Cit

Director, Information Technology 

Ju
` The U.S. healthcare industry lacks a compreh

nationwide information infrastructure.

◦ A standards-based, secure, interoperable natio

infrastructure is needed.

` From both economic and quality of life persp

critical importance to individual citizens and 

◦ Healthcare spending is $1 of every $6 spent in ◦ Up to 98,000 people die annually due to medic◦ The U.S. ranks 24th in life expectancy though w

money per capita ($5.7K) per year on healthcarcountry;

◦ Healthcare costs put U.S. industry at a global d

` “...lives can be saved, outcomes of care impr

reduced ... through the appropriate use of intechnology.” (Healthcare Information and Management Sy

Call for Action, Dec 2008.)

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` Administration Priorities

◦ “Use health information technology to lower the cos

Invest $10 billion a year over the next five years to health care system to broad adoption of standards-health information systems, including electronic hewhitehouse.gov

◦ “Our health care is too costly” and we will “wield tec

to raise health care’s quality and lower its cost.” – Pinaugural address 

◦ "Obama, who has advocated for healthcare reform b

electronic health records (EHRs), [...], said his admi“make the immediate investments necessary to ensyears all of America’s medical records are computeTelemedicine and e-Health News Alerts, Liebert Inc

◦ At a White House summit on healthcare reform, the 

to health IT as “the low hanging fruit.” – www.ihealthbeat.org/Articles/2009/3/6/

` Congressional Initiatives

◦ Numerous Health IT bills in the past several session◦ The American Recovery and Reinvestment Act (ARRA

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Standards and 

Certification Industry Groups F

- GE Healthcare- IBM - Microsoft- McKesson- Phillips- Siemens Healthcare

Key Industry Players

- Kaiser Permanente- Mayo Clinic

Key Healthcare 

Delivery Organizations

- HIT - HIT - Nat

Key A

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` Trichotomy of Federal Role

◦ Agencies with Policy/Regulatory Role (e.g., HHS◦ Agencies with Research Role (e.g., NIST)◦ Agencies that are Health Care Providers (e.g., V

` Health IT-specific standards for federal us

Secretary of HHS

` Generally, each federal agency provides its 

representation for defining standards deveand SDO participation

` Federal Health Architecture (FHA) E-Govern

Business Initiative is one coordination body (others for clinical research, public health) 

` Nationwide Health Information Network (N

coordinates (standards-based) trial implemconnecting to federal HIT systems

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` Breadth of knowledge in infrastructure and in

` Mission to work with industry` HIT global reputation` Leverage expertise/success in other domains

◦ E-commerce◦ Security◦ Networking

` NIST’s roles are articulated in the Federal He

Plan 2008 – 2012 (http://healthit.hhs.gov)

◦ Interagency agreement with HHS/ONC since 20

` Now is the time to build on the momentum o

collaborations

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` “...the Secretary of Health and Human Serv

transfer $20,000,000 to the Director of the continued work on advancing health care ienterprise integration through activities sustandards analysis and establishment of cotesting infrastructure...” (Title VIII)

` “The Director of the [NIST], in consultation 

Director of the National Science Foundatioappropriate Federal agencies, shall establisassistance to institutions of higher educatimultidisciplinary Centers for Health Care InEnterprise Integration.” (Section 13202)

` Also,

◦ Consulting on Certification of health IT◦ Contributing to an updated health IT strategic p◦ Consulting on health IT implementation assista

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` When standards and tests are developed s

the resulting standards are more correct, land result in better industry products (feed

◦ NIST developed testing infrastructure◦ Collaborations on testing tools

` Testing extends into the industry product 

lifecycle

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` HL7 Clinical Document Architecture (CDA) do

validators

` IEEE Medical device information model` IHE Cross Enterprise Document Sharing (XDS

◦ Details in the upcoming demo

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` Expanding the health IT infrastructure to 

environments, such as home healthcare

` Applying NIST-wide competencies to add

clinical needs, personalized medicine, anreasoning

` Advancing usability and accessibility of h

information technologies

` Researching the standards and testing n

evolving technologies

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