The EHR Association’s Code of Conduct's Impact on Healthcare IT

Brien Posey, Freelance Writer and Former CIO | 7/11/2013 | 8 comments

Brien Posey
Earlier this month, the HIMSS EHR association released a code of conduct for its members. The HIMSS EHR code of conduct is targeted toward developers within the association, but it is up to each member organization to adopt and implement the code of conduct as they see fit.

As such, this new code of conduct does not come from the government and was not intended as a way of further regulating healthcare provider organizations. Even so, the code of conduct could have a positive, but unintentional, impact on healthcare IT.

There isn’t really a single rule in the code of conduct that has the power to radically transform IT. However, there are a number of different rules that could potentially result in small, but important changes to the way that healthcare IT operates.

One aspect of day-to-day IT operations that could change as a result of the code of conduct is patch management. Many IT shops like to spend significant time testing patches. However, the code of conduct states that “we will notify our customers should we identify or become aware of a software issue that could materially affect patient safety and offer solutions.” If an EHR vendor notifies a healthcare facility of an issue that could have a direct impact on patient safety, then a healthcare provider knowingly jeopardizes patient safety if they choose not to deploy the patch or if they spend an excessive amount of time testing the patch.

That being the case, some organizations will likely have to rewrite their patch management policies to allow for expedited testing of patches that are specifically designed to address patient safety issues.

Another area in which the code of conduct could potentially impact healthcare IT is in the documentation and reporting of IT-related patient safety events. The code of conduct specifically states that “We will participate with one or more Patient Safety Organizations (PSOs) (and / or other recognized bodies) in reporting, review, and analysis of health IT related patient safety events”.

It is going to be really interesting to see how this particular rule from the code of conduct plays out in practice. The rule implies that EHR vendors could potentially share responsibility for IT-related patient safety events with the provider’s IT department. The rule also states that the vendor will be involved in reporting such incidents, which implies that EHR vendors may be working a lot more closely with healthcare IT than they do today. I think that for right now, establishing responsibility for patient safety incidents is a bit of a grey area, but regulations will no doubt be amended in the future to address vendor involvement.

Most of the rules in the code of conduct relate to the adherence of accepted standards. EHR standardization should eventually lead to universal portability for patient health records.

One of the most interesting aspects of the policy however, is a rule stating that vendors must provide customers with a mechanism for exporting patient data in a standardized format. Such a feature will make it vastly easier for healthcare providers to switch from one EHR system to another. In the past, some providers have expressed frustration with sub par EHR products that store patient data in a proprietary format, making it difficult to replace the product with another vendor’s product. The use of open standards and a universal data export mechanism should make migrating to a competing vendor’s product a lot more practical.

Although the EHR code of conduct is targeted toward developers, it will be healthcare providers who truly benefit from the code. The code should eventually lead to standards based systems, and universal patient health data portability. Of course, it may also mean you’ve got to get faster managing patches, but once you adjust, it will only make you more efficient.

View Comments: Newest First | Oldest First | Threaded View
SunitaT   The EHR Association’s Code of Conduct's Impact on Healthcare IT   7/27/2013 10:41:21 AM
Re : The EHR Association’s Code of Conduct's Impact on Healthcare IT
Though the EHR Association's Code of Conduct was written with software developers in mind, the principles laid out also give hospitals and other healthcare establishments a good idea of some of the key things to look for when evaluating EHR vendors. The document, which the EHR Association said advance safe care delivery via health IT, covers areas like business practices, patient safety and data sharing.
Susan Nunziata   The EHR Association’s Code of Conduct's Impact on Healthcare IT   7/16/2013 10:11:49 PM
Re: Good News
@Dave: not to mention job security. let's hope nobody's career falls as a result of the choices they were forced to make before standards were solidified.
David Wagner   The EHR Association’s Code of Conduct's Impact on Healthcare IT   7/12/2013 5:56:20 PM
Re: Good News
@Susan- Unfortunately this problem already existed and CIOs couldn't wait. The incentives for adopting EHR (not to mention the penalties if you didn't) have made CIOs make choices, some of which will undoubtedly be wrong. I wonder where the subsidies will be if they are forced to change.
Susan Nunziata   The EHR Association’s Code of Conduct's Impact on Healthcare IT   7/12/2013 3:04:13 PM
Re: Good News
@David: this creates a true challenge for the IT organizations then. How do you decide which technology to align with if you're not sure which one will emerge as the standards winner? 

do you think this could have a chilling effect on technology decision-making and buying in healthcare until the standards are finalized?
David Wagner   The EHR Association’s Code of Conduct's Impact on Healthcare IT   7/12/2013 2:51:42 PM
Re: Good News
@Susan- I don't think it will take that long to agree on the standard, but there's goign to be a few people who pull out of the association when they "lose" the battle. And so there are goign to be people stuck in the wrong standard for a while.
Susan Nunziata   The EHR Association’s Code of Conduct's Impact on Healthcare IT   7/12/2013 2:40:44 PM
Re: Good News
@Dave, @Brien: This!-- One of the most interesting aspects of the policy however, is a rule stating that vendors must provide customers with a mechanism for exporting patient data in a standardized format.

it is a HUGE step forward, although it will make life more difficult for vendors and customers like. In the long run standardization is a must. How long do you think it will take for this standard to become reality? 

Zaius   The EHR Association’s Code of Conduct's Impact on Healthcare IT   7/11/2013 3:56:12 PM
Re: Good News
I see, the IT people need to have good ears. Listening to the customer requirement will not be enough any more. In addition to that, IT needs to be vigilant about the codes that their customers are bound to follow. With every change in codes, IT should follow up.
David Wagner   The EHR Association’s Code of Conduct's Impact on Healthcare IT   7/11/2013 11:49:24 AM
Good News
I am so happy this is happening. Setting a standard for data is going to be very helpful. But more than anything, I'm just happy these guys are getting together. It probably means more cooperation and more standards as we go forward.

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