The section will include but not be limited to other CBIIT internal requirements and national standards.
ONC and National Health Standards
The US Office of the National Coordinator for Health Information Technology (ONC), is developing a set of recommendations for a nationwide health information network (NHIN) [http://healthit.hhs.gov/portal/server.pt?open=512&objID=1142&parentname=CommunityPage&parentid=25&mode=2&in_hi_userid=11113&cached=true]. The NHIN is a set of standards, services and policies that enable secure health information exchange over the Internet. The network will provide a foundation for the exchange of health information across diverse entities, within communities and across the country, helping to achieve the goals of the HITECH Act.
Because of the convergence of federal agencies, local, regional, and state-level Health Information Exchange Organizations (HIOs), the NHIN is setting tremendous precedent for semantic interoperability in the United States. Many of the recommendations will likely work their way into future meaningful use specifications. With a growing number of organizations jumping onto the NHIN, it stands to reason that the more NCI's Semantic Infrastructure 2.0 can align with NHIN, the less likely it will be that implementers will need to develop multiple semantic interoperability strategies.
HL7
The Health Level Seven International Standards Development Organization (HL7) is an international community, working together towards a common goal of improving patient care through technology. HL7 interoperability protocols include messaging standards, decision support standards, clinical document standards, EHR functional requirements, drug product labeling standards, and more. Many of these protocols are specifically called out in the meaningful use final rules.
In addition, HL7 defines EHR and Personal Health Record (PHR) functional requirements, which provide a reference list of functions that may be present in an EHR. The function list is described from a user perspective with the intent to enable consistent expression of system functionality. In 2009, HL7's EHR-System Functional Model became an internationally recognized ISO standard [http://www.hl7.org/documentcenter/public/pressreleases/HL7_PRESS_20091209.pdf], setting the stage to achieve common functionality of EHRs globally.
At the heart of many HL7 specifications is the Reference Information Model (RIM) [http://www.hl7.org/implement/standards/rim.cfm]. An object model created as part of the HL7 Version 3 methodology, the RIM is a large, pictorial representation of the HL7 clinical data (domains) and identifies the life cycle that a message or groups of related messages will carry. It is a shared model between all domains and, as such, is the model from which all domains create their messages. The RIM is an ANSI approved standard.
The growing adoption of HL7 standards (e.g. the HITSP/C32 specification called out in the meaningful use final rule) throughout the world suggests that aligning NCI's Semantic Infrastructure around these specifications will streamline attainment of NCI objectives. Â
