Federal officials should follow 10 guidelines as they write rules for healthcare IT adoption, according to members of an HIT Standards Committee workgroup.

At a Thursday meeting of the HIT Standards Committee, Judy Murphy, a representative of Aurora Health and member of the HIT Standards Committee Implementation workgroup, said the feedback received from providers, vendors and other stakeholders on how to promote healthcare IT adoption could best be summed up as follows:

1. Start small and simple.

2. Don't let perfection be the enemy of 'good enough.'

3. Keep cost as low as possible by eliminating royalties, licensing fees and other expenses.

4. Make adoption easy for providers from small practices.

5. Don't try to create a one-size-fits-all system that adds burden and complexity.

6. Separate content and transmission standards.

7. Create publicly available vocabularies and code sets that can be easily downloaded.

8. Leverage standards that already work on the Internet.

9. Position quality measures so they motivate standards adoption and strive for the automation of quality reporting.

10. Support the implementation. – give HIT adopters readable guides and open-source reference implementations.

John Halamka, vice chairman of the HIT Standards Committee, said the group will recommend these guidelines to federal officials who are writing rules for adoption and use them as a rubric as the group works on more recommendations.

The Centers for Medicare and Medicaid Services, with advice from the Office of the National Coordinator for Health Information Technology, is expected to issue a rule by the end of December, according to Jodi Daniel, director of the ONC's Office of Policy and Research. That rule will include a definition of 'meaningful use' to which providers must adhere if they want to receive federal incentive bonuses starting in 2011.

Halamka said he expects many comments in the 30 days allotted after the rule is published. He said the HIT Standards Committee should use his group's guidelines to create recommendations for the government on how to implement the comments.

At the Thursday meeting, the group also discussed privacy and security. Several panel members voiced their concern on the need for privacy.

"If patients don't trust the records, none of this will work," said Anne Castro, from Blue Cross Blue Shield of South Carolina.

Dixie Baker, from the Science Applications International Corporation, said trust in the privacy and security of electronic health records is "the essential enabler in everything we do."