The HIT Policy Committee and its Meaningful Use Working Group will be defining meaningful use very soon. Although I have no inside knowledge of what meaningful use will be, I think it will likely include several elements of health information exchange.

To me, health information exchange is three things

1. Policies for exchange which protect confidentiality, ensure compliance with regulations, and meet the service expectations of stakeholders.

2. Workflow which supports the business processes of payers, providers and patients.

3. A technical architecture which implements the workflow.

To achieve meaningfully useful health information exchange, Massachusetts has recently convened three committees under the auspices of the Eastern Massachusetts Healthcare Initiative. During May and June, we'll complete meetings of our Policy Committee, the Workflow Committee and the Architecture Committee which will take our existing health information exchanges to the next level.

I'm an active participant in these activities and want to share our work in progress with you.

Policy Committee - we're working through complex issues of consent, liability, service levels, and the division of responsibility between the health information exchange and local organizations sending/receiving data. Last Friday, we discussed these issues in detail. Here's the powerpoint outlining the issues and the draft policy for health information exchange we have developed thus far, based on our experience with NEHEN.

Workflow Committee - There are several high priority workflows among our stakeholders including clinical summary exchange, referral management, admission notification, results exchange, and quality reporting. Here's an overview of our workflow activities in progress.

Architecture Committee - In Massachusetts, we've tended to implement a service oriented architecture using CAQH Core Phase II common data transport and XML constructs such as CCD. I'll post the details of our implementation guides when they are complete.

With sound policies, prioritized workflow, and a single architecture including content, vocabulary, and secure transmission standards, Massachusetts will be "shovel ready" for health information exchange supporting meaningful use by this Summer.

John Halamka, MD, blogs regularly at Life As a Healthcare CIO.