Tests of Metadata Tags for EHRs PlannedFederal Authorities Also Seek Comments on Standards
These projects complement a recently announced effort to solicit comments on certain proposed metadata standards, such as for privacy preferences, which would be used to describe specific data elements within electronic health records.
The catalyst for all this activity is a December 2010 report from the President's Council of Advisors on Science and Technology. PCAST called for creation of a health information exchange architecture, based on a new universal exchange language. Its ambitious vision for a single national approach to health information exchange, which has proven to be controversial, endorsed, among other things, the use of mandatory metadata tags within EHRs to ease information exchange.
In its Aug. 9 advance notice of proposed rulemaking, the Office of the National Coordinator for Health IT sought comments on using metadata tags within summary care records for patient identity, provenance (the source of data) and privacy preferences. ONC will consider the comments before deciding whether to require the use of metadata tags in certain circumstances for stage two of the HITECH Act EHR incentive program (see: ONC Releases Metadata Standards Notice).
Metadata Pilot DetailsIn a blog posted Aug. 17, Farzad Mostashari, who heads ONC, unveiled a number of pilot projects designed to test-drive the use of metadata. They include:
- A "query health initiative," slated to begin this fall. This project will study the use of metadata tags to support queries of electronic health records for broad population analyses used to develop new clinical and payment strategies. The project will involve calculating quality measures for populations of patients.
- A "data segmentation initiative," also slated for fall. The goal of this project is to enable patients to grant their consent for certain providers to access only certain portions of their records. This form of granular consent would be enabled through metadata tagging of consent information (privacy preferences) for specific data elements within records, such as information about substance abuse.
- Tests at the Indiana Health Information Exchange. The HIE is testing enabling more detailed queries of records at the data element level by using metadata tags in patient summary care records. It's also developing a user interface to enable patients to have more granular control over the sharing of their information.
- Tests at the Health Information Exchange of Montana. This HIE plans to test metadata standards by generating patient care summaries from EHR systems and enabling queries to answer population health questions.
Although PCAST advocated an aggressive timeline for moving to a new, uniform approach to health information exchange, Mostashari is spearheading a go-slow approach to testing some of the theories the PCAST report advocated. "Let's find a place to get started," he said.