The President’s Council of Advisors on Science and Technology (PCAST), a group of experts appointed by the President released the report “Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans: The Path Forward” on December 8th.
The report calls for the widespread adoption of a universal exchange language that would be able to transfer of relevant pieces of health data while maximizing privacy. The report finds that the technology for creating the necessary infrastructure and exchange language is already proven and available. But since developing these systems is not likely to be profitable in itself, the Federal government should develop the systems with the private sector.
Implementing PCAST’s recommendation to designate a universal exchange language for health information has an advantage. It would not require physicians to replace their existing electronic health records systems since virtually all of these systems could be made compatible through “apps” and other “middleware”.
The report recommends breaking the data down into the smallest individual pieces that make sense to exchange as the way to manage and store data. These individual pieces are called “tagged data elements” because each unit of data is accompanied by a mandatory “metadata tag” that describes the attributes, and requires security and privacy protections for the data.
A key advantage of the “tagged data element” approach is that it allows a more sophisticated privacy model—one in which privacy rules, policies, and applicable patient preferences are innately bound to each separate tagged data element and are enforced both technology and by law.
For example, a patient with diabetes may decide that her blood sugar information should be available to her doctors and to emergency physicians requesting that information if she should have a problem while traveling in another state—but that details about her past treatment for cancer should remain private and not be shared.
Also addressing a widespread privacy concern, such a system would not require the creation or assignment of universal patient identifiers nor would it require the creation of any centralized Federal database of containing patients’ health information.
The report calls upon ONC and CMS to move rapidly to implement the report’s recommendations by creating appropriate definitions in its “meaningful use” standards for health information technology which must be achieved in stages by 2010 and 2015. It also calls upon CMS to accelerate the modernization and restructuring of their IT platforms and staff expertise.
For more information on PCAST and to view the report, go to www.whitehouse.gov/ostp/pcast.
