AMIA Meeting
Today is my second day in Washington DC. Yesterday was the STFM communications committee meeting. These all-day meetings can be a challenge - as it seems that everyone gets kinda antsy toward the end of the day. We got a fair amount accomplished.
Now I'm at the AMIA Primary Care Informatics Working Group meeting.
Bob Phillips from the Graham Center is talking about the new project of the Center for Health Information Technology. - specifically the AAFP's EHR project. There will be a press release next Wednesday morning on the project - and how the flavor has changed a bit - with less of an emphasis on open source, and more of an emphasis on vendor openness. The "acid test" to define which vendors would be involved is as follows:
ACID test:
A = affordability.
C = Compatible. The systems must be compatible with each other and vendor lock needs to be avoided.
I = Interoperability. The data must be stored in a manner that permits access regardless of system or hardware.
D = Data stewardship. The data must remain owned.
Hmmm. This is tough to interpret, and its not clear to me exaclty what this really means. Tomorrow Alan Zuckerman is holding a session on the project and I think we can build a more detailed understanding of it then. David Kibbe has held these cards rather close to his chest - and in this absence of transparency - it's hard to trust that what he's doing is the right thing. I do trust Alan - and I'm curious how he's been able to engage David in such a detailed fashion. I look forward to learning more from him.
Bob's next topic was a discussion of a statement that will soon be released by NAPCRG at their recent meeting in Banff.
The short version is that NAPCRG wants the US to embrace a coding system that makes sense to primary care physicians, and that they feel that ICPC-2 is the right answer rather than SNOMED-CT.
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Now David W Bates is talking about the NAPCI project. It's an effort to pull primary care together to provide one voice toward the unification of efforts in primary care informatics. The NAPCRG statement is a good example. NAPCRG will be one of the members of NAPCI. While it's good that NAPCRG releases a statement on coding, it would be much more meaningful if such a statement came from NAPCI- representing all of primary care.
David is also discussing the IOM EHR report - which is a must-read for anyone thinking about these topics.
David a good speaker - and clearly has a good vision for where this stuff ought to go. He's urging us to become involved in the HL7 EHR project. This is a big project - and it's not clear that it's going in the right direction. The vendors hold a great deal of control in HL7 - and while this project is uniqie in that the cost of becoming involved is only $100 - it's still not clear to me what the content of this proposal is. There will be another draft of the "EHR DSTU" released here at the AMIA meeting tomorrrow night. Hmm.
In addition to the national efforts, David is reviewing a project that he's leading in Massachusetts. The goal of the project is to build and fund a state-wide initiative that would enhance the implementation of electronic health records in primary care practices in Massachusetts. Core concepts include data exchange (meds/labs/radiology) (?? problems & allergies??) - along with the selection of a few EMR vendors to guide physicians in the appropriate selection fo software and hardware.
The Massachusetts project will be a good model fro what NAPCI may be able to spread to other states.
Other next steps for NAPCI will be to become more involved in the NHII project, to provide tools that practices may be able to use to make decisions about EHR adoption. Such tools may be ROI calculators - or guildelines about features/functions etc. Seems like AAP and ACP may have some of these tools developed - as does AAFP. Our goal would be to catalog these tools and perhaps edit them so so that they meet all of our needs.
Other notes/links relevant to David's talk:
DOQIT (I can't find a link defining this right now ... but at least this is a placeholder)
AMIA Primary Care Working Group position paper
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Comments from the audience:
What are the unique needs for IT in primary care? Do we know?
- David: Not yet - and in fact this is what we are working on establishing.
- Lost of discussion now about NAPCI and what it is and what it will become. David says that there are an awful lot of moving parts here. Can we influence the standards bodies?
- A mention of Leapfrog. They're going to release their next "leap" in a few weeks. Focus: Primary care.