NCVHS Logo The National Committee on Vital and Health Statistics The National Committee on Vital and Health Statistics
The Public Advisory Body to the Secretary of Health and Human Services
 

 

As advisory committee to the Secretary of the Department of Health and Human Services, the NCVHS accomplishments in FY 2004 include:

  • In a milestone decision, after several years of intensive deliberation, submitted a letter (November 2003) culminating response to all of the testimony and letters received, concluding that “it is in the best interests of the country as a whole that ICD-10-CM and ICD-10-PCS be adopted as HIPAA standards for national implementation.”   The Committee recommends that the Department initiate the regulatory process by issuing an NPRM for a structured and methodological analysis towards implementation.
  • The President named a National Coordinator for Health Information Technology in April 2004, consistent with recommendations of the NCVHS in its 2001 ground-breaking report on the National Health Information Infrastructure.
  • NCVHS was specifically identified in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) as responsible for making recommendations to the Secretary on e-prescribing standards in consultation with physicians and hospitals, pharmacists, state boards, electronic prescribing experts and other stakeholders.   Committee recognizes that a critical challenge will be assuring that e-prescribing standards can be successfully integrated into Medicare Part D implementation.
  • Submitted a letter of recommendations (September 2004) in response to requirements in MMA and a desire by the Secretary to accelerate the development, implementation, and pilot testing of e-prescribing standards.   To accomplish this, the Subcommittee held over 11 days of deliberations in an intensive hearing schedule from March to September 2004.  Hearings provided an overview of the “state of the art of e-prescribing,” e-prescribing standards, state and federal requirements, various perspectives, and messaging and terminology standards.  The Subcommittee heard from 65 testifiers and other industry experts, and, with the assistance of a consultant, developed a comprehensive document with recommendations in sixteen areas.   Recommendations on 14 additional areas will be made by March 2005, with several more hearings planned in late 2004 and early 2005.  The health industry has followed the hearings and development of recommendations closely and been highly complimentary of the collaborative and inclusive process orchestrated by the Subcommittee. 
  • Submitted a letter to the Secretary recommending a core set of specific Patient Medical Record Information (PMRI) terminologies (November 5, 2003).   This second set of recommendations will complement the 2002 recommendations made for PMRI Message Format Standards.  Adoption and use of standards for PMRI message formats and terminologies are important to facilitate higher quality and more efficient healthcare and delivery.  These recommendations have been adopted by the Department.
  • Endorsed standards for billing of supplies in a letter to the Secretary (June 17, 2004).  NCVHS recommends the continued use of the NCPDP Telecommunication Standards for billing of supplies that are consumed or used during, or as a consequence of, the administration of a drug therapy or commonly dispensed via a retail pharmacy channel. The Committee also recommends that the Department investigate this issue further, especially as it relates to possible overlaps in the use of NCPDP and X12 standards for the billing of certain supplies by pharmacies.  Adoption is expected.
  • Initiated a process to review and make recommendations on the final recommendations for clinical standards, as identified under the Consolidated Health Informatics (CHI) Initiative. NCVHS is working closely with CHI to study, select and recommend domain specific terminology standards.  As such, NCVHS submitted a letter to the Secretary (Sept 24, 2003) with recommendations for unit domain, lab result and demographic domain.  A subsequent letter (November 5, 2003) specified clinical standards for medications, immunizations, and interventions and procedures-- laboratory test order names, and further letters enumerated extensive lists of additional domain areas (January 29, 2004.   These recommendations are consistent with the Subcommittee’s statements on PMRI terminologies, and have been instrumental in the Department’s development of a timely and meaningful review process with the health industry.  These recommendations have been adopted.
  • Contributed to the successful implementation of the Administrative Transactions and Code Sets rules (effective October 16th, 2003), and addressed urgent issues that providers had about readiness and ability to comply with the rules.  Collaborated with DHHS agencies, providers, and stakeholders in justifying the need for contingency plans to accept non-compliant claims.  These recommendations have been adopted.
  • Continued to support HHS leadership in building the NHII in terms of priority setting and developing specific proposals for HHS oversight and coordination.   Representatives of the NHII Workgroup were instrumental in the design and orchestration of the Department’s first conference, on the topic, “Developing a National Action Agenda for NHII (June 30- July 2, 2003) and the second conference and Health Information Technology Summit on July 21-23, 2004).  The NHII Workgroup conducted an unprecedented open Workgroup meeting on the 3rd day of the 2004 Conference to facilitate communication among the hundreds of stakeholders in attendance.   In the joint summary session hosted by NCVHS, representatives from each of the topic tracks presented their groups’ recommendations. Connecting for Health, a public-private collaborative, provided an overview of their Preliminary Roadmap for Achieving Electronic Connectivity in Healthcare. The NCVHS NHII Workgroup discussed the strategies, recommendations, and roadmap; and identified next steps for activities and future hearings.
  • Submitted a letter to the Secretary recommending that the Department of Health and Human Services increase participation in federal interagency IT research (October 8, 2003) and development initiatives to advance an improved national networking information infrastructure.   This recommendation has been partially adopted.
  • Through the Subcommittee on Privacy, has continued exploring issues involving implementation of the Privacy rule as well as impact of the rule on collecting survey and research data (hearings held November 19-20, 2003 and February 3-4, 2004).    A letter to the Secretary (March 5, 2004 ) included recommendations to  expand  OCR education and outreach activities,  consider special circumstances such as schools and  nontraditional settings, and the need for clarity between the Privacy Rule and the Protection of Human Subjects Rule.
  • Through the Subcommittee on Privacy, submitted letters of recommendation based on hearings to obtain testimony on various aspects of  implementing the Privacy rule, specifically the effects on banking, law enforcement, and schools (hearings conducted February 18-19, 2004, letters dated June 17);  fundraising, marketing and the media (hearings July 14-15, 2004, letters for fundraising and marketing dated September 1).  The Committee also submitted a letter (September 1, 2004t) supporting the continued position of a DHHS privacy advocate, following the retirement of John Fanning, whose exemplar service was recognized..  OCR has created a new FAQ about disclosures to law enforcement, responding to a NCVHS recommendation.  This recommendation has been partially adopted.
  • Through the Populations Subcommittee, prepared a letter (January 29, 2004) to the Director of the National Institute for Child Health and Human Development (NIH) recommending a population health approach in the large comprehensive study, analysis of behavioral, social and economic factors, and encouraging a plan for public data use.
  • Through the Populations Subcommittee, prepared a letter recommending specialized surveys to  collect health data on population subgroups, and another recommending the collection of racial/ethnic data by health plans  (September 26, 2003).   These efforts are intended to encourage progress towards the national goal of eliminating racial and ethnic disparities.
  • Through the Quality Workgroup, approved “candidate recommendations” in a report:  “Measuring the Quality of Health Care:  Obstacles and Opportunities” (May 2004).   The report summarizes the testimony on data issues in quality measurement presented to the Committee by 16 panels at nine meetings between 1998 and 2002, and offers recommendations to improve the information available for health care quality.
  • Through the Quality Workgroup, received testimony about the feasibility of the “candidate recommendations” from Quality measurement organizations, purchaser stakeholders, providers and health plans  (June 2004) and from organizations that are directly involved in developing and implementing administrative transactions  (September 2004). The speakers in the latter hearing provided overviews of their organizations, their roles and duties in the transaction processes, as well as their inter-relationships with each other. Their testimonies have been posted on the NCVHS homepage, and were distributed to the Full Committee as a ready reference to such organizations as NUBC, NUCC, CPT, AHIMA, ANSI X12, HL-7, as well as the National Quality Forum.
  • Through the Quality Workgroup moved Candidate Recommendation #3 to full status, since testimony indicates that Discharge Diagnosis Indicator (changed from "modifier"), is currently being considered by key groups and this item is somewhat time sensitive. Candidate recommendation #3 “Facilitate the reporting of a diagnosis modifier to flag diagnoses that were present on admission on secondary diagnosis fields in all inpatient claims transactions” was universally sought by the purchasers of care, endorsed by the providers and is poised for implementation by the Designated Standards Maintenance Organizations.  Endorsement by the Department at this time could be effective in moving forward this standard.
  • NCVHS continues to support NCHS programs and activities, and through liaison with the BSC has a complementary function of fulfilling its own departmental mandate while maintaining alliance with NCHS objectives.  Concerns include need for sufficient appropriations for the Center, need for continued and consistent recognition of NCHS as the premiere federal statistical agency on health, and potential impact of the CDC Future’s  Initiative on NCHS management and operational decisions.  Collaborative projects are being planned for the next several years, with a meeting of the executive/core groups in 2005 to plan a joint meeting of both Committees in 2006.
  • Submitted a letter to the Secretary (February 28, 2003) expressing concern about the inability of NCHS to fully support its data systems, which are the backbone of the nation’s health statistics system.  This recommendation was adopted as reflected in the significant budget increase to the Center to support its programs.

Return to Top