Daily Rules, Proposed Rules, and Notices of the Federal Government
On December 8, 2010, the President's Council of Advisors on Science and Technology (PCAST) released an important new report entitled “Realizing the Full Potential of Health Information Technology To Improve Healthcare for Americans: The Path Forward” (the PCAST Report). (The full report is available at
ONC seeks comment on the questions below. Comments on other aspects of the PCAST report are also welcome.
1. What standards, implementation specifications, certification criteria, and certification processes for electronic health record (EHR) technology and other HIT would be required to implement the following specific recommendations from the PCAST report:
a. That ONC establish minimal standards for the metadata associated with tagged data elements;
b. That ONC facilitate the rapid mapping of existing semantic taxonomies into tagged data elements;
c. That certification of EHR technology and other HIT should focus on interoperability with reference implementations developed by ONC.
2. What processes and approaches would facilitate the rapid development
3. Given currently implemented information technology (IT) architectures and enterprises, what challenges will the industry face with respect to transitioning to the approach discussed in the PCAST report?
a. Given currently implemented provider workflows, what are some challenges to populating the metadata that may be necessary to implement the approach discussed in the PCAST report?
b. Alternatively, what are proposed solutions, or best practices from other industries, that could be leveraged to expedite these transitions?
4. What technological developments and policy actions would be required to assure the privacy and security of health data in a national infrastructure for HIT that embodies the PCAST vision and recommendations?
5. How might a system of Data Element Access Services (DEAS), as described in the report, be established, and what role should the Federal government assume in the oversight and/or governance of such a system?
6. How might ONC best integrate the changes envisioned by the PCAST report into its work in preparation for Stage 2 of Meaningful Use?
7. What are the implications of the PCAST report on HIT programs and activities, specifically, health information exchange and Federal agency activities, and how could ONC address those implications?
8. Are there lessons learned regarding metadata tagging in other industries that ONC should be aware of?
9. Are there lessons learned from initiatives to establish information-sharing languages (“universal languages”) in other sectors?