Healthcare Data Standards In nursing informatics, there are a lot if standards to be followed.

One of these is the Healthcare Data Standards. This standard is a critical component in the development and implementation of an Electronic Health Record Types of Standards
What is the difference between data, information and knowledge?
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Data is raw material, for example numbers, text, images and sounds, in a form suitable for storage in or processing by a computer. It is without context or specific meaning. Information is the result of processing, manipulating and organising data. It is the context in which data is taken. Knowledge is the right information delivered to the right person just in time, in order to take the most appropriate decision. Wisdom is the knowledge and experience needed to make sensible decisions and judgements, or the good sense shown by the decisions and judgements made.

Standards can be divided into the following types, building from data to knowledge and wisdom:
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Technical standards - e.g. those covering document formats or networking. Data standards - defining the structure and type of data. Information standards - a specification defining not just the structure of the data but how it should be used. Professional standards - specifying how professionals should manage information in the patient record.

Data Standard:
Data standards promote the consistent recording of information and are fundamental to the efficient exchange of information. They provide the rules for structuring information, so that the data entered

In particular. primarily. State and community health data needs. Medical device communications Digital Imaging Communications Administrative Data Exchange Clinical Data Exchange The National Committee on Vital and Health Statistics was established by Congress to serve as an advisory body to the Department of Health and Human Services on health data. It fulfills important review and advisory functions relative to health data and statistical problems of national and international interest. and patient data linkage. For much of history. The temporal and physical proximity of the communicators provided ample opportunity to clarify ambiguity regarding the intended meaning of what was being communicated. stimulates or conducts studies of such problems and makes proposals for improvement of the Nation’s health statistics and information systems. with the longterm goal of improving the compatibility of private sector. and shared. mental health statistics. it is necessary to have prior agreement on the syntax of the messages to be exchanged. The Committee has been associated with ground-breaking contributions in such areas as disease classification. the Committee was restructured to meet expanded responsibilities under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). 3. Message Format Standards 1. verbal communication between a patient and a healthcare provider characterized this process. They help protect the long-term value of data. retrieved. clinical templates. 4. the format of messages that are exchanged between computer systems. Healthcare is fundamentally a process of communication. the new charter enables the NCVHS to foster collaboration on voluntary means to facilitate and accelerate the development of consensus across the public and private sectors around these key data standards and privacy issues. and federal health information systems while assuring the confidentiality of the information collected. 2. state. sorted. document architecture. *to achieve data compatibility between systems. The NCVHS is in a unique position to serve as a national forum for the collaboration of interested parties. and privacy protection for health information. statistics and national health information policy. communicated between systems. user interface. data needs for minority and other special populations.into a system can be reliably read." . health surveys. The National Committee on Vital and Health Statistics (NCVHS) was called upon to "study the issues related to the adoption of uniform data standards for patient medical record information [PMRI] and the electronic exchange of such information. uniform health data sets and other data standards. In 1996. indexed. Healthcare Data Interchange Standards -addresses.

chartered by the American National Standards Institute in 1979. Improvement.g. sharing. and methodologies by which various healthcare systems can communicate with each other. * HL7. printers. printing.g. application standards (e. HL7 CCOW). v2. v3. HL7 v2. With more than 315 X12 EDI standards and a growing collection of X12 XML schemas. document standards (e. Theoretically.. DICOM enables the integration of scanners. NCPDP members have created standards such as the Telecommunication Standard and Batch Standard. It was developed by the DICOM Standards Committee. standards development organization with over 1575 members representing virtually every sector of the pharmacy services industry. HL7 RIM). "HL7" is also used to refer to some of the specific standards created by the organization (e. National Council for Prescription Drug Programs (NCPDP) National Council for Prescription Drug Programs (NCPDP) was founded in 1977 as the extension of a Drug Ad Hoc Committee that made recommendations for the US National Drug Code (NDC). HL7 v2. develops electronic data interchange (EDI) standards and related documents for national and global markets. The communication protocol is an application protocol that uses TCP/IP to communicate between systems. the Manufacturers Rebate Standard and more to improve communication within the pharmacy industry.. Accredited Standards Committee x12N/Insurance. the SCRIPT Standard for Electronic Prescribing. non-profit organization involved in development of international healthcare informatics interoperability standards. are the most commonly used in the world. DICOM files can be exchanged between two entities that are capable of receiving image and patient data in DICOM format. ANSI-accredited. this ability to exchange information should help to minimize the tendency for medical care to be geographically isolated and highly variable. and messaging standards (e. NCPDP has been named in US federal legislation. The diverse membership provides leadership and healthcare business solutions through education and standards. HL7 and its members provide a framework (and related standards) for the exchange.x.” Hospitals and other healthcare provider organizations typically have many different computer systems used for everything from billing records to patient tracking.x and v3.Adopted Message Format Standards Health Level Seven (HL7) is an all-volunteer.. All of these systems should communicate with each other (or "interface") when they receive new information but not all do so. reduces costs and expands organizational reach.x of the standards.0). created using the consensus building process. Digital Imaging Communication in Medicine Standards Committee (DIGICOM) STANDARD Digital Imaging and Communications in Medicine (DICOM) is a standard for handling. integration. HL7 specifies a number of flexible standards. and transmitting information in medical imaging.. The National Electrical Manufacturers Association (NEMA) holds the copyright to this standard. which support clinical practice and the management. Messaging standards are particularly important because they define how information is packaged and communicated from one party to another. ASC X12 enhances business processes. HL7 RIM). Such guidelines or data standards are a set of rules that allow information to be shared and processed in a uniform and consistent manner. storing. workstations. provides the messaging standard that aims to connect healthcare organizations that speak different “languages. servers.The Accredited Standards Committee (ASC) X12. delivery. HL7 CDA).g. whose members are also partly members of NEMA. and Modernization Act..0. guidelines. which stands for health level seven. NCPDP is a not-for-profit. NCPDP has twelve active work groups where electronic standards for transmission of pharmacy data are created and modified. including Health Insurance Portability and Accountability Act and the Medicare Prescription Drug. It includes a file format definition and a network communications protocol. Such standards set the language. DICOM has been widely adopted by hospitals and is making inroads in smaller applications like dentists' and doctors' offices. The different devices come with DICOM conformance statements which clearly state the DICOM classes they support. ASC X12's diverse . HL7 develops conceptual standards (e. and evaluation of health services.g.g. and retrieval of electronic health information. These data standards are meant to allow healthcare organizations to easily share clinical information. structure and data types required for seamless integration from one system to another. and network hardware from multiple manufacturers into a picture archiving and communication system (PACS).

Standardized terminologies enable data collection at the point of care. signs. and emergency departments. continuous. These data include physiologic parameter measurements and device settings. Clinical Modification (ICD-10-CM) provided by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS). including communications. and retrieval of data. and ill-defined conditions List of ICD-9 codes 800–999: injury and poisoning List of ICD-9 codes E and V codes: external causes of injury and supplemental classification ICD 10 CM International Classification of Diseases. nutritional and metabolic diseases.member base includes 3.                    List of ICD-9 codes 001–139: infectious and parasitic diseases List of ICD-9 codes 140–239: neoplasms List of ICD-9 codes 240–279: endocrine. Major Systems: TERMINOLOGIES: ICD 9 CM The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. and the puerperium List of ICD-9 codes 680–709: diseases of the skin and subcutaneous tissue List of ICD-9 codes 710–739: diseases of the musculoskeletal system and connective tissue List of ICD-9 codes 740–759: congenital anomalies List of ICD-9 codes 760–779: certain conditions originating in the perinatal period List of ICD-9 codes 780–799: symptoms. supply chain and transportation. 10th Revision. insurance. 1 Conventions . The ICD-10-CM is a morbidity classification for classifying diagnoses and reason for visits in all American health care settings. and comprehensive capture and communication of data from bedside medical devices such as those found in intensive care units. These codes are in the public domain (ex. childbirth. the statistical classification of disease published by the World Health Organization (WHO) which replaces ICD-9. The ICD-10-CM is based on the ICD-10. and immunity disorders List of ICD-9 codes 280–289: diseases of the blood and blood-forming organs List of ICD-9 codes 290–319: mental disorders List of ICD-9 codes 320–359: diseases of the nervous system List of ICD-9 codes 360–389: diseases of the sense organs List of ICD-9 codes 390–459: diseases of the circulatory system List of ICD-9 codes 460–519: diseases of the respiratory system List of ICD-9 codes 520–579: diseases of the digestive system List of ICD-9 codes 580–629: diseases of the genitourinary system List of ICD-9 codes 630–679: complications of pregnancy. ICD9-cm). operating rooms. which support real-time. government. for medical coding and reporting in the United States.000+ standards experts representing over 340 companies from multiple business domains. and knowledge in support of clinical practice. finance. Terminologies  A fundamental requirement for effective communication is the ability to represent concepts in an ambiguous fashion between both the sender and receiver of the message. information. Institute of Electrical and Electronic Engineers The IEEE has developed a series of standards known collectively as P1073 Medical Information Bus (MIB).

CPT-4 CODE SET The Current Procedural Terminology (CPT) code set is maintained by the American Medical Association through the CPT Editorial Panel. childbirth and the puerperium (O00-O99) 17 CHAPTER 16 .2 Seventh character and placeholders 1.Y04.2.3 23.M84.S88. nutritional and metabolic diseases (E00-E90) 6 CHAPTER 5 .9 S82 23.Diseases of the nervous system (G00-G99) 8 CHAPTER 7 .1 M1a 23.8 S79.8.6 S00 . The current version is the CPT 2010. patients.Neoplasms (C00-D48) 4 CHAPTER 3 .1 . Y00 . O33.S81. signs and abnormal clinical and laboratory findings.   1.Pregnancy.10 S89.21.External causes of morbidity (V01-Y99) 22 CHAPTER 21 .V99. S83 .T28.Diseases of the eye and adnexa (H00-H59) 9 CHAPTER 8 . poisoning and certain other consequences of external causes (S00-T98) 21 CHAPTER 20 . S89. T33 .S99 23.O41.23 23.4 O31 .7. S89. S90 .T85.3 Excludes Notes 2 CHAPTER 1 . O69.1. There are three types of CPT codes:    Category I CPT Code(s) Category II CPT Code(s) – Performance Measurement Category III CPT Code(s) – Emerging Technology . R40.Diseases of the skin and subcutaneous tissue (L00-L99) 14 CHAPTER 13 .Diseases of the circulatory system (I00-I99) 11 CHAPTER 10 . T88 23.12 V00 . and diagnostic services and is designed to communicate uniform information about medical services and procedures among physicians.0.4 .O32. Y08 . S89.4 . 23. S79.3 M80.9.S78 23.W99.Endocrine. not elsewhere classified (R00-R99) 20 CHAPTER 19 .7 S79.Congenital malformations.1 Level of Detail in Coding 1.Diseases of the blood and blood-forming organs and certain disorders involving the Immune mechanism (D50-D89) 5 CHAPTER 4 .Symptoms. R40.2.Y38.Certain conditions originating in the perinatal period (P00-P96) 18 CHAPTER 17 .O60. O35 .Diseases of the ear and mastoid process (H60-H95) 10 CHAPTER 9 . and analytical purposes. The CPT code set accurately describes medical.M48.11 T15 .Injury.5 R40. deformations and chromosomal abnormalities (Q00-Q99) 19 CHAPTER 18 .O33. and payers for administrative.5 23. S89. O64.1 23. O60.3 .22.Diseases of the respiratory system (J00-J99) 12 CHAPTER 11 .Factors influencing health status and contact with health services (Z00-Z99) 23 7th Character             23. accreditation organizations. financial.6 23.Diseases of the digestive system (K00-K93) 13 CHAPTER 12 . X00 .9. S80 . W00 .8. coders.2 M48.Mental and behavioral disorders (F01-F99) 7 CHAPTER 6 . S79.Certain infectious and parasitic diseases (A00-B99) 3 CHAPTER 2 .X99.Diseases of the musculoskeletal system and connective tissue (M00-M99)= 15 CHAPTER 14 . S89.Diseases of the genitourinary system (N00-N99) 16 CHAPTER 15 .0. M84. surgical.

Descriptions are Terms or names (synonyms) assigned to a concept. findings. However. encoded and used for clinical care of patients and research. microorganisms. For example Viral pneumonia might be defined as Pneumonia that is caused by a Virus. Since its inception. It also helps organizing the content of medical records. But SNOMED also allows concepts to be Defined by a predicate. Upper level concepts include Procedure. in 1994. HL7 or openEHR. Clinical finding. Several standards. It was developed and is maintained by the Regenstrief Institute. The Concept graph must be acyclic — a parent cannot be its own child. such as IHE. The purpose is to assist in the electronic exchange and gathering of clinical results (such as laboratory tests. SNOMED SNOMED CT (Systematized Nomenclature of Medicine -. for Diagnostic Imaging procedures Knowledge databases used in clinical decision support CDSS Remote Intensive Care Unit Monitoring Laboratory Reporting Emergency Room Charting Cancer Reporting Genetic Databases LOINC STANDARDS Logical Observation Identifiers Names and Codes (LOINC) is a database and universal standard for identifying medical laboratory observations. a US non-profit medical research organization. Pharmaceutical/biologic product. SNOMED concepts are often referred to by an information model such as HL7. such as Virus. outcomes management and research). procedures. The Concepts are arranged in a type or IS-A hierarchy. reducing the variability in the way data is captured. Concepts often have several Descriptions. It allows a consistent way to index..Clinical Terms). Some Concepts can be Primitive. Immunosuppression might be a Therapy or a Finding. Concepts can have Roles. It is endorsed by the American Clinical Laboratory Association and the College of American Pathologist. store. Organism. to electronically transfer results from different reporting systems to the appropriate healthcare networks. Viral pneumonia has a role Causitive Agent which must be a Virus.g. Managed care providers. pharmaceuticals etc. This has obvious disadvantages to the healthcare network that may need to adopt different codes to access and manage information coming from multiple sources. For example. and a description may sometimes refer to more than one concept. Concepts may have multiple parents. For example.g.CPT is currently identified by the Centers for Medicare and Medicaid Services (CMS) as Level 1 of the Health Care Procedure Coding System. but also: nursing diagnosis. Viral pneumonia IS-A Infectious pneumonia IS-A Pneumonia IS-A Lung disease. for example. outcomes classification. the health information enclosed is identified by a multiplicity of code values that may vary according to the entity producing those results. Body structure. clinical observations. e. often have negotiated contracts that reimburse episodes of care and unique coding to trigger . Defined concepts are based on Description Logic. and aggregate clinical data across specialties and sites of care. LOINC was created in response to the demand for an electronic database for clinical care and management and is publicly available at no cost. nursing interventions. LOINC applies universal code names and identifiers to medical terminology related to the Electronic health record. the database has expanded to include not just medical and laboratory code names. Event. SNOMED CT consists of over a million medical Concepts. For example 22298006 means myocardial infarction (MI). retrieve. is a systematically organized computer processable collection of medical terminology covering most areas of clinical information such as diseases. for example Infectious pneumonia is also an Infectious disease. and patient care data set. Sample Computer Applications Using SNOMED CT          Electronic Health Record Systems Computerized Provider Order Entry CPOE Such As E-Prescribing Or Laboratory Order Entry Catalogues of clinical services e. Inc.

related terms. volume.. financing. RxNorm now includes the National Drug File . molar mass. The database currently has over 58. enforcement.. it was identified by the HL7 Standards Development Organization as a preferred code set for laboratory test names in transactions between health care facilities.characteristics of what is measured. Gold Standard Alchemy.S. the software RELMA (Regenstrief LOINC Mapping Assistant) is available in separate downloads that contain an additional word index in Spanish. The scale may be quantitative. Currently(as of January. Spanish.. or Korean. improved community wide electronic health records.interval of time over which the observation or measurement was made System.g. LOINC is one of the standards for use in U. laboratory testing devices. monitoring. such as length.. and public health authorities. A universal code system will enable facilities and departments across the world to receive and send results from their areas for comparison and consultation and contribute toward a larger public health initiative of improving clinical outcomes and quality of care. physiologic effect. 2009). and Multum. structure. urine.. 3. translations. ordinal. and therapeutic category. NDF-RT is a terminology used to code clinical drug properties. including those of First Databank.context or specimen type within which the observation was made (example: blood. laboratories. Other database fields include status and mapping information for database change management. By providing links between these vocabularies. including mechanism of action. A formal. Some of the advantages resulting from adopting LOINC may include improved communication in integrated healthcare delivery networks.) Type of scale. and integration of standards within the broader health care system.000 observation terms that can be accessed and understood universally. or observed (example: urea. German.procedure used to make the measurement or observation A unique code (format: nnnnn-n) is assigned to each entry upon registration. CAS registry number). For more information on LOINC International. see LOINC International.) Kind of property. 4. improved transfer of payment information for services rendered and a significant improvement in the overall quality of health care by reducing errors in the system. synonyms. Federal Government systems for the electronic exchange of clinical health information. The fact that universal standards are being promoted (if not adopted by national organizations and agencies) is an indication that the dialogue will continue regarding the development..automated claim payment. mass. observation. Micromedex. distinct. evaluated. MediSpan. and unique 6-part name is given to each term for test or observation identity. or measurement: 1. substance information (e. RxNorm can mediate messages between systems not using the same software and vocabulary. such as Simplified Chinese. In 1999. Mapping each entity-specific code to its corresponding universal code can represent a significant investment of both human and financial capital. UNIFIED MEDICAL LANGUAGE SYSTEM . time stamp and so on Time aspect. Simplified Chinese. which allows searching in these languages in addition to English RxNORM STANDARDS RxNorm provides normalized names for clinical drugs and links its names to many of the drug vocabularies commonly used in pharmacy management and drug interaction software. 5. the automatic transfer to public health authorities of case reports for reportable diseases (e. 6.g. Each database record includes six fields for the unique specification of each identified single test. Component. 2. for disease control or detection of epidemics). choices of answers for nominal scales. International interest in LOINC continues to grow.Reference Terminology (NDF-RT) from the Veterans Health Administration. nominal or narrative Type of method. A number of efforts have been undertaken to translate the LOINC documents and terms into various languages.the scale of measure.what is measured.

HL7. it chooses areas to focus on..rather than rewritten. More characteristics are:      each Integration Profile is based on relevant use-cases described by real users Integration Profiles are independent of manufacturers or products Integration Profiles are stable once published and may be extended by amendments . LOINC. It is intended to be used mainly by developers of systems in medical informatics. UMLS consists of Knowledge Sources (databases) and a set of software tools. It solicits proposals. Lindberg.The Unified Medical Language System (UMLS) is a compendium of many controlled vocabularies in the biomedical sciences (created 1986[1]).gov systems.) to accomplish it. . IHE is an international organization that focuses on the development of open and global IHE Integration Profiles and on the regional deployment of interoperable IT systems. identifies available standards. is updated quarterly and may be used for free. UMLS further provides facilities for natural language processing. a consortium of radiologists and information technology experts formed IHE. The UMLS was designed and is maintained by the US National Library of Medicine. to facilitate the communication between different systems. it may also be viewed as a comprehensive thesaurus and ontology of biomedical concepts. IHE also stages "connectathons" and "interoperability showcases" in which vendors assemble to demonstrate the interoperability of their products. The UMLS can be used to design information retrieval or patient record systems. The project was initiated in 1986 by Donald A. For many of these applications. then and current Director of the Library of Medicine. Often this is a problem due to the large volume of documents retrieved when the medical literature is searched. Integration Profiles describe basic functional elements and therefore are reusable in many IT applications. The group gathers case requirements. or "Integrating the Healthcare Enterprise. The purpose of the UMLS is to enhance access to this literature by facilitating the development of computer systems that understand biomedical language.. and after surveying its members to better understand their priorities. B. In 1997. or to develop systems that parse the biomedical literature." IHE created and operates a process through which interoperability of health care IT systems can be improved. IHE Technical Frameworks are the detailed documents which specify the Integration Profiles and the associated actors (systems) and transactions. It provides a mapping structure among these vocabularies and thus allows one to translate among the various terminology systems. DICOM. IHE concentrates on specific projects. M.. and develops technical guidelines that manufacturers can implement. Integrating health care enterprise (IHE) IHE is an initiative by healthcare professionals and industry to improve the way computer systems in healthcare share information.g. Because of its limited resources. A group of systems that implement the same Integration Profile address the need/scenario in a mutually compatible way. This is achieved by overcoming two significant barriers: "the variety of ways the same concepts are expressed in different machine-readable sources & by different people" and "the distribution of useful information among many disparate databases & systems". IHE Integration Profiles describe a clinical information need or workflow scenario and document how to use established standards (e. The Library of Medicine itself uses it for its PubMed and ClinicalTrials. The number of biomedical resources available to researchers is enormous. the UMLS will have to be customized locally according to one's particular needs. Integration Profiles provide an implementation guide for equipment vendors Integration Profiles are an effective shorthand for healthcare providers to specify integration requirements when purchasing systems and therefore achieved considerable recognition in the market.D. IHE Integration Statements are simple documents prepared and published by a vendor to list the IHE Profiles supported by a specific release of a specific product.

and that products are tested the same way. health care system. The organization's headquarters are in Washington. known as the Administrative Simplification (AS) provisions. Switzerland. makes it more powerful than most non-governmental organizations.L. Title I of HIPAA protects health insurance coverage for workers and their families when they change or lose their jobs. companies. It was originally sponsored by Sen. Pennsylvania. particularly health vocabulary and messaging standards. for implementation in federal government systems. The organization's headquarters is in West Conshohocken. and employers.000 standards. According to the Centers for Medicare and Medicaid Services (CMS) website. systems. ANSI's operations office is located in New York City. Congress in 1996. ANSI also accredits organizations that carry out product or personnel certification in accordance with requirements defined in international standards. and others. that people use the same definitions and terms. which draw their members from around the world and collectively develop and maintain more than 12. either through treaties or national standards. ASTM supports thousands of volunteer technical committees. American society for testing and materials(ASTM) ASTM International (ASTM). standards with international standards so that American products can be used worldwide. services. Using a consensus process. American National Standards Institute The American National Standards Institute or ANSI is a private non-profit organization that oversees the development of voluntary consensus standards for products. products. government agencies. Founded on February 23. accreditation services. the organization promulgates worldwide proprietary industrial and commercial standards. is an international standard-setting body composed of representatives from various national standards organizations. membership dues and fees. The ANSI annual operating budget is funded by the sale of publications.104-191) [HIPAA] was enacted by the U. International Organization of Standardization (ISO) The International Organization for Standardization widely known as ISO. health insurance plans.S. Consolidated Health Informatics (CHI) CHI is a collaborative effort to adopt health information interoperability standards. is an international standards organization that develops and publishes voluntary consensus technical standards for a wide range of materials. standards ensure that people who own cameras can find the film they need for that camera anywhere around the globe.IHE Connectathons are annual events where equipment vendors bring products with IHE Profiles and test them with other vendors. originally known as the American Society for Testing and Materials. ANSI accredits standards that are developed by representatives of standards developing organizations. and services. For example. These standards ensure that the characteristics and performance of products are consistent. Nancy Kassebaum. It has its headquarters in Geneva. Title II of HIPAA.S. about 5 miles (8 km) northwest of Philadelphia. consumer groups. DC. requires the establishment of national standards for electronic health care transactions and national identifiers for providers. and personnel in the United States. HIPAA The Health Insurance Portability and Accountability Act (HIPAA) of 1996 (P. Edward Kennedy and Sen. feebased programs. and international standards programs. The organization also coordinates U. and claims to be the world's largest developer of standards. systems. The Administration Simplification provisions also address the security and privacy of health data. While ISO defines itself as a non-governmental organization.S. 1947. processes. . ASTM has a dominant role among standards developers in the USA. its ability to set standards that often become law. The standards are meant to improve the efficiency and effectiveness of the nation's health care system by encouraging the widespread use of electronic data interchange in the U.

Once agreement has been reached on which technical aspects are to be covered in the standard. The latter proposes the new work item to ISO as a whole. ISO has established the general rule that all ISO standards should be reviewed at intervals of not more than five years. a second phase is entered during which countries negotiate the detailed specifications within the standard. new methods and materials. testing laboratories. the Department of Defense and the Department of Veteran's Affairs are active in the CHI governance process. Originally. 2. Several factors combine to render a standard out of date: technological evolution. following which the agreed text is published as an ISO International Standard. To take account of these factors. the first phase involves definition of the technical scope of the future standard. 1. . governments. It is also possible to publish interim documents at different stages in the standardization process. and approval by 75% of all members that vote). STANDARDS DEVELOPMENT PROCESS ISO standards are developed according to the following principles. CHI identified a portfolio of 24 health domains that later expanded to 27. which communicates this need to a national member body. and Identification and adoption of new standards. Industry wide Global solutions to satisfy industries and customers worldwide. consumer groups. CHI is focusing on    Implementation of adopted standards. Once the need for an International Standard has been recognized and formally agreed. Maintenance of adopted standards. new quality and safety requirements. CHI is an integral element of the Federal Health Architecture (FHA) Program that is in the Office of the National Coordinator for Health Information Technology. The need for a standard is usually expressed by an industry sector. In Phase II. This phase is usually carried out in working groups which comprise technical experts from countries interested in the subject matter. This is the consensus-building phase. The final phase comprises the formal approval of the resulting draft International Standard (the acceptance criteria stipulate approval by two-thirds of the ISO members that have participated actively in the standards development process. CHI adopted 20 uniform standards for electronic exchange of clinical information to be used across the federal health enterprise. Most standards require periodic revision.   Voluntary International standardization is market driven and therefore based on voluntary involvement of all interests in the market-place.About 20 department/agencies including the Department of Health and Human Services. Phase I ended in May 2004. engineering professions and research organizations. There are three main phases in the ISO standards development process as follows. vendors and users. it is necessary to revise a standard earlier. On occasion.  Consensus The views of all interests are taken into account: manufacturers. 3.

but hierarchically ordered and layered. and outcomes reporting. Such records may include a whole range of data in comprehensive or summary form.  Improve quality of care The implementation of electronic health records (EHR) can help lessen patient sufferance due to medical errors and the inability of analysts to assess quality. quality management. Also. and private payers would receive $31 billion per year. the best practices in software engineering and medical informatics must be deployed. to avoid failures that can cause injury to the patient and violations to privacy. Medicare would receive about $23 billion of the potential savings per year. medical history. If savings are allocated using the current level of spending from the National Health Accounts. easing to get access on details is improved with browser capabilities applied to screen presentations also cross referring to the respective coding concepts ICD. these benefits may only be realized if the EHR systems are interoperable and wide spread (for example.ELECTRONIC HEALTH RECORD An electronic health record (EHR) (also electronic patient record (EPR) or computerised patient record) is an evolving concept defined as a systematic collection of electronic health information about individual patients or populations. thus helping to reduce administration costs which then in turn can free up time and money for patient care. a vast amount of funds are allocated towards the health care industry—more than $1. Its purpose can be understood as a complete record of patient encounters that allows the automation and streamlining of the workflow in health care settings and increases safety through evidence-based decision support. medication and allergies. and billing information. including demographics. vital signs. During compilation while hospitalisation or ambulant serving of the patient. EHR systems can help reduce medical errors by providing healthcare workers with decision support.  Promote evidence-based medicine EHRs provide access to unprecedented amounts of clinical data for research that can accelerate the level of knowledge of effective medical practices. by being embedded in network-connected enterprise-wide information systems. Realistically. Improved usage of EHR is achieved if the presentation on screen or on paper is not just longitudinal. Computerized Physician Order Entry (CPOE)—one component of EHR—increases patient safety by listing instructions for physicians to follow when they prescribe drugs to patients. CPOE can tremendously decrease medical errors: CPOE could eliminate 200. It is a record in digital format that is capable of being shared across different health care settings. Information Technology is being used today to automate day-to-day processes.7 trillion per year. DRG and medical procedures information.000 adverse drug events and save about $1 billion per year if installed in all hospitals. immunization status. Fast access to medical literature and current best practices in medicine are hypothesised to enable proliferation of ongoing improvements in healthcare efficacy. radiology images.S. Naturally. Benefits:  Reduction of cost In the U. . laboratory test results. personal stats like age and weight. national or regional level) so that various systems can easily share information.

 Record keeping and mobility EHR systems have the advantages of being able to connect to many electronic medical record systems.It is also easier to check in their records whether a patient as been admitted to such a medical centre or if they have any allergies since they have been admitted before. patients are shopping for their procedures. Clearly the importance of data standards to enhancing the quality and efficiency of healthcare delivery is being recognized. Reviewing the business value of defining and using data standards is critical for driving the implementation of these standards into applications and systems. . In the current global medical environment. Coordinating these appointments via paper records is a time-consuming procedure. Many international patients travel to US cities with academic research centers for specialty treatment or to participate in Clinical Trials.

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