XML the Rx for sharing health data, panel says

White House report says HHS should facilitate universal exchange language for health IT

Extensible Markup Language, which has a long track record of facilitating interoperability among systems, should become the basis for health IT as well, a White House advisory group says.

The Health and Human Services Department should help develop and promote a universal exchange language and infrastructure for patient health care information that would more readily enable the data to flow between disparate systems, according to a new report from the President’s Council of Advisors on Science and Technology.

Current electronic health care record systems are based on proprietary technologies, which make sharing difficult. XML would facilitate a new level of sharing, with metadata and common data elements that can be tagged with privacy and security restrictions, according to the Dec. 8 report, titled “Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans: The Path Forward.”

The universal language would be used by physicians, hospitals, researchers and public and private agencies to facilitate information sharing, states the 108-page report. The report calls on HHS’ Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health Information Technology to develop guidelines to spur adoption of the universal exchange language that allows for transfer of patient health data while protecting privacy.

The advisory committee said XML has proved to be useful in creating the necessary infrastructure and exchange language, but has not been adopted for health care data. “Since the development of those systems is not likely to be a profitable venture in itself, the federal government should facilitate their creation and then leave the private sector to develop products that build on them,” the report recommends.

Under the new exchange system, patient data would be divided into small individual pieces, which are tagged for attributes, provenance, and required security and privacy provisions. This allows for a more sophisticated model for data exchange and for protection of privacy, the committee said.

“A key advantage of the tagged data element approach is that it allows a more sophisticated privacy model — one in which privacy rules, policies and applicable patient preferences are innately bound to each separate tagged data element and are enforced both by technology and by law. For example, a patient with diabetes may decide that her blood sugar information should be available to any of her doctors and to emergency physicians requesting that information should she have a problem while traveling in another state — but that details about her past treatment for cancer should remain private and not be shared,” the committee said in the news release.

Also, the report states that physicians would not have to replace existing electronic record systems, which can be made to conform to the new exchange model with the addition of software.

The new system does not require a patient identifier number or a central database of patient data, the committee’s report said.

About the Author

Alice Lipowicz is a staff writer covering government 2.0, homeland security and other IT policies for Federal Computer Week.

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