# Meaningful use criteria **Category:** [Technical (archive)](https://discourse.openehr.org/c/technical-archive/156) **Created:** 2010-01-14 11:31 UTC **Views:** 5 **Replies:** 5 **URL:** https://discourse.openehr.org/t/meaningful-use-criteria/14953 --- ## Post #1 by @Stef_Verlinden1 Is anybody following the current discussion in the US about the meaningful use citeri and/or is anybody actively involved? The published criteria can be found here: [http://frwebgate5.access.gpo.gov/cgi-bin/PDFgate.cgi?WAISdocID=467405454267+0+2+0&WAISaction=retrieve](http://frwebgate5.access.gpo.gov/cgi-bin/PDFgate.cgi?WAISdocID=467405454267+0+2+0&WAISaction=retrieve) Is just scanned it very quickly and one thing stroke me, this is just a pre-definition.: 'In order for an EHR technology to be eligible for certification it must first meet the definition of a qualified electronic health record. This term will be defined by ONC in its upcoming interim final rule, and we propose to use the definition of qualified electronic health record adopted by ONC.' So it appears that the ONC final rule will set an important road ahead for the coming decades. Is anybody promoting the benifits of the 13606 standard and if not shouldn't we do that? Cheers, Stef --- ## Post #2 by @Richard_Dixon_Hughes Stef, You may also wish to scan the proposed rules on standards in Part III: [http://www.gpo.gov/fdsys/pkg/FR-2010-01-13/pdf/E9-31216.pdf](http://www.gpo.gov/fdsys/pkg/FR-2010-01-13/pdf/E9-31216.pdf) (sorry - couldn't find link to one with a "Federal Register" cover) In relation to your quote - you will notice that they talk about "EHR technology". The proposed rules in Part II of CFR vol 75 no 8 are about systems adoption and measuring their use in clinical settings - much more than any focus the actual record content. While interoperability is central to the idea of "meaningful use" it is pretty basic interoperability that is being sought - much of it at codeset level. Some of us have spent years trying to emphasise these differences - but in the US they usually think of a "system" when you say "EHR" (as in the title of the former EHRVA - EHR Vendors Association). On your comment about 13606 - it is my understanding that ONC is working hard to get their own local standards groups onto the same page. It is unfortunate that proposed work such as the 13606/HL7 implementation guide and continuing engagement with HL7 on clinical statement found their way onto the back burner as these were possible grounds in which openEHR might engage with US interests. There are many people contributing to and guiding current DHHS/ONC deliberations - so it is not a question of convincing one person about the merits of 13606 - a large proportion of the US HIS vendor, standards, regulatory and health provider communities would need to be on board to have any success. The most interesting recent development was the failure of HL7v3 messaging to get a guernsey in the proposed standards; however, CDA is strongly there in the form of CCD - but ASTM and the XML-heathens appear to have succeeded in their lobbying to get CCR back onto the list (it was omitted in some earlier drafts following extensive debate) - many would see CCR as a step away from true semantic interoperability. As I am not from the US, I think I should butt out at this point and let others look at the documents for themselves - but thanks for raising the point Stef. --- ## Post #3 by @thomas.beale well before we do that, someone at ISO/CEN needs to think about a profile for 21090 data types (in reality HL7v3 data types tidied up and enhanced somewhat) that can work for 13606 or indeed anyone not using HL7v3 messages. See [http://www.openehr.org/wiki/display/stds/openEHR+to+ISO+13606-1%2C+ISO+21090+mapping](http://www.openehr.org/wiki/display/stds/openEHR+to+ISO+13606-1%2C+ISO+21090+mapping) for details. - thomas beale --- ## Post #4 by @system Hi\! I read at http://www.ehealtheurope.net/news/5531/va_and_kaiser_pilot_record_sharing that VA and Kaiser are looking at sharing parts \(or summaries\) of EHRs\. A quote from the link:   \.\.\.Dr Robert M\. Smith, chief of staff of the VA San Diego Healthcare System,   as comparing the importance of the electronic health information program   to the first moon landing, "much like President Kennedy's charge, we're   going to take President Obama's charge \[to create a nationwide EHR   system\] and move forward quickly\."\.\.\. If they move past summaries and are serious about sharing complete records later they will sooner or later \(probably\) come to the conclusion that one needs to agree on semantics at the point of data entry instead of only at the point of exchange if one wants to avoid the need for manual reinterpretation for every record exchange\. \(The conversion task of complete EHRs will in many cases not have an algorithmic solution, and thus no matter the number or quality of standards they choose/create for exchange, a computer system won't be able to solve it safely\.\) When they the conclusion above, then openEHRs approach to the "moon landing" of components, tools and processes for agreeing on semantics at the point of data entry might become interesting\. That might become a time for increased openEHR interest in the US\. Best regards, Erik Sundvall erik\.sundvall@liu\.se http://www.imt.liu.se/~erisu/ Tel: \+46\-13\-286733 \(Mail & tel\. recently changed, so please update your contact lists\.\) --- ## Post #5 by @ian.mcnicoll I haven't read any of this in detail but I would agree with Erik. If openEHR/EN13606 is to get any traction on the US this is likely to come from individual vendor interest rather than at govt level. We already have several professional bodies in the US using openEHR to model their professional standards and there are vendors / local providers such as VA, Kaiser and Intermountain who have a much better understanding of the challenges of growing and maintaining semantic coherence. We are just starting to be able to demonstrate that the archetype based approach has significant advantages in this highly complex area and is probably the only really scalable and controllable mechanism. The big interoperability success in the UK (GP2GP project) arose from close and continued vendor involvement with a very 'maximal dataset' like approach to the harmonisation of information structures. Ian Dr Ian McNicoll office / fax +44(0)141 560 4657 mobile +44 (0)775 209 7859 skype ianmcnicoll [ian.mcnicoll@oceaninformatics.com](mailto:ian.mcnicoll@oceaninformatics.com) [ian@mcmi.co.uk](mailto:ian@mcmi.co.uk) Clinical Analyst Ocean Informatics openEHR Archetype Editorial Group Member BCS Primary Health Care SG Group [www.phcsg.org](http://www.phcsg.org) / BCS Health Scotland 2010/1/15 Erik Sundvall <[erik.sundvall@liu.se](mailto:erik.sundvall@liu.se)> --- ## Post #6 by @Thilo_Schuler1 Hi I found Dr. Halamka's blog ([http://geekdoctor.blogspot.com](http://geekdoctor.blogspot.com)) a good resource for US health IT related topics. He seems to be an influential person and shares his views openly. If you search his blog with ´meaningful´ ([http://geekdoctor.blogspot.com/search?q=meaningful](http://geekdoctor.blogspot.com/search?q=meaningful)) there are many posts showing how this topic evolved. In the most recent post he shares his view on the requirements for meaningful use in the form of a presentation naming standards and metrics from 25 projects. -Thilo --- **Canonical:** https://discourse.openehr.org/t/meaningful-use-criteria/14953 **Original content:** https://discourse.openehr.org/t/meaningful-use-criteria/14953