Metadata standards that could be attached to patient-downloadable summary data from electronic health records is the subject of an August 5 advance notice of proposed rulemaking released by the Office of National Coordinator for Health Information Technology.

Metadata standards could become a part of the second stage of "meaningful use" requirements for care givers who participate in a federal incentive program for EHR adoption. The Health and Human Services Department stands to disburse up to $27.4 billion to encourage medical practitioners to implement EHRs in a meaningful way.

The advance notice outlines three proposed categories of metadata in a use-case scenario of patients seeking to obtain an electronic copy of their health information--although any metadata standards applied to that situation could also be applied to transfers of health information among facilities when a patient transfers from one care giver to another, the notice states.

The three categories are patient identity, including elements such as name and date of birth, etc.; provenance, including a digital identity certificate; and privacy, including elements such as applicable privacy policies for clinical information.

An underlying assumption, the advance notice says, is that the data would be encrypted during transit. These metadata standards would potentially increase the level of trust providers would place in electronically-transmitted health data, the advance rule states. The advance notice also appears to take for granted that patients would be able to download summary data from health care providers, something that the Veterans Affairs Department is also encouraging through a competition.

For more:
- download the metadata advanced notice of proposed rulemaking (.pdf)

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