The advancement of interoperable electronic health records in Minnesota depends on the capability of the various health information systems in Minnesota to exchange data seamlessly. Standards are a critical ingredient of this interoperability. Because the health care domain has many standards (~2100) to choose from, there needs to be a process for standardizing the standards. By standards harmonization and utilization of approved standards, the various information systems and software applications will have the ability to work together. For progress on interoperable electronic health records in Minnesota, it is critical to promote standards. Minnesota e-Health must keep track of activities and progress on standards at the national level.

The process of harmonization of standards is headed at the national level by the Health Information Technology Standards Panel (HITSP). The objective of HITSP is to achieve widely accepted and readily-implemented consensus-based standards that will enable and support widespread interoperability among healthcare software applications, as they will interact in a local, regional and national health information network for the United States. HITSP functions as a cooperative partnership between the public and private sectors, operating through a neutral and inclusive governance model with participation by experts from across the health care IT community.

An overview of the standards selection and approval process at HITSP:

• A particular scenario for harmonization of standards is chosen based on requests to HITSP and priorities of the American Health Information Community (AHIC).
• Description of this scenario is a “Use Case” which provides details on the interactions between the end user or another system to achieve a specific business goal.
• An agreed upon standards taxonomy is used to organize standards that support each major Use Case event and Tier 1 and Tier 2 Harmonization Readiness Criteria are applied to select standards for inclusion in the Interoperability specifications.
• Standards harmonized for a particular Use Case are presented as recommendations to the American Health Information Community (AHIC).
• AHIC approved standards need to be accepted by the U.S. Department of Health and Human Services (HHS) Secretary.
• These standards would be tested and implemented for a period of time with a possible recognition of the standards after that time frame.

The following table presents details of Use Cases, recommended standards, interoperability specifications and requirements, design and standards selection for selected scenarios.
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