The following are my observations on a meeting to form a task group to
accelerate the development of Computer-based Patient Records and the
sharing of these records across various hospitals/health care providers:
Date: 10 January 1994
From: L. J. Rheaume
Subject: Trip Report: Computer-Based Patient Record Institute (CPRI)
meeting to discuss Healthcare Informatics Standards, 7 January 1994
Luke J. Rheaume: Member of the Technical Staff, MITRE Department G044,
Network Technology Systems; Vice-Chair of ASTM Committee E-31 on
To participate in a CPRI meeting for the purpose of discussing its concept
of a National Task Force to Complete Standards Requirements Necessary to
Support the Computer-based Patient Record. This meeting was held at the
Hyatt Regency Crystal City, 2799 Jefferson Davis Highway, Arlington, VA
22202 on 7 January 1994 from 10:00 to 16:00.
Due to weather related flight cancellations and delays, I arrived at the
meetings at 11:00, one hour into the meeting. I received handouts (Contact
CPRI - Address Below) identifying the attendees, the CPRI Sponsors, a Task
Force Concept Document, and information about the next meetings.
CPRI has proposed a three phased approach to create and put into use
standards for Computer-based Patient Records.
1. An Accelerated Standards Development Period: A one year period during
which a group of specialist (paid by the project) would takeover and write
the standards documents (now being developed by various standards groups:
HISPP, ASTM, HL7, ACR/NEMA, ASC X12, IEEE MEDEX/MIB, NCPDP,...). Upon
completion of the documents, the document would be approved by the group
that was writing it and then submitted for ANSI approval.
2. A Prototyping Period: Two years during which a number of prototypes,
based upon the standards developed in phase 1 would be implemented and
3. A Selected Site Test Period: Several years during which the prototypes
and projects developed by phases 1 and 2 would be tested in a working
environment across several health care facilities/groups where the
capabilities of sharing the patient information in different systems would
At 12:00, a luncheon was held during which the meeting and the concept were
At 13:00, there were a number of Facilitated Discussion meetings held
(five groups of 20-25 persons). The purpose these discussions was to give
a first response to the Concept Document and proposal made during the
morning presentations. The groups may have been a bit too large to get
more than general feelings about the proposal.
At 14:20, attendees were all gathered to report on the discussions of the
groups. The Reports of the groups were varied, however in general they
% There needs to be standards in this area.
% The Scope of the Task Force needs to be better defined. What is being
standardized? The contents of the patient record; the functionality of
accessing the patient record; the transfer of the patient record or a
subset of its data to a care provider/payee/researcher.
% There needs to be a concept of how the system will work.
% Security of the information: is it valid information, how is it
protected, who has access to the information
% There needs to be a national recognition of the need for the system.
The need for medical informatics system legislation is not a goal of the
% There should be a set of tools to use the standards that are replaced by
efficient products in the market place.
% The task does not end with phase 3, but continues.
% Phases 2 & 3 should begin at the same time as phase 1, allowing for
input to phase 1.
At 15:20, based upon the input of the meeting, a summary of the meeting was
presented. A modified concept document would be generated and another
meeting of the task force was scheduled for 3 February to discuss the
proposal prior to the ANSI HISPP (Healthcare Informatics Standards Planing
The next meeting scheduled by CPRI to discuss the acceleration of Medical
Informatics Standards Development is scheduled for February 3, the day
before the next scheduled HISPP meeting.
Luke J. Rheaume
Member of the Technical Staff
Network Technology Systems
CPRI may be contacted through the following:
Margret Amatayakul, MBA, RRA
Computer Based Records Institute
919 N. Michigan Ave., Suite 1400
Chicago IL 60611-1683
InterNet: margret at ahima.mhs.compuserve.com
Standard Disclaimer Applies: These are my opinions, not my employers.
Luke J. Rheaume, Technical Staff, Department G044, ms K319
The MITRE Corporation, 202 Burlington Rd., Bedford, MA 01730-1420
Voice: (617)271-7001, FAX: (617)271-2423, E-Mail: ljr at mitre.org
hope some of this is helpful,
steve langer sglanger at vela.acs.oakland.edu
"You need only reflect that one of the best ways to get yourself a
reputation as a dangerous citizen these days is to go about repeating the
very phrases which our founding fathers used in the struggle for
independence." - C.A. Beard