Executives of two health information exchange vendors expressed serious reservations about recommendations from the President’s Council of Advisors on Science and Technology to establish a universal exchange language for health care.

The language would include metadata tags--the separation and tagging of specific data elements--to facilitate HIE while giving patients more control over the use and disclosure of their protected health information.

The recommendation for a universal language is significant because tagging data elements is important for measuring and research purposes, said Chris Voigt, vice president of development at MobileMD., during a session at HIMSS11 in Orlando.  However, metadata to facilitate HIE isn’t necessary because HIE technology already supports data exchange, he noted.

The PCAST report does little to address current data exchange standards already used in health care, Voight contended. These include HL7, IHE, the Direct Project, SNOMED, LOINC, ICD-10 and CCD/CDA.

The PCAST slight is a concern. “I think the report was kind of silent on the success of HIE today.” That success is noticeable in the success of enterprise and other private HIEs, which are sustainable today, Voight said, although HIE continues to have limited success in public efforts that involve disparate organizations.

Scott Holbrook, executive vice president at Medicity, when further with his concerns. HIEs are system integrators, he noted. If data elements are completely separated from information, then the challenge is to express the context, such as the term “allergy,” for each separated element. Consequently, tagging metadata would slow industry adoption of HIE. Rather, the industry and regulators should push hard for widespread adoption of Continuity of Care Documents and Continuity of Care Records, he asserted.

But if tagging metadata isn’t necessary to facilitate HIE and plenty of data exchange standards already exist, should the industry even adopt a universal exchange language?  “We don’t need it today,” Holbrook replied. He did praise the PCAST recommendations concerning HIE, privacy and health information technology adoption for bringing more light and debate to the issues. “I don’t like everything in the report, but if you look at it overall, it brings us visibility.”

--Joseph Goedert


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