In response to an advanced notice of proposed rulemaking on the use of metadata standards to support health data exchange, CHIME is urging government officials “to study the complex issues more closely and to work with industry partners to develop and test metadata standards before considering any broader action,” the organization stated.
In comments it submitted, the organization told ONC that “current thinking around metadata standards needs further investigation through established processes before being codified into regulations.”
Two initiatives being undertaken by ONC to help inform metadata and health information exchange include Query Health and Data Segmentation. Together, these pilot projects are expected to advance understanding of how metadata could be used within healthcare, “but they are very early in development,” CHIME notes.
“CHIME believes that these and other initiatives hold promise, but that metadata standards being currently considered for use are underdeveloped. CHIME recommends that ONC investigate metadata standards using an inclusive volunteer network of technical experts established through the Standards & Interoperability (S&I) Framework.”
“Presently, we do not believe there is consensus around HL7 CDA R2 header syntax, or any other metadata standards, that could be implemented across the healthcare ecosystem in time for Stage 2 Meaningful Use,” the group said in comments submitted Wednesday.
“CHIME recommends that ONC push forward with Query Health, Data Segmentation and other initiatives relating to metadata inside the established Standards & Interoperability (S&I) Framework in order to fully vet the range of possible standards and assemble the needed implementation processes.”
“For those of us working on expedient and scalable ways to do agnostic EHR-to-EHR CCD (CDA family) exchanges, metadata is a very important component to get right,” said George Hickman, EVP and CIO at Albany Medical Center. “We’re making strides in New York to demonstrate use cases with implementable outcomes for exchange, but to undertake an industry-wide pilot project that requires vendors to develop and providers to implement metadata standards is more than a stretch.”
Instead, CHIME urges ONC to use its existing channels of collaboration to test standards and protocols more extensively in preparation for Stage 3 of Meaningful Use.
“What we’re saying is not news to ONC,” said Sharon Canner, senior director of advocacy programs with CHIME. “In June, the HIT Standards Committee recommended that ONC conduct further testing and evaluation prior to proposing any metadata standards in rulemaking.”
Because CHIME agrees with ONC that metadata holds great promise to help advance electronic health information exchange across a variety of different exchange architectures, CHIME also offered its services to assist ONC in establishing implementation guidelines to ensure that protocols can scale across the provider community.