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White House Group Pushes XML for Health IT

The U.S. government can spur the adoption of health IT by promoting open standards and XML, a new report from a group of presidential advisers recommends.

The Office of the National Coordinator for Health Information Technology and the Centers for Medicare and Medicaid Services, both part of the U.S. Department of Health and Human Services, should develop guidelines for the exchange language, which could integrate with existing electronic health records (EHRs), said the report, from the President's Council of Advisors on Science and Technology (PCAST).

An XML-based approach would allow health IT to expand beyond EHRs, largely used in individual doctors' offices, to a more widespread use across the health-care industry, members of PCAST and President Barack Obama's administration said Wednesday.

Many existing EHRs are complicated for doctors to use and are not interoperable, "so that data cannot easily be shared or aggregated across organizations," the report said.

An expanded use of IT in the treatment of patients will help prevent medical and prescription errors and cut down on the number of redundant tests doctors give patients, said Lawrence Summers, assistant to Obama for economic policy. "There is no good reason why the average 7-Eleven uses more information technology than the average doctor's office," he said during an event to announce the release of the report. "It is wrong, and it is costly."

The XML-based system wouldn't require doctors to replace their existing EHR systems, said Eric Lander, co-chairman of PCAST. It could ride on top of existing systems for now and vendors could more fully integrate the XML when they make updates to their EHR packages, he said.

Using XML tags on data would also allow granular privacy protections for data, added Lander, president of the Broad Institute at Harvard University and the Massachusetts Institute of Technology. Patients or health-care providers could tag one piece of data in a health record for more privacy protections than other data, he said.

EHR adoption rates in U.S. doctors' offices were 36.1 percent in early 2010, according to a study by health IT company SK&A. Just over 50 percent of hospital-owned health-care sites used EHRs, that study said.

Two years ago, just two of every 10 doctors and one of every 10 hospitals used EHRs, said Kathleen Sebelius, HHS secretary. Health IT will protect patient privacy and improve the quality of health care, she added.

"When electronic health records are designed and implemented correctly, they are a powerful force for reducing errors, lowering costs and increasing both provider and patient satisfaction," Sebelius said. "I still haven't met a single doctor who says, 'I really want to go back to those days when I had those great paper files.'"

The PCAST report also recommends that HHS move quickly to define so-called meaningful use of EHRs by health-care providers. Starting in 2011, health-care providers can get incentive payments from the U.S. government of up to US$44,000 over five years for demonstrating meaningful use of EHRs.

The report also called on the Medicare and Medicaid programs to move faster in their efforts to update their IT infrastructure.

Eric Schmidt, CEO of Google, and Craig Mundie, chief research and strategy officer at Microsoft, are among the members of PCAST.

Grant Gross covers technology and telecom policy in the U.S. government for The IDG News Service. Follow Grant on Twitter at GrantGross. Grant's e-mail address is grant_gross@idg.com.

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