CCDS and the CCCP both lost to the US (CDI)
- jschremp
- May 29, 2019
- 2 min read
The Office of the National Coordinator (ONC) is the Federal Agency which is responsible for certifying Electronic Health Records (EHR) products as meeting all of the functions that the Federal Government deems necessary to be able to meet all Meaningful Use Objects, and the successor "Promoting Interoperability" program standards as well as security/encrption/CPOE/eRx etc standards. All of these standards and their relationships to CMS/HHS and states could spawn volumes of blogs, but for this entry, it's important to focus on sweeping changes to the patient health data that MUST be exportable (easily) to meet interoperability standards. Historically, this was the Common Clinical Data Set (CCDS) which is outlined in this great resource:
The CCDS is a relatively basic set of information. But, this is the set of information that is mapped to be exported into those healthcare apps that are supported through API transfers to patients. Again, think Apple Health. The CCDS is what is being shared from each EHR end point and into the Apple Health aggregator:
The successor to this data set, is the so called US Core Dateset for Interoperability (USCDI). This proposed data set is far more extensive, and includes things such as provider notes, pediatric specific vital signs, and additional provenance data to show where the component pieces stem from:
This is currently still a proposed rule which has not taken the full force of regulation yet. But, what is fascinating is that the ONC would ultimately be driving a lot of the (potential) adherence to this new standard because they are going to retroactively re-certify EHRs to the 2015 version to be able to export all of this information! This is interesting because the EHRs are ALREADY certified to 2015 and beyond standards; so this would be a massive shift in moving already released software into a state where it can support the USCDI export. It would also signal that the ONC sees FHIR transfers as having come out of the "pilot" phase successfully and they feel confident in its ability to be utilized as a tool to export more data. This would create machine readable data sets of nearly full clinical snapshots, but the question is are the EHRs ready/able to support this major increase in sophistication.
I want to continue to explore the USCDI in more detail because I think it shows the vision of what interoperability is morphing into in the 2020s.
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