NIST Intros Health IT Systems Test Framework

The suite of software tools released by the National Institute of Standards and Technology tests health information systems for compliance with existing standards.
As the nation's health care system establishes a non-proprietary health information exchange which adheres to national standards, the National Institute of Standards and Technology (NIST) this week released the first of four installments of a new health IT test method and related software.

Operating under the American Recovery and Reinvestment Act (ARRA) mandate, NIST and the Department of Health and Human Services (HHS) are collaborating with health IT system vendors, standards organizations, certification bodies, and system integrators to develop a suite of software tools to support the health IT testing infrastructure.

"The tools will assist vendors to test their health IT products and ensure basic functionality, such as the calculation of body mass index or proper formatting of common electronic health records in XML (eXtensible Markup Language)," NIST said in a statement on Wednesday.

The statement continued: "The health IT testing infrastructure does not create any new standards, only the tools necessary to test for compliance with existing standards that HHS announced late last year."

Bettijoyce Lide, NIST's senior advisor, program coordinator for Health IT, said the goal is to establish a health IT infrastructure that provides a high level of security to American's electronic medical records.

"New test methods, along with testing infrastructure, certification, security, and usability, help ensure that the health information of Americans is exchanged safely, securely, reliably, and only to appropriate sources," Lide said.

Among NIST's draft testing procedures, medical providers are asked to maintain an up-to-date list that will electronically record, modify, and retrieve information on a patient's medical problems, update and keep a history of his or her medications, and lists the patient's vital signs including, at a minimum, height, weight, blood pressure, temperature, and pulse.

The development of test and related software are part of the federal government's effort to provide every citizen with the use of an electronic medical record by 2014. Under provisions in the Recovery Act, medical professionals and hospitals participating in Medicare and Medicaid who appropriately use electronic medical records may be deemed meaningful users of health IT and may receive bonus payments under the Medicare and Medicaid electronic health record (EHR) incentive program.

There are three broad criteria for demonstrating one is a "meaningful user" of electronic medical records. These are:

  1. Meaningful use of certified EHR technology;
  2. information exchange; and
  3. reporting on measures using EHR

"NIST is leading the development of the core health IT testing infrastructure that will provide a scalable, multi-partner, automated, remote capability for real world, current, and future health IT testing needs, including robust conformance and interoperability testing capabilities," Lide said.

The issue of standards in health care information sharing surfaced earlier this week in The National Broadband Plan, a report published by the Federal Communications Commission. The document dedicated a chapter on how broadband infrastructure expansion can improve the quality of health information technology.

The report noted that the shift toward electronic medical records and their ability to update, store, share and analyze data can provide the medical profession with critical information that could lead to significant advancements in social medicine.

According to the report, coordinated standards and protocols can improve the healthcare system by increasing innovation and discovery within basic science research, clinical research, and public health research. "The analysis of combined genomic, clinical, and real-time physiological data (often captured wirelessly) could help researchers better understand the interplay of genetics and the environment. This could result in personalized interventions based on associations between people and their surroundings, leading to better outcomes," the report said.

A Health IT Standards and Testing website has been established here. For more on NIST's draft test procedures, click here.