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The HIT Standards Committee, a federal advisory body, has approved recommendations for data standards that support the exchange of patient information among disparate entities. Such data exchange will be a requirement for meaningful use of electronic health records under the economic stimulus law.

The approval is the first step in requiring that EHRs support these standards and providers use them to facilitate health information exchange. The recommendations now go to the HIT Policy Committee, another federal advisory body. If approved, the recommendations would be transmitted to federal officials for consideration as they write the rules governing the Medicare/Medicaid incentive programs for meaningful use of EHRs. It will be up to federal officials to declare any mandates to use the data standards.

The recommended primary content exchange standards are:

* Structured electronic documents: HL7 v.3 CDA, e.g., relevant CDA profile for consultation notes, or CCD for summary records;
* Clinical messaging: HL7 v.2.5.1, e.g., encounter or lab results;
* Immunization queries and vaccination updates (only): HL7 v.2.3.1;
* Prescriptions: NCPDP Script v.10.x (ambulatory) and HL7 v.2.5.1 (inpatient);
* Eligibility, benefits and referrals: ASC X12 v.4010A1, NCPDP Script v.5.1 and
CAQH CORE Phase I and Phase II; and
* Quality measure reporting: CMS PQRI Registry XML Specification.

Recommended primary vocabulary standards are:

* SNOMED CT for clinical problems and procedures;
* RxNorm for drugs and medication allergies;
* UNII for ingredient allergies;
* LOINC for laboratory tests;
* UCUM for units of measure; and
* ASC X12 and NCPDP Script for administrative terminology.

The HIT Standards Committee also approved recommendations from its clinical quality and privacy/security workgroups. All recommendations are available at http://healthit.hhs.gov/portal/server.pt. Click on Federal Advisory Committees, then Health IT Standards Committee and scroll down to the Aug. 20 meeting.

--Joseph Goedert