For electronic health records (EHRs) across the country to effectively share vital information for patient care, the Texas Medical Association is urging federal officials to standardize technology guidelines.
TMA submitted comments on the latest round of proposed updates to the United States Core Data for Interoperability (USCDI), which the Office of the National Coordinator for Health IT (ONC) issued in January. USCDI aims to standardize how health information is shared across electronic systems and between clinicians. For example, USCDI standardizes how information like patient demographics and medication histories in EHRs are shared so that other clinicians receive the information as intended.
In an April 13 letter to ONC, TMA offered several suggestions on how to improve the flow of information between EHRs. As it has advised ONC in the past, TMA asked the agency to include data elements – units that capture patient, clinical, and administrative data – in USCDI only if there are vocabulary standards for each element.
Vocabulary standards require specific language to ensure comprehension across digital systems, such as requiring the vaccine type, administration date, and lot number when noting a patient has received an immunization. These standards are applied universally to information used by clinicians, payers, vendors, and others.
If a data element does not have an assigned vocabulary standard, it can cause significant interoperability and accuracy issues, which may affect clinical decision-making.
Of the 30 proposed data elements in the draft USCDI Version 7, 23 do not have correlating vocabulary standards. If ONC adopts the proposed data elements, USCDI Version 7 will have 76 data elements without a vocabulary standard, per TMA’s letter.
The association advocates for universal common encoding of all data elements. If accomplished, it allows disparate systems to “share and consume information more easily,” with the potential to “rapidly advance ONC’s interoperability goals while decreasing user burden,” TMA stated in its comments.
In that vein, TMA also strongly urged ONC to:
- Require all exchanged clinical data to include standardized provenance metadata, including source system ID, timestamp, and history of record changes;
- Allow the ability to suppress nonapplicable fields to reduce EHR-screen clutter with the goal of improving EHR usability, which is an important patient-safety factor;
- Standardize encoding of all data elements to support physicians who need to change EHRs so physicians can transition systems with little effort and cost; and
- Support industry-led testing of EHR vendors to verify the USCDI data elements are truly interoperable between systems.
For more information about electronic health records, including how to switch systems and navigate vendor contracts, see TMA’s dedicated webpage.
Alisa Pierce
Reporter, Division of Communications and Marketing
(512) 370-1469