# Presentation: 100757

## NLM’s HSR Research Agenda June 27, 2003

**Betsy L. Humphreys**
**Associate Director, Library Operations**
**Assistant Director, Health Services Research Information**
**National Library of Medicine**
**(301) 496-6921, blh@nlm.nih.gov**
**http://www.nlm.nih.gov**

## NLM’s HSR Research Agenda

- Develop better information infrastructure for HSR
- Measure the impact of information services/systems on health care and prevention

## HSR Information Infrastructure  

- Accessible information resources/technology
- Conducive information policies and standards
- Sources of better data, e.g.,
- Electronic patient records that can generate HSR data as a by-product of care
- “Reusable” research data
- More investigators trained to:
- Shape/use emerging data sources
- Evaluate impact of information services/systems

## National Network of Libraries of Medicine (http://nnlm.gov)  

- National Network of Libraries of Medicine (http://nnlm.gov)

## NN/LM Hospital Internet Access Task Force

- Charge:
- Identify current barriers to easy access
- Develop strategy for finding “best practices” for ensuring easy access **AND** maintaining security and privacy
- Develop plan for disseminating “best practices” to hospitals, their libraries, and their IT departments
- Recommend other actions that NLM and the NN/LM could take to promote easier access to electronic information within the hospital environment

## NN/LM Hospital Internet Access Task Force

**Ruth Holst,** U. Illinois, Chair
**Susan Barnes**, U. Washington
**Anna Habetler**, Children’s Hospital and Health Center, San Diego
**Janie Kaplan**, NY Academy of Medicine
**Maureen Malloy**, Milwaukee Veterans Affairs Medical Center
**Sal Marotta**, Director, IT Telecommunications, University of Oklahoma Health Science Center
**Denise O’Shea**, NY Academy of Medicine
**Tracy Powell**, University Hospital, University of Alabama Birmingham Lister Hill Library
**Carolyn Willard**, NLM

## HSR Information Infrastructure  

- Accessible information resources/technology
- Conducive information policies and standards
- Sources of better data, e.g.,
- Electronic patient records that can generate HSR data as a by-product of care
- “Reusable” research data
- More investigators trained to:
- Shape/use emerging data sources
- Evaluate impact of information services/systems

## NLM Long Range Plan2000-2005

- Work with other agencies and organizations to support the establishment, maintenance, testing, and use of health data standards.
- Use the UMLS Knowledge Sources and programs to facilitate maintenance and distribution of vocabulary standards.

## Federal Health Data Standards Developments

- HIPAA administrative data standards
- U.S. government-wide clinical data standards
- Federal support for maintenance and distribution of clinical vocabularies

## http://ncvhs.hhs.gov

**http://ncvhs.hhs.gov**

## http://www.hhs.gov/ocr/hipaa

**http://www.hhs.gov/ocr/hipaa**

## Slide 12

## Slide 13

## http://www.cms.gov/hipaa/hipaa2/default/asp

**http://www.cms.gov/hipaa/hipaa2/default/asp**

## Slide 15

## Federal Health Data Standards Developments

- HIPAA administrative data standards
- U.S. government-wide clinical data standards
- Federal support for maintenance and distribution of clinical vocabularies

## Clinical Data Standards Recent History

- July 6, 2000 - NCVHS Report on Uniform Standards for Patient Medical Record Information (PMRI) – *mandated by HIPAA*
-  “HIPAA-like” process for *choosing* U.S. clinical standards (messages, vocabulary, etc.)
- Federal guidance, *NOT* regulation
- Federal agencies as early adopters
- Federal support of clinical vocabularies
- http://ncvhs.hhs.gov/reptrecs.htm

## Clinical Data Standards Recent History

- February 14, 2002 - CDC Public Health Information Technology Functions and Specifications (NEDSS/bioterrorism)
- February 27, 2002 - 1st NCVHS PMRI recommendations  for  clinical transaction standards

## http://www.whitehouse.gov/omb/egov/gtob/health_informatics.htm

**http://www.whitehouse.gov/omb/egov/gtob/health_informatics.htm**

## Clinical Data Standards Developments - 3

- First U.S. government-wide *target* clinical standards announced March 21, 2003
*from* Consolidated Health Informatics (CHI) Initiative e-Gov project, 2002-
- Complementary to NCVHS –
- Vehicle for pushing early adoption by federal government
- Major focus on vocabulary and message standards

## Federal Health Data Standards Developments

- HIPAA administrative data standards
- U.S. government-wide clinical data standards
- Federal support for maintenance and distribution of clinical vocabularies

## Federal support for ongoing maintenance of clinical vocabularies

- 1999- NLM/DOD/VA/CMS contract support for** ****LOINC**** **
- original development funded by RWJ, AHRQ, NLM grants
- 2001- NLM/VA/FDA collaboration – **RxNorm**: “clinical drugs”, i.e., what is prescribed
- Coming soon - NLM-negotiated arrangement for U.S.-wide use of **SNOMED CT** as distributed in the UMLS

## Slide 23

## HSR Information Infrastructure  

- Accessible information resources/technology
- Conducive information policies and standards
- Sources of better data, e.g.,
- Electronic patient records that can generate HSR data as a by-product of care
- “Reusable” research data
- More investigators trained to:
- Shape/use emerging data sources
- Evaluate impact of information services/systems

## http://grants2.nih.gov/grants/policy/data_sharing

**http://grants2.nih.gov/grants/policy/data_sharing**

## http://www.cdc.gov/osp/sharing_policy.htm

**http://www.cdc.gov/osp/sharing_policy.htm**

## HSR Information Infrastructure  

- Accessible information resources/technology
- Conducive information policies and standards
- Sources of better data, e.g.,
- Electronic patient records that can generate HSR data as a by-product of care
- “Reusable” research data
- More investigators trained to:
- Shape/use emerging data sources
- Evaluate impact of information services/systems

## NLM-Funded University Medical Informatics 

**NLM-Funded University Medical Informatics **
**Training Center Programs, 2002-2006**

## Informatics Training Centers

**With HSR training components:**
- Oregon Health Sciences University
- University of Missouri
- Indiana University/ Regenstrief Institute
- University of Washington

**With public health or health administration components:**
- University of Minnesota
- University of Pittsburgh
- Columbia University
- University of Utah
- Vanderbilt University
- Johns Hopkins University

**http://www.nlm.nih.gov/ep/T15Training.html**

## NLM’s HSR Research Agenda

- Develop better information infrastructure for HSR
- Measure the impact of information services/systems on health care and prevention

## Health Information Prescription

**Partners:**
**American College of Physicians**
**American Society of Internal Medicine Foundation**
**Medical Libraries**

## Prescription Pad