The Booz and the Abstract Truth

Last week, the National Institute of Standards and Technology tapped Booz Allen Hamilton to develop testing documents and processes that will drive HHS’ EHR certification program.

The news prompted CCHIT boss Mark Leavitt to speculate that EHR accreditation won’t begin ‘till next summer, too late for providers to acquire and Meaningfully Use a certified EHR in time for Bonanza Days.

So Leavitt resolved to help Dr. Blumenthal by mapping CCHIT criteria onto ONC’s certification criteria (a.k.a the Abstract Truth). Alas, CCHIT was going to do that anyway, so it's hard to award him bonus points for that offer.

Note to Mark: All organizations that aspire to provide certification services for HHS are engaged in similar preparations. Is adopting the Abstract Truth from scratch somehow less worthy than retrofitting CCHIT criteria?

Regardless, kudos to the Feds for maintaining vendor neutrality every chance they get. As mentioned here, ONC’s concept of EHR Modules was a tour-de-force in vendor neutrality. NIST’s decision to tap Booz is more of the same.

And NIST couldn't engage CCHIT for this task because CCHIT's Commissioners include execs from EHR vendors including NextGen, McKesson and Siemens.

In fact, if HHS continues to emphasize vendor neutrality in its contracting decisions, how can it even designate CCHIT as an EHR certification agent when CCHIT is encumbered as it is by EHR vendors on its roster of Commissioners?

Mark, if you really want to help Dr. B. (and your own organization), I suggest you clean up this Commissioner list. That would be a downright righteous of you!

Speaking of the Abstract Truth (and CMS’ Meaningful Use dictates, also known as the NPRM): HIT Standards co-chair John Halamka got a ton of feedback on the documents since their release, and summarizes it here.

Several folks think the lab standards are not specific enough, Halamka reports. Others worry that the absence of a standard API for submitting immunization, syndromic surveillance data and public health reporting renders these tasks nearly impossible (a topic we covered here), and so on. Halamka’s penultimate paragraph says it all (the italics are mine):

“Summarizing the comments I have received - aggressive interoperability timelines require specific implementation guides and reference implementations. This leaves a choice - either the standards need more detail, especially in the transmission area, or the NPRM goals need to (be) reduced in scope/extended in time.”

Whew. We'd love to have seen Dr. B's reaction upon reading that for the first time!

Closing question for ONC: What is syndromic surveillance, anyway? According to Merriam Webster, syndromic is a legit word (though MSWord seems to disagree). It’s an adjective, in fact. It means “occurring as a syndrome or part of a syndrome.” Thus, syndromic deafness has obvious other symptoms associated with it.

But combining the adjective syndromic with the noun surveillance has me reaching for a red pen. Maybe ONC could hire a former editor of the Harvard Crimson to help with this kind of thing?

Glenn Laffel MD, PhD
Sr. VP Clinical Affairs, Practice Fusion