Continuing his stunning reversal of long held perspectives, Dr. John Halamka’s blog post today suggests Guiding Principles for HIT Standards Committee:
- Keep it simple; think big, but start small; recommend standards as minimal as possible to support the business goal and then build as you go
- Don’t let “perfect” be the enemy of “good enough”; go for the 80% that everyone can agree on; get everyone to send the basics (medications, problem list, allergies, labs) before focusing on the more obscure
- Keep the implementation cost as low as possible; eliminate any royalties or other expenses associated with the use of standards
- Design for the little guy so that all participants can adopt the standard and not just the best resourced
- Do not try to create a one size fits all standard, it will be too heavy for the simple use cases
- Separate content standards from transmission standards; i.e., if CCD is the html, what is the https?
- Create publicly available controlled vocabularies & code sets that are easily accessible / downloadable
- Leverage the web for transport whenever possible to decrease complexity & the implementers’ learning curve (“health internet”)
- Position quality measures so that they will encourage adoption of standards
- Create Implementation Guides that are human readable, have working examples, and include testing tools
Commentary: These new guidelines are the right answer…let’s hope they are Dr. Halamka’s “final” answer.
Feedback from the community has been mixed:
Cats are pissed and stressed!
Dogs are thrilled!
Table of contents for the series--The Dog Manifesto: A Disruptive Innovator's Guide to Health IT
- Will HITECH Lead to Innovation? The Continuing Cat/Dog Dialogue
- Dogged Optimism: Five Innovative Aspects of HITECH
- Feline Foot-Dragging: Three Non-Innovative Aspects of HITECH
- Wait and See: What’s Unclear or To-Be-Determined (TBD) About HITECH.
- Can Cats Think Outside the Box? Here’s a Role Model.
- Stand for Quality Group: “Link HIT Investment to Quality Improvement”
- EHR 2.0: Thinking Outside the Cat Box
- Stunning Announcement: AMA Goes to the Dogs in Deal With Physician Web Portal Company
- Markle v. HIMSS: Differing Views of “Meaningful Use” and “Certification”
- Time for EHRs to Become Plug-and-Play
- Blueprint for Change: From EMR 1.0 to Clinical Groupware (EHR 2.0)
- Joe the Doctor: “…’scuse me, why do I want to bet-my-practice on an EMR?”
- RHIOs Emerging From Coma
- HIT Policy Committee Recommends “Minimum” Certification of EHRs
- PR Blunder of the Year: Federation of American Hospitals Says Meaningful Use Should Not Tie to Quality Improvement
- The Third Rail in HITECH Implementation: “Please Don’t Make Us All Speak Latin”
- Senator Grassley: You’re on Track About EMR Problems, But Here Are Some More Questions to Ask
- John Halamka’s Stunning 180: “Dogs and Cats Should Live in Harmony”
- Feedback Rolls in on Halamka’s New Stance on Standards: Cats Pissed, Dogs Thrilled