Archive for the ‘Healthcare IT’ Category

The National Alliance for Health Information Technology (NAHIT) recently released new definitions of certain healthcare IT terms. This project was completed for the Office of the National Coordinator of Health Information Technology; this office was created by the President on April 27, 2004 to promote the adoption of electronic health records by most Americans by 2014.

Outlined below are the definitions published by NAHIT. These healthcare IT definitions were published in the report entitled Defining Key Health Information Technology Terms (PDF).

• Electronic Medical Record: An electronic record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one healthcare organization.
• Electronic Health Record: An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one healthcare organization.
• Personal Health Record: An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual.
• Health Information Exchange: The electronic movement of health-related information among organizations according to nationally recognized standards.
• Health Information Organization: An organization that oversees and governs the exchange of health-related information among organizations according to nationally recognized standards.
• Regional Health Information Organization: A health information organization that brings together health care stakeholders within a defined geographic area and governs health information exchange among them for the purpose of improving health and care in that community.

The greatest understatement in the report is: “Interoperability is the common thread running through health IT terms. Interoperability is the essential factor in building the infrastructure to create, transmit, store and manage health-related information.”

For more definitions, check out our healthcare interoperability glossary.

As we have discussed in previous RSNA posts, Integrating the Healthcare Enterprise (IHE) has had a major presence at the show. Yesterday, Nikolaus Wirsz, PhD, manager IT standards, Siemens Medical Solutions, gave a presentation entitled The IHE Initiative Worldwide: An Update. During the presentation, he stated “IHE is not a local problem; we are seeing integration problems everywhere. As a result, IHE has been promoted worldwide.”

Although the crux of his statement is true, healthcare integration is being resolved locally by many hospitals, imaging centers, clinics, and labs. IHE is an important organization that is driving how the various standards can be used to enable healthcare interoperability, and it is essential that the standards be promoted worldwide.

In reality, healthcare institutions are not waiting. Radiology practices are putting information technology solutions in place to extend their electronic data exchanges to the referring physician community. Hospitals, labs, and clinics are doing the same.

Healthcare interoperability, with HL7 integration being an essential part of it, is occurring at the local level. Their driving forces are streamlining workflow, enhancing quality of patient care and experience, and improving productivity. Healthcare interoperability is being led locally as well as by IHE.

As mentioned in previous posts, the Continuity of Care Record (CCR) provides a way to send data between clinics, hospitals, labs, etc that are using various EMR, HIS, RIS, PACS, dictations, etc systems. The CCR is an XML-based standard that is related to and different from the HL7 2.X messaging standard.

While I posted a short description comparing CDA and CCR, there is a formal article written by Ed Hammond et al and is titled, The Clinical Document Architecture and the Continuity of Care Record: A Critical Analysis. This article was published in the Journal of the American Medical Informatics Association (JAMIA). Later in the month, I’ll summarize this article. For now, here is the abstract:

The Clinical Document Architecture and the Continuity of Care Record: A Critical Analysis

Jeffrey M. Ferranti, MD, R. Clayton Musser, MD, MS, Kensaku Kawamoto and W. Ed Hammond, PhD

Health care provides many opportunities in which the sharing of data between independent sites is highly desirable. Several standards are required to produce the functional and semantic interoperability necessary to support the exchange of such data: a common reference information model, a common set of data elements, a common terminology, common data structures, and a common transport standard. This paper addresses one component of that set of standards: the ability to create a document that supports the exchange of structured data components. Unfortunately, two different standards development organizations have produced similar standards for that purpose based on different information models: Health Level 7 (HL7)’s Clinical Document Architecture (CDA) and The American Society for Testing and Materials (ASTM International) Continuity of Care Record (CCR). The coexistence of both standards might require mapping from one standard to the other, which could be accompanied by a loss of information and functionality. This paper examines and compares the two standards, emphasizes the strengths and weaknesses of each, and proposes a strategy of harmonization to enhance future progress. While some of the authors are members of HL7 and/or ASTM International, the authors stress that the viewpoints represented in this paper are those of the authors and do not represent the official viewpoints of either HL7 or of ASTM International.