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National Committee on Vital and Health Statistics
2000 Accomplishments
The National Center for Health Statistics (Data Policy and Standards Staff)
serves as Executive Secretary to the National Committee on Vital and Health
Statistics (NCVHS), the advisory committee to the Secretary of the Department
of Health and Human Services on health information policy. The NCVHS
accomplishments in 2000 include:
- Submitted the third annual report to Congress on Implementation of the
Administrative Simplification Provisions of the Health Insurance Portability
and Accountability Act of 1996 (HIPAA). These annual reports by the Committee
are required by the HIPAA legislation. (Submitted March 27, 2000)
- Continued to maintain close liaison with the HHS Data Council and the
HIPAA departmental implementation teams in developing and carrying out the
Committees work plan.
- Finalized a report prepared by the Subcommittee on Populations on review
of Medicaid managed care data issues. The report, which includes findings and
recommendations on data collection, analyses and reporting for Medicaid managed
care organizations, was transmitted to the Secretary and the HHS Data Council,
as well as to HCFA, for review.
- Finalized a report prepared by the Subcommittee on Populations with
recommendations on health data needs and issues in the U.S.- associated insular
areas. The report, Health Data Needs of the Pacific Insular Areas, Puerto
Rico and the U.S. Virgin Islands was transmitted to the Secretary and HHS
Data Council.
- Completed and approved a report on NCVHS activities during 1999 which was
incorporated into the report on NCVHS at Fifty for the June 20, 2000
Anniversary Symposium.
- Celebrated its fiftieth anniversary with a Symposium featuring interim
reports prepared by the Workgroup on 21st Century Health Statistics and the
Workgroup on National Health Information Infrastructure. In addition to
presenting the reports with reactor panelists, the Symposium included remarks
by the Secretary, Data Council co-chair, and former NCVHS chairs, discussing
the historical accomplishments of the Committee and future challenges.
- Developed the interim report Shaping a Vision for 21st Century
Health Statistics which identifies trends and gaps in shaping the vision,
as well as cross-cutting issues encompassing population health and health
statistics data systems at local, state, and national levels. Ten principles
have emerged as essential qualities to developing the health statistics vision.
This is a collaborative project with the National Center for Health Statistics
and the HHS Data Council.
- Developed the interim report Toward a National Health Information
Infrastructure (NHII), which explores the concept of a framework that can
link health improvements and information technologies. Three
dimensions of the NHIIthe personal health dimension, the
health care provider dimension, and the community health
dimensionrepresent virtual information spaces and illustrate the ways in
which content, functions, users, and requirements overlap.
- Distributed the interim reports at NCHS Data Users Conference (July
26-28, 2000), as well as at other health data meetings throughout the year.
Earlier in the year, both projects were presented at the conference,
Partnership for Health in the New MillenniumLaunching Healthy
People 2010".
- Briefed CDC Director on issues presented in the interim reports in a
special session for senior CDC staff (October 5, 2000).
- Organized a series of national hearings (in Chicago, IL; San Francisco,
CA; Raleigh/Durham NC; Washington, D.C. ) seeking input about the interim
reports via panels of presenters as well as written and oral testimony.
Workgroups also sought reactions to specific issues, for example local, state,
and national health data needs, private and public sector cooperation, barriers
(e.g. financial or technical) to accomplishing objectives described in the
reports, confidentiality and privacy issues, and methodology and
technology-related issues. Information obtained will be included in final
reports expected to be completed in 2001.
- Completed a report, Uniform Data Standards for Patient Medical
Record Information (PMRI), through the 2-year-long effort of the
Computer-based Patient Record Workgroup. Activity included six hearings to
receive testimony from a wide range of data collectors, users and standards
organizations. The report discusses the needs for PMRI standards, explores
impediments to the development and implementation of PMRI standards, and
proposes recommendations to address these impediments. After submitting the
report to the Secretary on July 12, 2000, the NCVHS and Workgroup Chairs
presented it to the HHS Data Council (August 9).
- Provided consultation to representative from GAO to share insight about
CPR and quality of care. Subsequently, NCVHS received an update about
Government Computer-based Patient Record (GCPR) from
representatives of Framework Project Management Team (Sept 20, 2000.)
- Provided detailed comments and suggestions on the Notice of Proposed
Rulemaking (NPRM) on Standards for Privacy of Individually Identifiable Health
Information (2/2000). The Committee congratulated the Department for the solid
work done in drafting the NPRM and acknowledged that many of its 1997
recommendations on health information privacy had been incorporated into the
proposed role. The NCVHS further noted that there still is a need for anti-
discrimination legislation as well as comprehensive federal legislation to
cover all records or all entities with access to individually identifiable
health information.
- Facilitated the signatories for a Memorandum of Understanding Among
Organizations Designated to Manage the Maintenance of the Transaction Standards
Adopted Under HIPAA in an unprecedented display of solidarity (3/2000).
- Received testimony through hearings on tracking implementation of HIPAA,
including security implementation, enforcement, data content and local code
sets. Submitted a letter to the Secretary providing advice and recommendations.
- Held a hearing on electronic signatures and digital signatures and their
uses in health care applications. The Subcommittee on Standards and Security
will be conducting further study before formulating recommendations to the
Department regarding this HIPAA standard.
- Held a hearing on Internet use for health information and the privacy
implications, with presentations received from a variety of Internet-based
organizations, health care groups, academic resources, and the American Medical
Association.
- Received a briefing on best practices of Institutional Review Boards, as
detailed in an Institute of Medicine (IOM) report: Institutional Review Boards:
Health Services Research Data Privacy Protection. Also received a briefing on
the IOM report on patient safety in hospital care, To Err is
HumanBuilding a Safer Health System.
- Heard from a panel organized by the Subcommittee on Privacy and
Confidentiality on Analysis of State Privacy Laws, and reviewed a draft of the
proposed revisions of the Uniform Health Care Information Act.
- Received briefings on Departmental initiatives including the evaluation
plan for the State Childrens Health Insurance Program, and Eliminating
Disparities and Leading Indicators Initiatives.
- Participated in a series of regional discussions groups involving state
and local officials as well as health data producers and users in Harrisburg,
Pennsylvania, Albuquerque, New Mexico, and New Orleans, Louisiana, to elicit a
broad range of expert opinion on the major trends and issues in population
health and their implications for future health information needs. All of these
activities provided input to the interim report presented at NCVHS 50th
Anniversary Symposium.
- Has been exploring the feasibility of including a data element on
functional status in health administrative (encounter) records. Specifically,
the Subcommittee on Populations has been studying the possible use of the
International Classification of Impairments, Disabilities and Handicaps
(ICIDH-2), which is undergoing an international revision, as a system for
coding such data. During the course of this year the Subcommittee has been
hearing testimony and obtaining input on the ICIDH-2 from a variety of sources:
data users, professional associations, such as APTA and AOTA, advocates for
various groups of persons with disabilities, the World Health Organization,
etc.
- Commented on revision process of ICIDH as proposed by the World Health
Organization in letter to the Secretary (Oct 3, 2000).
- Received a briefing from the NCHS Director on NCHS activities, the
Interagency Working Group on Summary Measures of Health, and the ECE-WHO Joint
Meeting on Health Statistics.
- Held a panel presentation on Summary Measures of Population Health. The
session addressed the various purposes for using summary health measures, the
different measures that are proposed or in use, their implications for health
information system development, the major methodological issues under study and
plans to use summary health measures in the U.S. and internationally. The
Committee is considering further exploration of this topic.
- Continues to follow the activities of the Public Health Data Standards
Consortium, which was established in response to a consensus recommendation at
the 1998 Workshop on Implications of the Administrative Simplification
Provisions of HIPAA for Public Health and Health Services Research. The
Consortium is serving as a mechanism for ongoing representation of public
health and health services research interests in HIPAA implementation and other
data standards setting processes.
- Initiated a strategic planning process at an Executive Subcommittee
retreat in August.
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