HIMSS supports adoption of uniform health information exchange standards for federal government

Chicago 21 March 2003The Departments of Health and Human Services (HHS), Defense (DoD) and Veterans Affairs (VA) have launched the first set of uniform standards for the electronic exchange of clinical health information to be adopted across the U.S. federal government. The Healthcare Information and Management Systems Society (HIMSS) supports the announcement made by Health and Human Services Secretary Tommy G. Thompson. The three agencies are leading the way in this initiative, laying the groundwork for all federal agencies to use the same information technology standards for sharing clinical information.


According to the HHS announcement, these standards are part of the foundation of the National Health Information Infrastructure (NHII), which is a comprehensive, knowledge-based system that will serve consumers, patients, health care providers and public health professionals. Standardised information exchange, with privacy and security protections, makes it easier for health care providers to share relevant patient information and for public health professionals to identify emerging public health threats. Standardised information exchange also makes portable electronic medical records more likely and easily achievable.

The three federal departments that deliver health care services are co-ordinating with numerous other federal agencies to standardise across federal clinical health information as part of the Consolidated Health Informatics initiative (CHI). CHI is the health care component of President Bush's eGov Initiatives, created under the President's Management Agenda, to make it easier for citizens and businesses to interact with the government, save taxpayer dollars and streamline citizen-to-government transactions.

The new standards will help improve the quality of care by ensuring federal entities use a common coding system that will make it easier to co-ordinate care and exchange needed information. Currently, federal entities use different coding systems that make it difficult to maintain up-to-date information needed for quality care.

The members of the CHI are also participating in a number of projects individually and as part of the Consolidated Health Informatics group, looking to establish widespread use of electronic health data systems and programmes including electronic health records.

Under the announcement, as part of new systems development efforts, all federal agencies will:

  • Adopt Health Level 7 (HL7) messaging standards to ensure that each federal agency can share information that will improve co-ordinated care for patients such as entries of orders, scheduling appointments and tests and better co-ordination of the admittance, discharge and transfer of patients.
  • Adopt certain National Council on Prescription Drug Programmes (NCDCP) standards for ordering drugs from retail pharmacies to standardise 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 the announcement will make sure that parts of the three federal departments that aren't covered by HIPAA will also use the same standards.
  • Adopt 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.
  • Adopt 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.
  • Adopt laboratory Logical Observation Identifier Name Codes (LOINC) to standardise the electronic exchange of clinical laboratory results.

"We applaud the federal government for taking this step forward, as others have previously, in recognising the role standards such as Health Level 7 (HL7) and Digital Imaging Communications in Medicine (DICOM) play in the electronic communication of health information", stated Joyce Sensmeier, HIMSS director of professional services. "But, as evidenced in our work with the Integrating the Healthcare Enterprise (IHE) initiative, this announcement just begins the process of building an effective health information infrastructure of systems that are interoperable and accessible."

Using the IHE framework as an implementation guide for interoperability enables adopted standards, such as those cited in the government's announcement, to be implemented consistently across multiple vendor systems. Standardised information exchange that has a positive impact on patient safety, according to Joyce Sensmeier, will occur only after widespread adoption has been realised.

HIMSS members represent all facets of the industry that contribute to a common health care infrastructure. With that in mind, HIMSS created an NHII Task Force in 2002 to strengthen its advocacy efforts and work with the health care industry to further the development and implementation of this infrastructure. Additionally, HIMSS has been working to support the adoption and implementation of health information standards as evidenced by its sponsorship of the IHE initiative, membership in the American National Standards Institute (ANSI), and participation as a founding member in the National Alliance for Health Information Technology (NAHIT).

HIMSS will continue to take a leadership role in assembling health care industry vendors, providers, payers and other professionals with government to achieve a new level of performance related to this issue. "Our strategy of bringing together relevant parties in the health care system is the first step of many that eventually will result in the adoption of a national electronic health record", stated H. Stephen Lieber, HIMSS president and CEO. "We welcome the opportunity to work with other partners to achieve this goal."

Founded in 1961 with offices in Chicago, Washington D.C., and other locations across the country, HIMSS represents more than 13.000 individual members and some 150 member corporations that employ more than 1 million people. HIMSS shapes and directs health care public policy and industry practices through its advocacy, educational and professional development initiatives designed to promote information and management systems' contributions to quality patient care.

Leslie Versweyveld

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