1. Standards: The Benefits to Business Gaby Jewell Strategist

2. © Cerner Corporation All Rights Reserved 2 Standards: The Benefits to Business Agenda Challenges Standards Challenges Benefits Challenges

3. © Cerner Corporation All Rights Reserved 3 Standards: The Benefits to Business Cerner HBOC ClinStar SMS Invision Quest ADTs, Orders Kaiser Results, Charges ADTs, Orders Results Orders Results Results, Charges ADTs, Orders Old Challenges I I I I

4. © Cerner Corporation All Rights Reserved 4 Standards: The Benefits to Business Old Challenges – the need for Standards Identifying objects Translating coded values Missing/extra data elements Proprietary message/record formats

5. © Cerner Corporation All Rights Reserved 5 Standards: The Benefits to Business Messaging Standards ASTM HL7 v2.2 Vocabulary Standards HL7 Tables ICD-9 and -10 SNOMED Clients demanded implementation of these Standards

6. © Cerner Corporation All Rights Reserved 6 Standards: The Benefits to Business Cerner HBOC ClinStar SMS Invision Quest ADTs, Orders Kaiser Results, Charges ADTs, Orders Results Orders Results Results, Charges ADTs, Orders HL7 v2.2 UI I

7. © Cerner Corporation All Rights Reserved 7 Standards: The Benefits to Business Cerner HBOC ClinStar SMS Invision Quest ADTs, Orders Kaiser Results, Charges ADTs, Orders Results Orders Results Results, Charges ADTs, Orders HL7 v2.2 UI

8. © Cerner Corporation All Rights Reserved 8 Standards: The Benefits to Business Additional Messaging Standards ASTM HL7 v2.x X12 (U.S. EDI Standard) EDIFACT (ISO EDI Standard) HPRIM (France)

9. © Cerner Corporation All Rights Reserved 9 Standards: The Benefits to Business Next Challenges Health Data Bank (EHR, Spine, etc.)

10. © Cerner Corporation All Rights Reserved 10 Standards: The Benefits to Business Next Challenges Sharing data across multiple care settings Identifying objects Translating coded values Missing/extra data elements Multiple stores

11. © Cerner Corporation All Rights Reserved 11 Standards: The Benefits to Business Messaging Standards HL7 v3 Other Standards (or “Disruptive Technology”?) HL7 CDA ASTM CCR HL7 CCD CEN OpenEHR SOA PDF/H (Portable Document Format/Healthcare – working through AIIM and ASTM) Vocabulary Standards SNOMED CT LOINC ICD-9 and -10

12. © Cerner Corporation All Rights Reserved 12 Standards: The Benefits to Business Latest Challenges - Implementation Profiles HL7 Affiliates / Realms / Context of Use IHE Primarily HL7 v2.4/2.5 messages and “other” standards (i.e., ebXML/RS for XDS) Local IHEs HITSP - Healthcare Information Technology Standards Panel Interoperability specifications based on use cases identified by American Information Community (AHIC) for Electronic Health Record, Personal Health Record, and Bio-surveillance/Public Health Reporting. Primarily HL7 v2.4/2.5 messages CCHIT – Certification Commission for Healthcare Information Technology OpenEHR Based on CEN 13606 Canada’s Health Infoway Using HL7 v3 interactions Producing updated IHE Profiles using HL7 v3 NEHTA – Australia’s National eHealth Transition Authority SEHR Architecture based on EN13606 “Standard” Interchange information using HL7 v2.x messages initially and HL7 CDA Release 2 or XML serialization of EN13606 in longer term NHS England MIM Most messages based on HL7 v3 RIM or highly refined, constrained and localized HL7 v3 artifacts VA Kaiser

13. © Cerner Corporation All Rights Reserved 13 Standards: The Benefits to Business Future Challenges Where does “interoperability” begin/end? Current projects tend to talk about common architecture and common data structures and common user interfaces Should local EMR data be mappable to the common data structure for storage in the shared care record? Should local EMR data be stored in the common data structure? Must local EMR data be stored using the shared vocabulary? Future Benefits Incremental Interoperability Strategic Alliances Conformance Certification Responding to Request for Proposals

14. © Cerner Corporation All Rights Reserved 14 Standards: The Benefits to Business Thank you Questions?