Transcript healthcare data standards

HEALTHCARE DATA
STANDARDS
This chapter examines healthcare data standards in
terms of the following:
Need for healthcare data standards
Healthcare data interchange standards
Healthcare terminologies
Knowledge representation
Healthcare data standards development
Healthcare data SDOs
Need for Healthcare Data Standards
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Data standards as applied to healthcare include : methods, protocols,
terminologies, and specifications for the collection ,exchange,
storage, and retrieval of information associated with healthcare
applications, including medical records,medications,radiological
images, payment and reimbursement,medical devices and
monitoring systems and administrative processes.
In the domain of information management, standards can be further
categorized as:
1.those that support the generic infrastructure and are not
domain specific
2.those that support the exchange of information and are
domain specific
3.those that support activities and practices within a specific
domain
Healthcare is fundamentally a process of communication.
Data Standards is generally used to describe those standards having to
do with the stucture and content of health information, it may useful
to differentiate data,information and knowledge.
Data are collections of unstructured discrete entities(facts) that exist
outside of any particular context.
Data interchange standards adress,primarily,the format of messages that are exchanged
between computer systems, document architecture,clinical templates,userinterface, and
patient data linkage.
The following section describes some of the major organizations involved in the development of
data interchange standards:
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Message Format Standards
four broad classes of message format standards have emerged in the healthcare sector:
1. medical devise communications
2. digital imaging communications
3. administratve data exchange
4. clinical data exchange
The National Committee on Vital and Health Statistics (NCVHS) is the advisory committee
established to make recommendations on health information policy to the Department of
Health and Human Services (HHS) and Congress.
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Institute of Electrical and Electronic Engineers
The IEEE has developed a series of standards known collectively as P1073 Medical
Information Bus(MIB) which support real-time,continous,and comprehensive capture and
communication of data from bedside medical devices such as those found in intensive care
units, operating rooms and emergency departments.
The most widely known standard, 802.11, commonly referred to as Wi-Fi, allows anyone
with a computer and either a plug-in card or built-in circuitry to connect to the Internet
wirelessly through a myriad access points installed in offices, hotels, airports, coffeehouses,
convention centers and even parks,ammong other locations
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National Electrical Manufactures Association
in collaboration with the American College of Radiologists and others,
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/Insurance
has developed a broad range of electronic data interchange(EDI)
standards to facilitate electronic business transactions.
National Council for Prescription Drug Programs
develops standards for information processing for the pharmacy
services sector of the healthcare industry.
HL7 standards focus on facilitating the interchange of data to support
clinical practice both within and across institutions.
The major areas covered by the standard include:
1. medical orders
2. clinical observations
3. test results
4. admission
5. transfer and discharge
6. document architecture
Terminologies
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A fundamental requirement for effective communication is the ability to
represent concepts in an unambiguous fashion between both the sender and
receiver of the message.
1. International Statistical Classification of Diseases and Related Health
Problems: Ninth
Revision and Clinical Modifications
-the latest version of a mortality and morbidity classification that
originated in 1893
2. International Statistical Cassifications of Diseases and Related Health
Problems: Tenth Revision
- most recent revision of the ICD classification system for mortality
and morbidity, which is used worldwide
3. Current Procedural Terminology, Fourth Revision
- listing of descriptive terms and codes for reporting medical
services and procedures
4. Systematized Nomenclature of Human and Veterinary Medicine
International, Clinical Terms
- comprehensive, multiaxial nomenclature and classification system
created for indexing human and veterinary medical vocabulary, including
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Unified Medical Language
speciaized vocabularies, code sets, and classification system for almost
every practice domain in healthcare.
Data Content Standards
National Uniform Claim Committee Recommended Data Set for a
Noninstitutional Claim
- was organized in 1995 to developed,promote and maintain a standard
data set for use in noninstitutional claims and encounter information.
Standard Guide for Content and Structure of the Computer-Based Patient
Record(ASTM E1384-96)
- one of the largest SDOs in the world and publishes over 9,000
standards covering all sectors in the economy.
Standards Development Process
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Proprietary Standards
- can often be developed quickly and are supported by
available implementations and tools.
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Legislated,government-developed standards
- are able to gain widesread acceptance by virtue of their
being required by either regulation or in order to participate in
large, government-funded programs ,such as Medicare.
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Standards developed by SDOs are consensus-based and reflect the
perspectives of a wide variety of interested stakeholders.
Integrating the Healthcare
Enterprise
Is an initiative that provides a detailed framework for
implementing standards, filling the gap between standards and
their implementation.
Standards Coordination Efforts
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The following is a brief description of some of the major international,regional, and
national organizations involved in broadbased standards development and
coordination:
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International Organization of Standardization
-an organization that develops and publishes standards internationally.
European Technical Committee for Standardization
- works to developed a wide variety of standards in the area of healthcare data
management and interchange.
American National Standards Institute
- serves as the coordinator for voluntary standards activity in the United States
Object Management Group
- representative of a different approach to standards development
Health Insurance Portability and Accountability Act
National Committee on Vital and Health Statistics Subcommittee on Standards and
Security
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Framework for Strategic Action
These goals convey the vision for consumer-centric and information-rich healthcare:
Goal 1: Inform clincal practice
Incentivize EHR adoption
Reduce risk of HER investment
Promote EHR diffusion in rural and underserved areas
Goal 2: Interconnect clinicians
Foster regional collaborations
Developed a national health information network
Coordinate federal health information systems
Goal 3: Personalize care
Encourage use of PHRs
Enhanced informed consumer choice
Promote use of telehealth systems
Goal 4: Improved population health
Unify public health surveillance architectures
Streamline quality and health status monitoring
Accelerate research and dessimination of evidence