Feds raise standards bar

March 31, 2003

A set of uniform standards for the electronic exchange of clinical health information has been proposed for adoption across the federal landscape. It could eventually have an impact on private healthcare as well. The standards, mandatory for all

A set of uniform standards for the electronic exchange of clinical health information has been proposed for adoption across the federal landscape. It could eventually have an impact on private healthcare as well.

The standards, mandatory for all federal agencies, are the work of the Defense, Health and Human Services, and Veterans Affairs departments.

Currently, federal healthcare agencies use several different coding systems, making it difficult to share patient data. Common standards should improve patient safety and reduce healthcare costs. They should also help public officials identify emerging public health threats. The ultimate goal is to promote the standards across the entire healthcare industry, not just within the government.

The VA has been pushing for federal standards for some time.

"The VA has been working on getting widespread implementation of standards throughout its 172 hospitals and hundreds of outpatient centers," said Dr. Eliot Siegel, vice chair of information systems at the University of Maryland radiology department and chief of radiology for VA Maryland Healthcare System. "The important news is that they're at the table talking much more seriously about closer interagency collaborations than ever before, rather than a 'new' set of standards per se."

There has been increasing talk in radiology about using teleradiology links between the VA and the DoD, especially with the acute crisis in staffing and the hyperacute crisis due to the war in Iraq, he said.

The Healthcare Information and Management Systems Society (HIMSS) supports the government's initiative.

"We applaud the federal government in recognizing the role standards such as HL7 and DICOM play in the electronic communication of health information," said Joyce Sensmeier, HIMSS director of professional services. "But this announcement just begins the process of building an effective health information infrastructure of systems that are interoperable and accessible."

The initiative require agencies to adopt five standards:
? DICOM to capture imaging studies
? HL7 for sharing patient information, such as entries of orders, scheduling of appointments and tests, and coordination of admittance, discharge, and transfer records during in-patient care
? NCDCP (National Council on Prescription Drug Programs) for ordering drugs from pharmacies
? IEEE 1073 for systems integration
? LOINC (Logical Observation Identifier Names and Codes) to support the exchange of clinical lab results

There is no adoption deadline. Agencies will be expected to convert to the standards as they upgrade systems.