You Have to Play to Win

By Margaret Dittloff, MS, RD

Chair, Nutrition Informatics Sub-Committee on Interoperability and Standards

Who is going to come out a winner in the rapidly evolving world of health care technology and standards—the vendors, the clinicians, or the patients? Ideally we all come out winners. When health care information is shared among consulting clinicians, and between patients, authorized patient advocates, and clinicians, we can improve health care outcomes, safety, and efficiency, and help slow the rising costs of health care. But we have to find the best ways to foster that communication, using a common language and process that everyone can understand.

Here is where we enter the world of consensus-driven standards development for health care interoperability. We all know that getting agreement from a group of people, even when they share a common goal, sometimes is quite challenging. But that is what happens multiple times a year when new or modified standards for the exchange, management, and integration of electronic health care information produced by Health Level Seven International (HL7), a standards development organization, are balloted.

The ballot process involves review of proposed standards and implementation guides, and provides a process to submit detailed comments and vote on the standards. A number of key items will appear on the May 2012 HL7 ballot, which got underway a few weeks ago, including the second iteration of the Nutrition and Diet Orders Domain Analysis Model, produced in collaboration with Academy of Nutrition and Dietetics members. This is a high-level conceptual information model that will form the foundation of future work toward standardizing diets and the electronic exchange of diet order information. I will post additional information on how you can access the Nutrition Orders Information Model and provide your feedback for that ballot.

Meanwhile, other standards also are on the May ballot that members of the Nutrition Informatics Committee, the Sub-Committee on Interoperability and Standards, and the Nutrition Care Process/Standardized Language Committee are reviewing for comment on behalf of the Academy, such as the EHR-S Functional Model and Care Provision Record Topics, including Care Transfer and the Clinical Document Architecture (CDA) Implementation Guide for a Quality Reporting Document Architecture, which is a document format that will provide standard structure that organizations can/will use to report quality measure data as part of Meaningful Use EHR requirements going forward.

That is just a sampling of the ongoing standards work. Even where these standards do not immediately impact nutrition, it is important that we stay involved and voice our opinions. Standards development needs input from experts practicing in the field. HL7 recognizes this, and you can find out more in this recent article in Healthcare IT News. If you would like to get involved in standards development, you will find many opportunities available to participate as a volunteer in work groups and as a subject matter expert on task forces. Let us know if you would like to volunteer by participating in discussions with members in the Nutrition Informatics Community or e-mail us at Nutritioninformatics@eatright.org. I think of it a little like “the lottery”—you have to play to win!