Chapter 13 HEALTHCARE DATA STANDARDS

OBJECTIVES  Discuss the need for data standards in healthcare.  Describe the standards development process.  Identify standards development organizations (SDOs).  Describe the healthcare data standards initiatives.  Explore the business value of 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.  The ability to exchange health information across organizational and system boundaries, whether between multiple departments within a single institution or among a varied cast of providers, payers, regulators, and other is essential.

 This chapter examines healthcare data standards in terms of the ff: 1. Need for healthcare data standards 2. Healthcare data interchange standards 3. Healthcare terminologies 4. Knowledge representation 5. Healthcare data standards development 6. Healthcare data SDOs 7. Healthcare data standards initiatives

I. Need for Healthcare Data Standards  Data standards as applied to healthcare include the “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 process”.

 Standards can be further categorized as those that support the generic infrastructure and are not domain- specific, those that support the exchange of information and are domain-specific. And those that support activities and practices within a specific domain. a) The first type of standard would include equipment specifications such as processor type or network transmission protocols such as token ring. b) The second type of standard typically involves the specification of data structures and content and would include such standards as message formats and core data sets. c) The third type of standard address the interpretation of that data as information, including how it should be acted on within a particular context. Example is professional practice guidelines.

 Healthcare is fundamentally a process of communication. For much of history, verbal communication between a patient and a healthcare provider characterized this process.  Healthcare delivery is far more complex, and a single episode may frequently take place across multiple settings and involve numerous parties.  The information about patients and their care is used not only for the direct care process but also for many other purposes including reimbursement, research, public health, education, policy development, and litigation.

 It is this tremendous increase in the need for health information exchange and management systems in the healthcare domain.  While current information technology is able to move and manipulate large amounts of data.  Data standards are an attempt to reduce the level of ambiguity in the communication of data.  The term data standards is generally used to describe those standards having to do with the structure and content of health information, it may be useful to differentiate data, information, and knowledge.  Data are the fundamental building blocks on which healthcare decisions are based.

II. Healthcare Data Interchange Standards  Data interchange standards address, primarily, the format of messages that are exchanged between computer systems, document architecture, clinical templates, user interface, and patient data linkage.  To achieve data compatibility between systems, it is necessary to have prior agreement on the syntax of the messages to be exchanged.

 The ff section describes some of the major organizations involved in the development of data interchange standards: A. Message Format Standards  Four broad classes of message format standards have emerged in the healthcare sector: medical device communications, digital imaging communications, administrative data exchange, and clinical data exchange.  It should be noted that there is considerable overlap among standards development activities.  The Nat’l Committee on Vital & Health Statistics (NCVHS) is the advisory committee established to make recommendations on health information policy to the Dept. of Health & Human Services (HHS) and Congress.

B. 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, continuous, and comprehensive capture and communication of data from bedside medical devices such as found in ICU, OR, and ED.  This data include physiologic parameter measurements and device settings.  The most widely known standard, , 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.

C. Nat’l Electrical Manufactures Association  The NEMA, in collaboration with the American College of Radiologist (ACR) and others, formed the DICOM to develop a generic digital format and a transfer protocol for biomedical images and image-related information.  The specification is usable on any type of computer system and supports transfer over the internet.  The DICOM standard is the dominant international data interchange message format in biomedical imaging.

D. Accredited Standards Committee X12N/Insurance  ASC X12N has developed a broad range of Electronic Data Interchange (EDI) standards to facilitate electronic business transactions.  In the healthcare arena, X12N standards have been adopted as Nat'l standards for such administrative transactions as claims, enrolment, and eligibility in health plans and first report of injury under the requirements of the HIPAA.  The American Nat’l Standard Institute (ANSI) developed these, and the X12N 837 Implementation Guide has been established as the standard of compliance for claim transactions.

E. Nat’l Council for Prescription Drug Programs  The NCPDP develops standards for information processing for the pharmacy services sector of the healthcare industry.  This has been a very successful example of how standards can enable significant improvements in service delivery.

IV. The Standards Development Process  The development and adoption of data standards is not only a technical process; it takes place within a sociopolitical context. In health care, there is an increasing recognition that there exist significant opportunities to improve the quality of care provided and the outcomes associated with that care. It has also been recognized that any potential improvement in quality of care depends greatly on the ability to communicate healthcare information consistently, efficiently, and effectively.

Some of the major international, regional, and national organizations involved in broad-based standards development and coordination are ff: A. International Organization of Standardization B. European Technical Committee for Standardization C. American National Standard Institute D. Object Management Group E. Health Insurance Portability & Accountability Act F. National Committee on Vital & Health Statistics Subcommittee on Standards & Security

V. The Business Value of Data Standards  The importance of data standards to enhancing the quality and efficiency to healthcare delivery is being recognized by our national leadership.  Reviewing the business value of defining and using data standards is critical for driving the implementation of these standards into applications and systems.  Considering the value proposition for incorporating data standards into products, applications & systems should be a part of every organization’s information technology strategy.

THE END!!! Prepared by: Dynna Mae M. Paquibot BSN II-Jade

Questions: 1.What is generally used to describe those standards having to do with the structure and content of health information, it may be useful to differentiate data, information, and knowledge. 2pts. 2.They 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. 3pts. 3.What is the used of terminologies in medical terms ? 5pts. 4.Defined data standards as applied to health care. 10pts.

Answers: 1.Data Standards 2.Institute of Electrical and Electronic Engineers 3.Terminologies is the medical terms and concepts used to describe, classify, and code the data elements and data expression languages and syntax that describe the relationships among the terms/concepts. 4.Data standards as applied to healthcare include the “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 process”.