Ten health IT and health information exchange vendors will test an interim standard that enables providers to exchange core summary data as patients move to different care settings when they leave hospitals.
The pilots aim to demonstrate through the end of the year the feasibility of a standard for the transitions of care to support meaningful use stage 2, said Jitin Asnaani, coordinator of the Standards and Interoperability Framework, which tackles thorny health data exchange problems in the Office of the National Coordinator for Health IT (ONC).
[Related: OHN's 12 health IT best practices, part 2: Collaboration.]
Stage 2 of meaningful use of electronic health records (EHRs) is expected to call for more complex health information exchange than the current stage, ONC has said.
The vendor pilots will report their metrics to ONC in early 2012, according to a timeline for the Transitions of Care initiative. Asnaani did not name the vendors, but a number of them are involved with the initiative.
“For the first time, we have a single standard for electronic exchange of patient information for care transitions,” Asnaani said at the Oct. 14 meeting of “Putting the IT in Transitions,” sponsored by ONC, the John A. Hartford Foundation, the Gordon and Betty Moore Foundation, and Kaiser Permanente.
Individuals participating in the wiki community around transitions of care agreed on a single harmonized standard template, called the Consolidated Clinical Document Architecture (CDA), for the exchange of information that maps to basic data elements about patients, including demographics, problem and medications lists and allergies.
The Consolidated CDA is based on components of the Continuity of Care Record (CCR) and the CDA specification of the Continuity of Care Document (CCD) standard formats, both of which are required for certified EHRs.
The Consolidated CDA is the result of bringing the CCD and CCR communities together, said Dr. Doug Fridsma, director of ONC’s Office of Standards and Interoperability. “So regardless of whether they use CCD or CCR, there is this path forward so people can converge on a singular standard,” he said.
Currently there isn’t a clinically unambiguously defined set of data that can be transferred from one care transition setting to another. In addition, multiple standards are used for care transitions, so there is no interoperability, Asnaani said.
A subset of the vendors and the four pilot communities developed so far will show how the Consolidated CDA standard can be used in conjunction with the Direct Project, a version of secure email used in simple point-to-point exchange.
[Related: The Direct route to more pertinent patent information.]
“This brings the two pieces together and enables the little guy, small clinic, rural physician practice, even labs, to send information from one place to another cost-effectively and in a way that is completely standardized for interoperability,” Asnaani said.
Separately, ONC and Health 2.0 have underway a developer’s challenge to build tools, such as a discharge checklist recommended by the Centers for Medicare and Medicaid Services, to create applications that are easy for patients and their caregivers to use to communicate about their condition with their health team. The first prize is $25,000, and submissions are due by Nov. 16.
