Groups Urge ONC Not To Include Metadata Standards in Stage 2

The College of Healthcare Information Management Executives recently sent a letter to the Office of the National Coordinator for Health IT urging the agency to continue studying metadata standards and not fold them into requirements for Stage 2 of the meaningful use program, Modern Healthcare reports.

Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health records can qualify for Medicare and Medicaid incentive payments.

CHIME sent the letter in response to ONC's advance notice of proposed rulemaking that was issued earlier this year (Conn, Modern Healthcare, 9/21).


The push for metadata standards stems from a December 2010 report by the President's Council of Advisors on Science and Technology, which recommended developing and using a universal exchange language to promote health data exchange and increase data privacy and security.

ONC is sponsoring two pilot programs to test recommendations on metadata standards -- the Data Segmentation Initiative and the Query Health Initiative.

The Data Segmentation Initiative will use metadata tagging to help health care providers exchange portions of EHRs while keeping certain sensitive information separate, while the Query Health Initiative will establish standards for requesting population health data from widely distributed sources (iHealthBeat, 9/20).

CHIME Letter

CHIME wrote that more work needs to be done to assess the feasibility of including metadata standards in future meaningful use requirements (CMIO, 9/21).

CHIME wrote, "We do not believe that the meaningful use regulatory schema is the appropriate venue to mandate unproven standards or incomplete protocols." The organization added that there is not enough consensus around metadata standards to warrant inclusion in Stage 2 of the meaningful use program.

However, the letter stated that if ONC decides to pursue metadata standards for Stage 2, CHIME would offer assistance in establishing implementation guidelines (Modern Healthcare, 9/21).

CHIME recommended that ONC move forward with the Query Health, Data Segmentation and other metadata initiatives to further analyze potential standards and implementation steps (CMIO, 9/21).

AHA Letter

The American Hospital Association also recently sent a letter to ONC arguing that it is too early to implement proposed metadata standards, AHA News reports.

AHA wrote that including such standards in the Stage 2 requirements for the meaningful use program would be "would be premature" without sufficient evidence that the metadata standards "offer demonstrated benefits that outweigh the costs of implementation and are feasible for use in all care settings."

AHA stated that although the metadata standards could be a positive step toward a query-based health data exchange system, the standards "have not been adequately analyzed or tested in the real world to know if they are appropriate for widespread use at this time."

AHA urged ONC not to release any final rules until the metadata standards undergo further pilot tests and evaluations (AHA News, 9/21).

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