Review of the Adoption and Implementation of Health IT Standards by the Office of the National Coordinator for Health Information Technology
Publication Date: September 2007
Publisher(s): California HealthCare Foundation
Author(s): Sam Karp
The Institute of Medicine, in collaboration with the National Research Council, has a fast-track study under way to examine the rate of health care IT data standards adoption and implementation. The standards effort, spearheaded by the Office of the National Coordinator (ONC), was the subject of a review at a September 17th hearing in Washington, D.C. Sam Karp, vice president of Programs for the CHCF, was asked to testify on the progress being made by the ONC. While he applauded the ONC for bringing focus to the important role health IT can play in helping improve the nation's fragmented health care system, he criticized the standards effort to date. Karp focused on two key areas: (1) the development and adoption of data standards, and (2) efforts to establish a national framework for safeguarding the privacy of health information. Karp, a former Certification Commission for Healthcare Information Technology commissioner, contended the current national data standards effort has been too slow, too cumbersome, too political, and too heavily influenced by large IT vendors and other large institutions. Karp said any data standards should emphasize simplicity, specificity, and minimal optionality, so that consistent implementations, reliable certification testing, and real-world interoperability can be achieved. On privacy, Karp noted a growing consensus that HIPAA's privacy protections do not adequately safeguard the confidentiality of health information in a digital world. He called for the adoption of uniform privacy standards for any health information exchange activity and for clear accountability and enforcement standards as well as federal leadership in setting policy and practice standards.