Difference between revisions of "Vendor Selection Criteria: Interoperability"
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* Section 2: Content/Structure Standard – meaning “syntax.” | * Section 2: Content/Structure Standard – meaning “syntax.” | ||
* Section 3: Transport Standard – the method by which information is moved from point A to point B. | * Section 3: Transport Standard – the method by which information is moved from point A to point B. | ||
| − | * Section 4: Services Standard – the infrastructure components deployed and used to accomplish specific information exchange objectives. <ref name="2015 | + | * Section 4: Services Standard – the infrastructure components deployed and used to accomplish specific information exchange objectives. <ref name="ONC 2015 ISA">Office of the National Coordinator for Health IT. 2015 Interoperability Standards Advisory http://www.healthit.gov/sites/default/files/2015interoperabilitystandardsadvisory01232015final_for_public_comment.pdf</ref> |
=== Section I === | === Section I === | ||
Revision as of 01:18, 24 September 2015
Contents
Interoperability
When selecting a vendor for EHR implementation, interoperability or functionality should be considered. In a 2015 publication, "What makes an EHR "open" or interoperable?" there were five cases where interoperability should be considered when selecting an EHR. The following should be considered:
- Clinicians- essential to provide safe and effective care
- Researchers- critical to advance and understand disease processes
- Administrators - to reduce the dependence on one EHR vendor
- Software developers- to develop interface and software
- Patients- important to access personal health information
Widespread access to EHR information is important if the full potential of the electronic health care system is to be realized.[1]
The purpose of EHR is to provide access of patient information to the right people at the right time. Interoperability is the ability to exchange this information between different EHR systems and stakeholders. [2] There are standards considered by the Health IT. These standards are divided into 3 different categories: content, terminology and transport.[3]
Importance of Interoperability
The communication, interoperability and analysis of Electronic Health Records (EHRs) is of growing global importance as the functionality and use of an EHR system increases. Longitudinal EHRs can improve the quality and safety of care to individuals, provide the knowledge needed to improve the efficiency of healthcare services and population health programs and accelerate clinical research.[4]
Interoperability is of significant importance for multiple reasons:
- Security: low standards of interoperability can lead to security hazards
- Behavior change in patient health habits may be affected
- Interactions between multiple branches of systems in the health industry depend on the interoperabilty of systems [5]
Safety
- Help deliver evidence-based health care
- Help to improve safety by reducing errors and inequalities [4]
Patient Centered
- Empower and involve citizens in their own health care.
- Help to protect a patient's privacy. [4]
References
- ↑ Sittig, D.F., Wright, A. (2015). What makes an EHR "open" or interoperable? Journal of the American Medical Informatics Association. http://jamia.oxfordjournals.org/cgi/doi/10.1093/jamia/ocv060
- ↑ http://www.healthit.gov/providers-professionals/faqs/what-ehr-interoperability-and-why-it-important
- ↑ Hoyt, R. E., & Yoshihashi, A. K. (Eds.). (2014). Health Informatics: Practical Guide for Healthcare and Information Technology Professionals (6th edition)
- ↑ Cite error: Invalid
<ref>tag; no text was provided for refs namedTapuria_2013 - ↑ Kahn, J. S., Aulakh, V., & Bosworth, A. (2009). What it takes: characteristics of the ideal personal health record. Health affairs, 28(2), 369-376. http://content.healthaffairs.org/content/28/2/369.long
Interoperability Considerations
It is important to determine prior to selecting a vendor what type of data and devices a facility needs to exchange information. [2]
- PACS Systems
- Medical Devices (Monitors, Ventilators, Anesthesia cart, etc.)
- Pharmacy
- Laboratory Orders and Results
- Critical Values Reporting
- Electronic Health Records to other facilities and/or physician's practices
EMR needs to have interoperability specifications
- Defined levels and mechanisms of desired semantic interoperability
- Well-defined architecture and modularized interfaces to build transition plans for future upgrades
- Patient data safety[3]
Ensure that Information Technology, Biomed and EMR vendor are engaged in all conversations to achieve desired interoperability level. [2]
Content Standards
There are mainly two types of contents in clinical data; 1. Structured Data, which is computationally tractable and used in Billing, Lab reports, problem lists and others and 2. Unstructured Data, which is usually physician dictations that is free text, this is not computationally tractable and requires Natural Language Processing. Data extractors likes cTAKES, METAMAP and MEDLEE are used to process free texts.[4]
Terminology Standards
"MEDCIN is a clinical terminology designed to support medical documentation entry into electronic health record systems. MEDCIN was initially developed as “an intelligent clinical database for documentation at the time of care.”(16) MEDCIN's producer, Medicomp, states that their software “makes capture of the encounter information fast enough, sufficiently comprehensive and rewarding to overcome physician reluctance.” MEDCIN has evolved to include more than 250,000 concepts since 1978, and has been installed in several EHR systems as an interface terminology for clinical documentation including AHLTA, the EHR system developed for the US Department of Defense." (Brown et al. 2007) [5]
Transport Standards
- The transport standards consist of ELINCS, IEEE 11073, NCPDP and ASC X12.[4]
ELINCS stands for EHR-LAB Interoperability and Connectivity Standards enables messaging between laboratory and clinicians ambulatory EHRs, IEEE 11073 is the transport standard for medical device connectivity and data exchange, National Council for Prescription Drug Program (NCPDP) is for the exchange of prescription related information and Accredited standards Committee (ASC)X12 is for electronic data interchange or computer-computer business data exchange. Other transport standards include Script (V10.10) for physician pharmacist communication, OpenID Connect helps web-based, mobile to connect to an authentication server and IHE-PCD based on IEEE integrates the healthcare enterprise and patient care device. [4]
2015 Interoperability Standards Advisory
On January 30, 2015, the ONC released a document entitled “2015 Interoperability Standards Advisory.”[6] It is essentially a document noting many standards that are recommended for interoperability among EHRs. There are criteria for content standards, structure standards, and transport standards, among other notable standards for interoperability.[7] The document is subject to change as the ONC moves forward and also contains a section noting how changes to the document will take place.[7]
These standards and implementation specifications for clinical health information are grouped into four categories or sections:
- Section 1: Vocabulary/Code Sets/Terminology Standard – meaning “semantics.”
- Section 2: Content/Structure Standard – meaning “syntax.”
- Section 3: Transport Standard – the method by which information is moved from point A to point B.
- Section 4: Services Standard – the infrastructure components deployed and used to accomplish specific information exchange objectives. [8]
Section I
Section II
Section III
Section IV
References
- ↑ Tapuria, A., Kalra, D., & Kobayashi, S. (2013). Contribution of Clinical Archetypes, and the Challenges, towards Achieving Semantic Interoperability for EHRs. The Korean Society of Medical Informatics, 19(4), 286-292.
- ↑ 2.0 2.1 Achieving INTEROPERABILITY: What's Happening Out There? Williams, Jill Schlabig; Jacobs, Brian, MD http://search.proquest.com.ezproxyhost.library.tmc.edu/docview/922925204?pq-origsite=summon&accountid=7034
- ↑ Interoperability Hufnagel, Stephen P, Phdhttp://search.proquest.com.ezproxyhost.library.tmc.edu/docview/217053410?pq-origsite=summon&accountid=7034
- ↑ 4.0 4.1 4.2 4.3 4.4 <Hoyt, R. E. Y. A. (2014). Health Informatics: Practical Guide for Healthcare and Information Technology Professionals (Sixth Edition) eBook: Robert E. Hoyt, Ann Yoshihashi: Kindle Store. Retrieved September 14, 2015, from http://www.amazon.com/gp/product/B00LBOO3Y8?psc=1&redirect=true&ref_=oh_aui_d_detailpage_o00_>
- ↑ <Brown, S. H., Rosenbloom, S. T., Bauer, B. A., Wahner-Roedler, D., Froehling, D. A., Bailey, K. R., ... & Elkin, P. L. (2007). Direct comparison of MEDCIN® and SNOMED CT® for representation of a general medical evaluation template. In AMIA Annual Symposium Proceedings (Vol. 2007, p. 75). American Medical Informatics Association. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2655894/>
- ↑ Interoperability to help achieve better care, smarter spending, and healthier people http://www.healthit.gov/buzz-blog/electronic-health-and-medical-records/interoperability-electronic-health-and-medical-records/interoperability-roadmap-standards-advisory/
- ↑ 7.0 7.1 2015 Interoperability Standards Advisory http://www.healthit.gov/standards-advisory/2015
- ↑ Office of the National Coordinator for Health IT. 2015 Interoperability Standards Advisory http://www.healthit.gov/sites/default/files/2015interoperabilitystandardsadvisory01232015final_for_public_comment.pdf
