RESOURCE GUIDE TO INFORMATICS

STANDARDSWayne Homan

INLS 770 Informatics

Seminar

INTRODUCTION Two semesters of seminar

There have been quite a few acronyms

What are we talking about? Ed Hammond from Duke

What I used to think informatics was like

HEALTH LEVEL 7 (HL7) What is HL7?

Standard?

Programming language?

Type of Cylon?

HL7 Actually none of these: It is an organization that was formed in 1987 to develop standards for exchanging, sharing, and retrieval of electronic

health information

International in nature

Has 1600 members

What happened to the first six health levels?

Regulated by ANSI

Not a governmental organization!

ANSI American National Standards Institute

A private organization that regulates organizations that are developing voluntary standards

Founded in 1918

Validates the procedures of its members

Not limited by technology -> hundreds of thousands of companies

Not a governmental organization!

HL7 HL7 standards regulate how data is packaged and exchanged Can be either normative or informative

Standards are grouped by reference categories: 1) Primary standards 2) Foundational standards 3) Clinical and administrative domains 4) Electronic health record (EHR) profiles 5) Implementation guidelines 6) Rules and preferences 7) Education & awareness

HL7 Section 1: Primary standards Most important standard (most used) 1) CDA (clinical documentation architecture) release 2Document markup standardStructure and semantics of clinical documents

2) Context management documentationAims to support integration of applications

3) HL7 Version 2 Product SuiteUsed by 95% of US healthcare systemsIs a messaging standard

HL7 Section 1: Primary standards 4) HL7 Version 3 Product Suite

Designed to replace HL7 Version 2 but some parts are still in development Trying to be the “universal” standard for integrating EHRs

5) HL7 Version 3 Labeling Standards An SPL (structured Product Labeling) standard Basically seeks to ensure that all documents use same “language”

6) Continuity of care document (CCD) Joint project with ASTM International (American Society for Testing and Materials) Encourages physicians to advocate

FHIR We heard a lot about this during the semester

What is it?

Fast Healthcare Interoperability Resources (FHIR)

Is designed to replace HL7 version 3 Starts from the ground up to create a new standard Hopes to be the future (internet seems to like it)

PATHWAY/CONCLUSION

HL7

Sections

Standards

ANSI

ASTM

ACRONYMS/CONCLUSION HL7 ANSI ASTM CDA FHIR EHR CCD

-This is only the voluntary standards organizations-There is a whole other governmental section with the power of coercion (Office of the National Coordinator for Health Information Technology)

REFERENCESCosta Teixeira J, Chronaki C. Smart Medications & the Internet of Things. Stud Health Technol Inform. 2016;221:116.Dolin RH, Rogers B, Jaffe C. Health level seven interoperability strategy: big data, incrementally structured. Methods Inf Med. 2015;54(1):75-82.Health Level Seven International - Homepage. (n.d.). Retrieved April 27, 2016, from http://www.hl7.org/index.cfm?ref=nav Li YC, Yen JC, Chiu WT, Jian WS, Syed-abdul S, Hsu MH. Building a national electronic medical record exchange system - experiences in Taiwan. Comput Methods Programs Biomed. 2015;121(1):14-20.Mandel JC, Kreda DA, Mandl KD, Kohane IS, Ramoni RB. SMART on FHIR: a standards-based, interoperable apps platform for electronic health records. J Am Med Inform Assoc. 2016.Neofytou MS, Neokleous K, Aristodemou A, et al. Electronic Health Record Application Support Service Enablers. Conf Proc IEEE Eng Med Biol Soc. 2015;2015:1401-4.What is 'FHIR' and why should you care? - iNTERFACEWARE Inc. (2013). Retrieved April 27, 2016, from http://www.interfaceware.com/blog/what-is-fhir-and-why-should-you-care/