Too early for metadata standards for health information

October 19, 2011

The government is jumping the gun in trying to develop metadata standards for healthcare technology, according to two industry groups. Those standards are proposed for meaningful use stage 2 and could affect your electronic health record implementation. Find out what prompted concerns that standards are too early for metadata, which embed descriptive information about the meaning and use of data.

A proposal to include metadata standards for health information exchange in stage 2 of meaningful use faces opposition by the College of Healthcare Information Management Executives (CHIME).

“CHIME simply cannot support the inclusion of metadata standards in the next notice of proposed rulemaking to support Meaningful Use Stage 2,” wrote Richard Correll, president and chief executive officer of CHIME, and Lynn Vogel, CHIME board chairman and chief information officer (CIO) at the University of Texas MD Anderson Cancer Center, in a letter to Department of Health and Human Services Secretary Kathleen Sebelius.

Metadata help information systems determine where data originated and how they have changed over time. They embed descriptive information about the meaning and use of data, so that health information remains associated with a patient across facilities, countries, and time without creating privacy issues. Metadata also are used in claims payment and medical review processes to ensure the authenticity and integrity of records, according to the American Health Information Management Association (AHIMA).

“The current health information technology [IT] environment is too premature to move forward in developing standards for metadata,” said Allison Viola, AHIMA director of federal relations, in a letter to the Office of the National Coordinator for Health IT (ONC). AHIMA said that methods for ensuring compliance with varying privacy laws and providing greater granularity in the data are not yet sufficiently mature to be mandated.

CHIME said that the industry has not yet reached consensus about header syntax or other metadata standards. As a result, “we do not believe that the Meaningful Use regulatory schema is the appropriate venue to mandate unproven standards or incomplete protocols,” wrote Correll and Vogel.

In support of the CHIME position, George Hickman, executive vice president and chief information officer at Albany Medical Center in New York, emphasized the importance of getting metadata right, “but to undertake an industry-wide pilot project that requires vendors to develop and providers to implement metadata standards is more than a stretch.”

ONC has rolled out two metadata pilot projects-Query Health and Data Segmentation-to increase understanding of the use of metadata in healthcare, but they are still in early stages. CHIME recommends that ONC develop these and other initiatives through existing channels of collaboration to ensure the standards and protocols are vetted thoroughly by industry experts and can be used across the HIT industry before they are required by regulation. AHIMA advised ONC to conduct additional demonstration programs to permit more thorough testing and evaluation that would allow the industry to explore the challenges of implementation.

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