Institute of Electrica

chapter 13

Healthcare Data Standards

Standards are critical components in the development and implementation of an electronic health record (EHR).

The effectiveness of healthcare delivery is dependent on the ability of clinicians to access critical health information when and where it is needed.

Standards can be further categorized:

Those that support the generic infrastructure and are not domain-specific

Support the exchange of information and are domain-specific

Support activities and practices within a specific domain

Healthcare is fundamentally a process of communication

The term data standards is generally used to describe those standards having to do with the structure and content of health information.

Healthcare Data Interchange StandardsData interchange standards address, primarily, the format of messages that are exchanged between computer systems, document architecture, clinical templates, user interface, and patient data linked.

It is necessary to have prior agreement on the syntax of the messages to be exchanged.

Message Format StandardsFour broad classes of message format standards have emerged in the healthcare sector:Medical device communicationsDigital imaging communicationsAdministrative data exchangeClinical data exchange

NCVHS was called on to study the issues related to the adoption of uniform data standards for patient medical record information (PMRI) and the electronic exchange of such information.

Institute of Electrical and Electronic EngineersHas developed a series of standards known collectively as P1073 Medical Information Bus (MIB), which support real-time, continuous, and comprehensive capture and communication of data from bedside medical devices.

802.11- most widely known standard and commonly referred to as Wi-Fi, allows to connect to the Internet wirelessly through a myriad access points installed.

Many healthcare organizations are currently evaluating and implementing wireless solutions that support point-of-care technology.

National Electrical Manufacturers AssociationIn collaboration with the American College of Radiologists(ACR) and others, the NEMA formed the DICOM to develop a generic digital format and a transfer protocol for biomedical images and image-related information.

DICOM standard is the dominant international data interchange message format in biomedical imaging.

Accredited Standards Committee X12N/InsuranceDeveloped a broad range of electronic data interchange (EDI) standards to facilitate electronic business transactions.

X12N standards have been adopted as national standards for such administrative transaction as claims, enrollment, and eligibility in health plans, and first report of injury under the requirements of the HIPAA.

The policies for protection of personal health information from country to country are primarily used in the United States due to the uniqueness of health insurance.

Standards Coordination EffortsIt has become clear to both public and private sector standards development efforts that no one entity has the resources to create an exhaustive set of health data standards that will meet all needs.

International Organization of StandardizationISO is an organization that develops and publishes standards internationally.

Developed from standards brought forth by member countries, and through liaison activities with other SDOs.

European Technical Committee for StandardizationCEN TC 251 works to develop a wide variety of standards in the area of healthcare data management and interchange.

CEN standards are adopted by its member countries in Europe and are also submitted for development into ISO standards.

American National Standards InstituteANSI serves as the coordinator for voluntary standards activity in the U.S.

1991- the ANSI Healthcare Informatics Standards Planning Panel was convened to act as a coordinating forum for both SDOs and other stakeholders in the area of health information standards.

Object Management GroupOMG is an international consortium of over 800 organizations, primarily for-profit vendors of information systems technology, who are interested in the development of standards based on object-oriented technologies.

Health Insurance Portability and Accountability ActAdministrative overhead includes:Tasks as enrolling an individual in a health planPaying health insurance premiumsChecking insurance eligibilityGetting authorization to refer a patient to a specialistFiling a claim for insurance reimbursement for delivered healthcareRequesting additional information to support a claimCoordinating the processing of a claim across different insurance companyNotifying the provider about the payment of a claimThe healthcare industry has been attempting to develop standards to allow these transactions to be accomplished electronically, but it has been very difficult to get voluntary agreement from all of the competing parties involved to adopt a uniform set of such standards.

The administrative simplification subtitle of the HIPAA represents the first time that the federal government has mandated health data standards on a national level.

National Committee on Vital and Health Statistics Subcommittee on Standards and SecurityThe administrative simplification provisions also begin the process of addressing the broader standards issues of electronic healthcare records in general.

Consolidated Health InformaticsThe goal of this project is to develop and implement a standard means of exchanging and managing health information across federal health providers.

It is focusing on creating interoperability between health information systems in terms of how data are defined, structured, and exchanged.

Framework for Strategic ActionDr. Brailer has submitted a report that outlines a framework for a strategic plan that will help the nation to realize a new vision for healthcare made possible through the use of information technology.These goals convey the vision for consumer-centric and information-rich healthcare. Goal 1: Inform clinical practice Incentive EHR adoption Reduce risk of EHR investment Promote EHR diffusion in rural and underserved areasGoal 2 : Interconnect cliniciansFoster regional collaborationsDevelop a national health information networkCoordinate federal health information systems

Goal 3: Personalize careEncourage use of PHRsEnhance informed consumer choicePromote use of telehealth information systemsGoal 4: Improve population healthUnify public health surveillance architecturesStreamline quality and the health status monitoringAccelerate research and dissemination of evidence

The Business Value of Data StandardsHaving data standards for data interchange and information modeling will provide a mechanism against which deployed systems can be validated.

Defining information exchange requirements will enhance the ability to automate interaction with external partners which in turn will decrease a costs.