The NCVHS Executive Subcommittee held a conference call on Tuesday, October 7, 2003, from 11:00 a.m. to 1:00 p.m. to: 1) review the NHII Letter on Internet Technology, 2), discuss the Quality Workgroup questionnaire, 3) plan the upcoming Full Committee Meeting scheduled for November 5-6, and 4) discuss plans for the Executive Subcommittee Retreat scheduled for November 21, 2003.
Discussion Topics:
1. Dr. Lumpkin asked for feedback on the NHII Letter to the Secretary, DHHS on Internet Technology. With a few minor edits, the letter was approved.
2. Quality Survey Instrument - Bob Hungate indicated that the Workgroup on Quality attempted to keep the questionnaire shorter. However, by lengthening it, they were able to include full recommendations directly into the survey statements. For example, specific language in the instrument was changed from "recommendation" to "action needed" to allow tailoring of the response to the specific action to reflect those things. Having the workgroup come up with tighter recommendations disseminated either in a letter or parceled out to the subcommittees was also discussed. Regarding the category "relative importance," Mr. Hungate clarified that the frame of reference should be importance to the system, not to the process. Mark Rothstein recommended that a change therefore be made to the definition of importance or add a fourth category or in some other place solicit input from the Committee about the main thrust of the report. Mr. Hungate pointed out that we should view this process as intermediate. What we are trying to do is provide some input to the Workgroup and determine what should be summarized. Some work will be completed on this project during the Quality Workgroup break-out meeting in November. The full Committee must remain on an accelerated schedule in order to receive feedback in time for distribution of background materials for the November agenda books. The Quality Workgroup will bring an action item to the full Committee in November. Dr. Simon Cohn remarked that it is a very important document and we should find some things that are all important and feasible. There will also be some controversial items as well. It was agreed that all members and lead staff should also receive the instrument.
3. Planning for the November 5-6 Full Committee Meeting
ICD-10 CM Letter – Dr. Cohn began by announcing that there is a transition of the Lead Staff for the Subcommittee on Standards and Security. They are delighted with Maria Friedman's leadership as the Subcommittee shifts leadership from Karen Trudel to Ms. Friedman. The Subcommittee has been working on early drafts of the ICD letter and comments have been received. The Subcommittee is very hopeful that a draft letter will be presented to the full Committee at the November meeting. Donna Pickett and Maria Friedman are both weeding through the testimony that has been taken by the Subcommittee and putting together a document that will be accessible for everyone. Mrs. Pickett is taking the lead for this and will have a list of everyone who testified and a synopsis of the testimony. Dr. Cohn indicated that he is optimistic that a letter will come forward and will need about thirty minutes on the November agenda to discuss the letter.
PMRI Report – Dr. Cohn indicated that the Subcommittee expects to present a letter and a report on PMRI at the November meeting.
CHI Recommendations – Dr. Cohn noted that a third action item will come forward from the Subcommittee on Standards and Security regarding other domain presentations. The domains consist of immunization, medication and interventions. The action item will be a letter with an attachment.
Subcommittee on Populations – Dr. Vickie Mays indicated that we may have time in March to present the letter/recommendations regarding the National Child Health Longitudinal Study. Dr. Mays further indicated that she was not clear how far we may get since the letter has not been started. Dr. Lumpkin noted that we need to convene a panel before the letter can come forward. Dr. Mays mentioned that there should also be discussion on whether there are issues of privacy and confidentiality. The study is very broad and raises a lot of issues. Populations’ issues have to do with sampling and whether they can do sampling on racial and ethnic minorities. For instance, do they take clinical or population samples? We will certainly have a panel presentation before the letter/recommendations will move forward to the full Committee.
Populations Report – Dr. Mays indicated that there was nothing done on the report and it is not realistic that the report will come forward during the November meeting. The Subcommittee staff will need to sit down and plan time schedule and process.
Subcommittee on Privacy and Confidentiality – Mr. Rothstein reiterated that hearings are scheduled for November 19-20 to discuss public health research issues of HIPAA.
Presentations – We will have an update from Dr. Sondik, however, he is only available the first morning around 10:00 a. m. He can provide updates on Summary Health Measures, NCHS activities, as well as an update on the Board of Scientific Counselors (BSC). We will check to see if he can talk about NHANES in addition to the State of the Center. Dr. Mays noted that it would be good to get feedback if Proposition 54 passes, i.e., what will be the impact for vital statistics for California? (The proposition did not pass.)
Role for NCVHS in CDC Futures Initiative - We are in the early stages of the initiative, but the invitation for the CDC Director will be for the March full Committee meeting. We will send the letter of invitation out to Dr. Gerberding inviting her to attend the full Committee meeting.
Draft 2003 HIPAA Report to Congress – This report will cover 2002 and 2003. Mr. Scanlon indicated that if we wait, the implementation dates would have just occurred and the report would end there. Dr. Lumpkin noted that it is not a bad place to end it, indicating in the report that we will continue to monitor and advise the Department. Dr. Cohn questioned whether we should do a report in December to close out the year or wait until the November Privacy hearing. Mr. Rothstein noted that we should not wait until the Subcommittee on Privacy hearings to add anything since they are not scheduled to meet until late November. The report may be able to come to the Executive Subcommittee for vetting. The Subcommittee on Standards and Security will update the report for factual development, plan a presentation for the full committee, and take it from there. Perhaps about 15-20 minutes on the full agenda in November will be needed.
It was noted that Mark Rothstein will not be at the November full Committee Meeting.
4. Executive Subcommittee Retreat
Dr. Mays asked if we can explore how to establish a working relationship with other agencies like Bureau of Labor, Census Bureau, etc. She would also like to discuss the needs of the Subcommittee on Populations in terms of getting their work done and the documents that need to be produced.
Dr. Lumpkin would like for the Executive Subcommittee to focus on optimizing effectiveness. He is now involved with the Council on Application of Health Information Technology and the Data Council and finding difficult to attend all meetings for both.
Dr. Mays will be the NCVHS Liaison to the BSC and will report to the Committee regarding the October 10th BSC meeting scheduled to be held at NCHS.
The presentations by Barbara Starfield and Dan Friedman will be scheduled for the March full Committee Meeting. We will schedule a presentation by the Public Health Informatics Institute some time next year regarding Information Systems for Public Health Laboratory (funded by the Robert Wood Johnson Foundation).
Dr. Lumpkin indicated that he would like for the Subcommittee to engage in some strategic planning. Recognizing that there are events that are pushed on us and goals that we have ourselves, our agenda should reflect those things we have developed ourselves. We will reevaluate what exactly is our role and how is it different from several years ago. We'll also consider whether we want to seek input from the public regarding strategic planning.
Jim Scanlon would like to spend some time talking about resources and dollars needed for the Committee's work, particularly large contracts. He further explained that his office contributes funding for more analytic and substantive work of the Committee and NCHS funds the logistical kinds of support needed.
There is a social planned for the evening of November 20 around 7:00 p.m. Further details will be provided regarding the dinner social.
New procedures for logistics of material – Members agreed that getting early feedback from the Exc Subc before action items are presented at the full Committee meeting is a good idea and should be continued. As long as deadlines are met, the process should go smoothly. It was agreed that the agenda book materials must be received one week prior to distribution of the agenda book. If letters and other documents have to be vetted through the Executive Subcommittee, they must be received two weeks prior to distribution of the agenda books. The deadline dates will be published early so that everyone will meet the established timeframes.
Alternate NCVHS Meeting Sites – everyone was reminded that we are having difficulty securing space at the HHH Building. We are finding that hotel space is very expensive and not a good alternative on many occasions. Therefore, we will be looking at the agencies (e.g., CMS, NCHS, AHRQ, etc.) to determine feasibility of using their space. Normally, we can obtain space at the HHH Building for the full Committee meetings, but the subcommittees are finding it difficult to obtain space especially when there are meetings scheduled less than one month away, meeting dates are changed, or meetings are scheduled for more than two days. Members were reminded that whenever hotel space is arranged, we normally block a number of sleeping rooms. However, folks must reserve their rooms by the established cut-off date.
Conference call was adjourned at 12:50 p.m.