Proposed inter-agency effort on health data standards



TO: Arati Prabhaker, Director of the National Institute of Standards and Technology
FROM: Bruce Vladek, Administrator of the Health Care Financing Administration, HHS
Jack Ebeler, Expert Consultant, HHS
Co-Chairs of the HHS Data Council
SUBJECT: Proposed inter-agency effort on health data standards

We are writing to inform you of, and seek your assistance in responding to, a request from the Vice President to address the issue of health data and information system standards. In response to the Vice Presidential memo, the Department of Health and Human Services is undertaking inter-agency efforts to address four key policy areas: privacy, consumer health information, telemedicine, and health data standards. Interagency workgroups in the first three areas, reporting to the HHS Data Council, have. already been established. It is in the area of the fourth, that of health data standards, that we seek your assistance.

We propose that a health workgroup be established under the auspices of the Federal EDI (Electronic Data Interchange) Standards Management Coordinating Committee (FESMCC), which is chaired by NIST. This inter- agency working group would report jointly to the FESMCC and to the Data Council, towards the goals of achieving coherence in government's use of health data standards. As with all other FESMCC workgroups, the health workgroup would not be mandating the private sector's use of standards, but would rather be coordinating the government's use of health data standards already adopted by private standard development organizations, in order to be promote public health and safety, and respond to the needs of the health consumer.

Although the focus of the FESMCC is solely on EDI standards, these are an important subset of the broader family of data standards. Ihe scope of the workgroup would necessarily be larger dm that of the FESMCC, in order to include all the key data standards issues which bear on interoperability. It is difficult if not impossible to draw clear boundaries between EDI and other data standards issues. It is thus important that this interagency effort bring together in a single forum those people who best understand the broad issues.related to health care, EDI and other health data standards.

Moreover, this effort must coordinate with private sector efforts to develop health data standards, so that we can best respond to the technical needs and policy concerns of service providers and vendors. By coordinating this effort with the HHS Data Council, which coordinates the National Committee on Vital and Health Statistics (a federal advisory committee on these and related issues), the concerns of the private sector can be brought to bear.

Thus, a single working group would serve several purposes. The work group would report to the FESMCC on EDI issues representing the health perspectives of the government but with an understanding of the needs of the private sector and states through its link to the advisory committee. At the same time, it would report to the HHS Data Council on a broader range of health data standards issues, but with an understanding of the needs of nonhealth sectors through its link to the FESMCC.

If this proposal is acceptable, or should you wish to discuss this further, please have the appropriate staff member contact Lisa Rovin at 202-690-7800. We anticipate that this effort may require the ironing out of some logistics, but it will nevertheless be a fruitful, unified, and valuable exercise. We look forward to your support for this initiative.

Attachment: Memo from Vice President Gore, "Proposed Agenda for Promoting Health Care Application of the National Information Infrastructure," March 8, 1995