Washington, D.C.
The Workgroup on Computer-based Patient Records of the National Committee on Vital and Health Statistics held a public meeting on March 30-31, 2000, at the Hubert H. Humphrey Building, Washington, D.C. Present:
Note: The transcript of this meeting is posted on the NCVHS website.
The NCVHS Workgroup on Computer-based Patient Records (CPR) conducted a meeting on March 30-31, 2000, to review the fourth draft of the report to the Secretary of Health and Human Services on uniform data standards for patient medical record information (PMRI). The members focused on Section 4, Issues, Observations, Assumptions, and Recommendations.
Dr. Yasnoff guided the discussion through a proposed reorganization of the document. Consensus was achieved that the new format was deemed a significant improvement. Ms. Fyffe acknowledged her responsibility to draft the executive summary and the introduction to the legislative proposals. Ms. Amatayakul’s next task was to reorganize the manuscript.
Members agreed to table a full discussion of Section III. Several topics were suggested for further examination, including discussion of (and perhaps a recommendation in the Research and Development section concerning) patient identifiers, the importance to testifiers of timely issuance of HIPAA identifiers, and the ramifications of an absence of unique patient identifiers in terms of standards and costs.
As members of the Workgroup commented on the draft report, Ms. Amatayakul incorporated suggestions into the working document. On some issues, members and/or staff of the Committee agreed to provide specific language.
Members agreed that the next draft could be finalized by April 17, comments requested by April 25, a tentative conference call scheduled for May 2 at 1:00 pm ET, comments returned by potential external reviewers and members of the Data Council’s Health Data Standards Committee by May 12, and the new draft completed for the June 1-2 CPR Workgroup meeting. The following week revisions could be processed, and a final draft sent to NCVHS for NCVHS distribution on June 9. Potential reviewers would be informed in advance of the tight timetable. A transmittal letter remained to be drafted. Ms. Greenberg suggested making a presentation to the Data Council at the July or August meeting.
Dr. Cohn thanked the members for their participation and adjourned the meeting at 1:00 pm.
The NCVHS Workgroup on Computer-based Patient Records (CPR) conducted a meeting on March 30-31, 2000, to review the fourth draft of the report to the Secretary of Health and Human Services on uniform data standards for patient medical record information (PMRI). The members focused on Section 4, Issues, Observations, Assumptions, and Recommendations.
Mr. Blair outlined the purpose of the Workgroup. Members, staff, and other participants introduced themselves.
REVIEW OF SECTION IV OF THE REPORT TO THE SECRETARY
Dr. Cohn established the importance of presenting actionable recommendations in the report. He also introduced the issue of redundancy and overlap in the recommendations as presented, and suggested the need for reorganization. He identified four programmatic themes among the recommendations, notably, the government should: (1) play an active role in choosing and selecting, or setting priorities for, health information standards and terminologies; (2) play a more active and facilitating role with standards development organizations (SDOs) and HISB; (3) begin to phase implementation as appropriate and promote where it cannot implement; and (4) play a role in financing of research and development, sponsoring standards development, and purchasing the right to use licenses.
Dr. Yasnoff observed interdependence among the recommendations, with some groups of recommendations calling for joint implementation. He suggested viewing the recommendations in terms of who will perform the function, such as NCVHS or the Secretary.
Members agreed to include language related to legislative proposals, or the lack of them at this time, in the discussion in the Introduction on the Workgroup’s charge, in the Executive Summary, and in the Recommendations section.
Mr. Blair reviewed the schedule for the report, which is due to the Secretary of Health and Human Services (HHS) in August. A June meeting is scheduled to fine tune the document before final approval is sought from the full NCVHS committee on June 21, 2000. The executive summary must still be written, and in April and May, the document will be circulated for review by subject matter experts within the federal government and in the private sector.
As members of the Workgroup commented on the draft report, Ms. Amatayakul incorporated suggestions into the working document. On some issues, members and/or staff of the Committee were to provide specific language.
Among the issues discussed were the location in the report of the Guiding Principles for Selection of Standards; enhanced emphasis on quality of care; government participation in standards development organizations, ANSI, and HISB; requirement for single, specific implementation guides; encouragement of conformance test development and compliance certification; methodology to identify and address gaps and inconsistencies; coordination among data standards; funding of working sessions to promote harmonization of message format standards and medical terminology development; evolution of national standards for medical terminologies; financial barriers to the use of medical terminologies; the role of vendors and other players in defining standards for the content and format of PMRI; coordination of recommendations with other Workgroups; preemption of state privacy laws and other privacy issues; subsidies for U.S. participation in international standards development; electronic/digital signatures; and retention of PMRI in electronic form.
The reorganized letter was to group recommendations for NCVHS action first, followed by recommendations for actions to be taken by the Secretary of HHS, and then “referrals.”
The meeting was recessed at 5:30 pm and reconvened on March 31, 2000, at 12:00 noon.
Mr. Blair recognized several individuals whose service to the Workgroup in this process has been outstanding, including Ms. Amatayakul and Drs. Fitzmaurice, Cohn, and Yasnoff.
Dr. Yasnoff guided the discussion through the proposed reorganization of the document. Consensus was achieved that the new format was deemed a significant improvement. Ms. Fyffe acknowledged her responsibility to draft the executive summary and the introduction to the legislative proposals. Ms. Amatayakul’s next task was to reorganize the manuscript.
Members tabled a full discussion of Section III. Several topics were suggested for further discussion, including discussion of (and perhaps a recommendation in the Research and Development section concerning) patient identifiers, importance to testifiers of timely issuance of HIPAA identifiers, and the ramifications of an absence of unique patient identifiers in terms of standards and costs.
Members agreed that the next draft could be finalized by April 17, comments requested by April 25, a tentative conference call scheduled for May 2 at 1:00 pm ET, comments returned by potential external reviewers and members of the Data Council’s Health Data Standards Committee by May 12, and the new draft completed for the June 1-2 CPR Workgroup meeting. The following week revisions could be processed, and a final draft sent to NCVHS for NCVHS distribution on June 9. Potential reviewers would be informed in advance of the tight timetable. A transmittal letter remained to be drafted. Ms. Greenberg suggested making a presentation to the Data Council at the July or August meeting.
Dr. Cohn thanked the members for their participation and adjourned the meeting at 1:00 pm.
I hereby certify that, to the best of my knowledge, the foregoing summary of minutes is accurate and complete.
/s/ Jeffrey S. Blair 1-18-2001
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Chair Date