advisory Committee Stakeholder Engagement Survey. The results were generally positive for all the advisory committees, and specifically for NCVHS. The NCVHS was not selected as one of the committees that demonstrated best practices, but the issues that we deal with are much broader and diverse than many other committees. For instance, Mrs. Greenberg pointed out that one of the CDC committees makes recommendations regarding immunizations, and all of their recommendations are accepted and adopted. We will include something in the agenda book and make a presentation at the June Meeting.
Dr. Cohn thanked Karen Trudel, Mike Fitzmaurice and Suzie Burke-Bebee for all of their assistance in pulling together the recent hearings and meetings for the Subcommittee on Standards and Security.
There have been no responses regarding whether to hold a closed session on ethical issues. We will explore the issue again after the June meeting.
Annual HIPAA Report to Congress - Dr. Cohn indicated that this will not be an action item for the June meeting, but perhaps in September.
Call was adjourned at 12:47 p.m.