Direction Needed

Health Story recently participated in an advocacy day on Capitol Hill. I helped prepare this broadsheet, and it came to mind when I was asked (again) yesterday about recognition for the Consolidation Project effort. That ballot is now closed (and a hearty Thanks! to all who provided review and comment, participation was excellent). The ballot pool was huge, as was the number of comments received, all an indication that there is widespread support for the standard.

So, we go into ballot reconciliation and then will pick up the remaining C32 templates and publish.

What then?

ONC hosts this effort, which is great, but will they also recognize it formally as the successor to the HITSP work in C32/C83/C80? If not, why not, and if so, when and through what process?

These questions are coming forward daily, and no wonder – standards are the means to achieve Meaningful Use. ONC says so, CMS says so, and the industry is bought into the concept. Great.

Phase 1 designated a number of standards, including C32.

The drive behind the Consolidation Project was three-fold:

  • Put the specs for all 9 balloted CDA Clinical Document Implementation Guides in one place
  • Harmonize discrepancies between HL7, IHE and HITSP C32
  • Provide a one-stop-shop Implementation Guide supported by model-driven tools so that implementers no longer need to peel an onion to figure out what the specs actually say

We are on target to achieve all three objectives, with a second ballot to pick up the non-MU-required templates. We will certainly publish by the end of the year, and, if needed, could publish with the MU-required templates mid-year. This is a known and reliable timetable, the kind required to support implementation.

Vendor implementation cycles take time – just about as long, maybe even longer, than standards development. Each day, decisions are being made whether to adopt the current C32, to look forward to the Consolidation Project templates or to put standards-based development on hold until…the next new thing. The absence of a clear signal, an indication, a roadmap, heck, even a pathway forward to recognize this effort as part of the next stage of requirements leave a void.

Until ONC provides leadership and guidance, uncertainty and confusion will fill this void, despite the best efforts of industry to coalesce around common standards.