|
|
|
As advisory committee to the Secretary of the Department
of Health and Human Services, the NCVHS accomplishments in FY 2003 include:
- Initiated strategies to implement recommendations of its report, Information
for Health: A Strategy for Building the National Health Information
Infrastructure (NHII) (November 2001). The NHII Workgroup
conducted hearings to explore the various dimensions described in the
NHII Report— starting off with the personal health dimension with
attention to internet capability, personal health record information
and standards (Jan 27-28, 2003); population health dimension including
public health privacy, registries, and public health surveillance
(April 22, 2003), and further exploration of the personal health
dimension (August 7).
- Continued to support HHS leadership in building the NHII in terms
of priority setting and developing specific proposals for HHS oversight
and coordination. NHII issues were explored in the Department’s
first conference on the topic, “Developing a National Action Agenda
for NHII” (June 30- July 2) Representatives of the
NHII Workgroup attended, served as facilitators and invited experts,
and the NCVHS Chair provided the key note address. Strategies
for implementing NHII recommendations were highlighted with significant
input from the NHII Workgroup.
- Submitted a letter (Nov 25, 2002) strongly urging that the Department
respond to the public’s lack of information about privacy rule
implementation issues with significantly increased resources.
The letter advocated the need for immediate and intense effort by the
Department to promote information about privacy implementation, including
a massive public education program in various formats and media, and
technical assistance to inform the public and providers about the process,
in preparation for the April 15, 2003 implementation date.
The letter was based on information received through national hearings
(Boston; Baltimore, MD; Salt Lake City, Utah), where testifiers provided
input on the needs of covered entities and affected parties trying to
implement the privacy regulations. The letter detailed issues
initially raised in an earlier transmittal (September 27th)
outlining the challenges of the privacy rule.
- Submitted a letter (June 2003) recommending that the Department initiate
a program to measure the effects of the Privacy Rule. An ongoing
program will help refine rulemaking, implementation, and enforcement
strategies for the Rule. The Committee has appreciated the updates
provided by OCR about the number, extent, and type of complaints submitted,
and the plans to address them. In order for NCVHS to stay informed
of latest developments, a list serve was developed to provide consistent,
timely updates.
- Completed the Report, “Shaping a Health Statistics Vision
for the 21st Century,” which establishes a vision
and outlines themes and guiding principles to improve the nation’s
health statistics enterprise. The information was developed
through consultative discussions involving statistics users, public
health providers, advocacy groups and health care providers at local,
state, and Federal levels. Ten principles have emerged as essential
qualities to developing the health statistics Vision. The report is
the culmination of a 3-year process through the partnership of the National
Center for Health Statistics, the National Committee on Vital and Health
Statistics, and the HHS Data Council, with the recommendations developed
by the NCVHS.
- Completed the NCVHS 2000- 2002 report containing highlights, activities,
and accomplishments of the Committee. During this period, the
Committee focused on HIPAA implementation and standards, accelerating
the evolution of public and private health information systems within
the framework of protecting privacy and security, and understanding
the data issues underlying the health care needs of special populations.
Its reports on the National Health Information Infrastructure and Health
Statistics for the 21st Century were published during this
period.
- Developing a sixth annual report to Congress on Implementation of
the Administrative Simplification Provisions of the Health Insurance
Portability and Accountability Act of 1996 (HIPAA). The 6th
NCVHS Report to Congress will describe the major milestones achieved
on the implementation of HIPAA by outlining the process as well as implementation
of the standards required by HIPAA. This report will also reflect
the modifications and implementation of the Privacy Rule, the publication
of the Security Rule and initial reactions to the October 16th
effective date of the Transactions and Code Set Rule. These annual
reports by the Committee are required by the HIPAA legislation.
- Through the Subcommittee on Standards and Security, is synthesizing
information heard in hearings and testimony (2002-2003) on current diagnosis
and procedure code sets adopted under the HIPAA transactions and code
set rule, including ICD-9-CM, Volumes 1- 3; CPT, CDT and alphanumeric
HCPCS; emerging procedure code sets and gaps; and transition from ICD-9-CM
to ICD-10-CM and ICD-10-PCS.
- In response to the testimony presented, the Subcommittee is studying
ramifications of changing code sets, and has taken the initiative to
undertake a study assessing the impact on the health care industry,
including a cost/benefit analysis, of the transition from ICD-9-CM to
ICD-10-CM (diagnoses) and ICD-10-PCS (procedures for inpatient
only) as the next version of the HIPAA medical code sets. The
results of the study, being conducted by RAND’s Science Policy
and Technology Institute, were presented during the August meeting of
the Standards and Security Subcommittee, and summarized for the full
Committee in September 2003.
- Through the Subcommittee on Standards and Security, the Committee
continues to be instrumental in coordinating efforts for the implementation
of the transaction and code sets rule. The Committee submitted
a letter to the Secretary in June 2003 on the healthcare industry’s
readiness to comply with the October 16 deadline and recommended flexibility
in enforcement during a transition period.
- Also through the Subcommittee on Standards and Security, the Committee
prepared a letter reporting progress of NCVHS review and evaluation
of PMRI terminologies (June 2003), which the Committee plans to propose
as candidates for a second set of clinical data standards for adoption.
The letter reviews hearings conducted since August 2002, the questionnaire
developed to solicit information from potential developers, the testimony
received from users and anticipated schedule for completion of final
recommendations, currently set for November, 2003.
- The Subcommittee on Standards and Security continues to serve in an
advisory capacity to the Consolidated Healthcare Informatics (CHI) Initiative,
receiving regular updates from the CHI Council and its work groups
The Committee transmitted a letter to the Secretary in September
2003 concurring with CHI recommendations on several vocabulary domains.
- Received a briefing from the directors of the DHHS Office of Minority
Health and the NIH National Center on Minority Health and Health Disparities
(11/2002) on their insights, strategies, and approaches to data needs
for racial/ethnic minority health and the elimination of health disparities.
Maintained active involvement with the respective advisory committees
through participation of their staffs at meetings and ongoing updates.
- In response to NCVHS recommendations, the Centers for Medicare and
Medicaid Services devoted a special issue of Health Care Financing
Review to articles on capturing functional status in administrative
records for payment and quality purposes (Spring 2003, Vol. 24, No.3).
Several articles address applications of the International Classification
of Functioning, Disability and Health, which the Committee previously
identified as the only viable candidate for a code set for classifying
functional status in clinical and administrative records.
- In an effort to maintain a focus on population issues throughout Committee,
heard from experts on population health, including a researcher from
the University of British Columbia.
- Through the Subcommittee on Populations, submitted a letter to the
Secretary (February 28, 2003) outlining support for NCHS programs, and
expressing concern about possible budget cuts to the National
Health Interview Survey (NHIS). The Committee strongly expressed
the need for sufficient funding for NCHS to collect data on high priority
topics through the NHIS, a cornerstone of the nation’s health statistics
system. Attention to these matters is needed to help NCHS maintain
its programs and advance its information technology capacity.
- Also through the Subcommittee on Populations, submitted a letter (March
27, 2003), referring to issues raised in hearings conducted throughout
2002 and suggested strategies to improve the collection and use of health
data in racial and ethnic populations. The letter recommended
that the Department expand the multifaceted approach to obtaining data
on these diverse populations in programmatic, research, administrative
and survey data.
- The Subcommittee on Populations followed its March letter with additional
recommendations (September 26) for targeted collection of health data
on subgroups of specific racial and ethnic minorities, especially those
concentrated in geographically distinct areas.
- The Subcommittee on Populations also prepared recommendations for
the collection of standardized racial and ethnic data in health
plans to support the management, monitoring, and evaluation of programs
to prevent disease and promote better health outcomes (September 26).
The ultimate goal of all of these efforts is to eliminate racial and
ethnic disparities in health so that all Americans receive quality health
care, a Department initiative.
- Also through the Subcommittee on Populations, conducted well-received
national hearings reflecting its ongoing theme of collecting racial
and ethnic data in health statistics. The Sept 27, 2002 hearing
in Denver, Colorado followed the OMH meeting on Native American Health
and focused on issues related to the collection and use of data on race
and ethnicity for American Indian/Alaska Native (AI/AN) populations.
Speakers and panelists addressed identification of AI/AN health disparity
issues from the tribal as well as urban/rural perspective. Issues
pertaining to health data collection for Asian and Pacific Islanders
were covered in a hearing in Los Angeles, CA (May 22-23, 2003) to consider
aspects of data collection for subpopulations within Asian, Native Hawaiian
and other Pacific Islander populations, specifically how language, geography,
and size of population impact the collection of data. The issues
will be further explored in a follow-up hearing in San Francisco, CA
(Nov 2003).
- Collaborating with the Agency for Healthcare Research and Quality
by serving in an advisory capacity on the new National Quality Report
and report on racial and ethnic health disparities. Through the
Workgroup on Quality, offered comments on the AHRQ Quality Framework
for development of the National Healthcare Quality Report.
Per the legislative mandate to AHRQ, the report will include a broad
set of performance measures that will be used to monitor the nation’s
progress toward improved health care quality.
- Also through the Quality Workgroup, is developing a report:
“Measuring the Quality of Health Care: Obstacles and Opportunities.”
The report will summarize the testimony on data issues in quality measurement
presented to the Committee by 16 panels at nine meetings between 1998
and 2002, and offers recommendations to improve the information available
for health care quality.
- Received several briefings from the NCHS Director on the status of
Center activities including major surveys, new features, and status
of its Board of Scientific Counselors (BSC), which held its first meeting
on October 10, 2003. The Chair of the NCVHS Subcommittee on Populations
will serve as liaison to the BSC.
- Received a briefing from executive staff of the Office of the General
Council (February 2002) on issues related to conflict of interest, recusal
from discussion and/or action, committee membership and professional
engagements, and travel and reimbursement situations. Subsequent
additional guidance was provided to members.
- Continuing its strategic planning process at an Executive Subcommittee
retreat (November 21, 2003).
Return to Top
|
