ONC revisits linking consumer preferences to EHRs
By Mary Mosquera
Sunday, October 18, 2009
The Office of the National Coordinator is weighing proposed requirements for how consumers’ preferences about their healthcare and personal health information could be made inseparable from their electronic health record.
According to a consumer preferences draft document, for which public comments were due Friday, standards built around the requirements would enable patient preferences about the use of their health information to be “interoperable” among those authorized to handle the record.
Patients would communicate their preferences in consultation with their physician and through options offered in their electronic health record, according to the document.
The aim is to promote consumer trust in sharing their electronic health information, said Dr. Walter Suarez, co- chair of the Education, Communications and Outreach Committee of the Health IT Standards Panel (HITSP), which will identify and harmonize standards for consumer preferences through early next year.
The means to make the preferences interoperable include using standard message formats, vocabulary and data sets.
“The goal is to simplify the mechanisms by which consumers express their preferences and to make it work in a way that it is efficient so they don’t have to express them every time their data is shared,” Suarez said during a HITSP webinar Oct. 13.
HITSP is a panel of health care experts formed during the Bush administration to begin harmonizing heath IT standards. It continues to advise the Office of the National Coordinator on its national health IT adoption agenda.
According to the proposed requirements, the electronic health record system of a physician practice or hospital would automatically apply the preferences to consumers’ data, and the preferences will follow the data as it is exchanged with other physicians and healthcare providers who request it, Suarez said.
“It is important because that information could relate to advanced directives or DNRs (do not resuscitate orders),” which the patient would want to share with other physicians and hospitals that provide treatment in an emergency room, he said. But consumers may want to limit the amount of information exchanged, such as data about past mental health counseling, to a new employer’s health plan.
According to the ONC document, the national health IT coordinator and organizations involved in the national health IT agenda have not “formally addressed all of the interoperability considerations for the communication of consumer preferences to support the goal of patient-centered healthcare.”
The expectation is that the requirements will be included in the set of standards for the exchange of health information under the stimulus law.
“Hopefully, it will lead to some standards that are developed, and that the Health IT Standards Committee will then decide whether they are the best standards to support consumer preferences and aid exchanges,” said Dr. John Halamka, HITSP chairman and vice chairman of the Health IT Standards Committee.
The national health IT coordinator’s office in December will update its draft requirements document, published Oct. 5, after it has analyzed comments it has received, Suarez said. The document is available online.
