Future Role for HITSP?

There have been a lot of changes in government-led health information technology (HIT) initiatives since the Obama administration came to power in January. Much of the federal activity in HIT originates with the Office of the National Coordinator for Health IT (ONC.) Some of the changes have been discussed here previously, especially as they relate to EMR/EHR certification. There is another potential change on the horizon that I want to explore now.

The Healthcare Information Technology Standards Panel (HITSP) go its start in 2005 under a federal contract from ONC. HITSP is a public-private partnership with representation from a broad range of vendors, government bodies, and other organizations that contribute hundreds of volunteers to the standards harmonization process. The contract is due to expire at the end of January 2010, next month. Surprisingly, the federal government has not made public any plans it might have to extend the contract or substitute another organization to provide HITSP's services.

The standards harmonization process needed to enable interoperability of electronic medical records and health information exchange is not complete. In fact, the task is likely to be an ever-evolving one as standards development organizations (SDO's) continue to revise and formulate new health care related standards. HITSP advised ONC on standards to be selected for meaningful use for 2011, 2013, and 2015. These standards are still in flux. The government position on standards should become clearer by the end of December when an Interim Final Rule release by ONC is expected.

Unless government action is taken immediately, much of the effort invested in the creation of HITSP will be sacrificed. The organization was not designed to be self-sustaining. It was not easy to develop the governance structure, hire the full-time staff, and enlist the hundreds of volunteers that constitute the organization. The amount of effort that goes into developing a group like HITSP should not be underestimated. The government stands to loose the benefit of accumulated knowledge and experience of HITSP participants. It will not be easy to retrieve all the actors if they are lost during any significant hiatus in HITSP activities. As it stands today, HITSP will essentially shutter its doors on January 31, 2010.

Some may suggest that an alternative already is extant to replace HITSP. The HIT Standards Panel, a FACA committee, has been advising ONC on standards issues since it was established under the American Recovery and Reinvestment Act. Although there are dedicated experts on the panel, they are not capable of performing the work HITSP has been doing. I think it would be a real shame if HITSP is allowed to founder. It will also be a setback for the Obama administration's effort to encourage wide-spread adoption of interoperable electronic medical records for all Americans.