Electronic clinical document exchange
Prior to the approval of the Continuity of Care Document () as an ANSI Standard in 2007, electronic data exchange of clinical data could utilize one of two formats: Clinical Document Architecture () or ASTM Continuity of Care Record (). Both formats allow providers to share clinical summary information about patients to referring physicians, pharmacies, systems and other providers.
Both formats also have the ultimate goal of improving patient care. But although they are similar in this way, they are not compatible with each other.
It would be overtly obvious to suggest that technology moves fast and advances quickly. In healthcare, the rate of new technology introductions has moved far more quickly than the industry can accommodate and implement. In other industries, accelerated technology adoptions may be considered “par for the course”. Healthcare, though, is unique. As much as business issues are a real factor, so too is the need for a level of cooperation and symmetry in order to comply with the first objective – quality patient care.
To address this workflow void, standards such as the Continuity of Care Document () and Continuity of Care Record () were introduced to begin solving the problem of patient-data portability and interoperability.
This white paper, the first in a series on the many healthcare standards, will serve to:
The HL7 standard is often called the “non-standard standard.” While not entirely fair, it does reflect the fact that almost every hospital, clinic, imaging center, lab, and care facility is “special” and, therefore, there is no such thing as a standard business or clinical model for interacting with patients, clinical data, or related personnel.
Whether you build or buy, the process is still essentially the same. If you are considering adding an subsystem to your healthcare application—provider or vendor, the process you need to undertake is essentially the same. The questions below encompass what we believe are the key questions to answer prior to building or buying and then implementing your HL7 subsystem.
Answering these questions will help make your HL7 implementation easier to understand, and less time-consuming, and less costly in the long term.
Although the 2.X messaging standard is the most widely used standard in the United States for the exchange of clinical patient data, it varies greatly in how it is implemented by each medical device and application. Consequently, it is often called the “non-standard standard”. The purpose of HL7 2.X is to provide a framework for negotiation so that each healthcare interface is closer to 20% custom rather than 100%.
Most hospital departments utilize an interfacing application to route and process messages throughout the hospital system. These interfaces are typically built in a point-to-point manner by the hospital IT staff or may be built on an interface engine platform.
Hospitals of all sizes are discovering it can be more productive for an individual department to create and manage its own connections.
The prospects of a fully integrated healthcare system are truly exciting. While patients’ expectations and capabilities may truly never completely align, the exchange of a patient’s health data within a health organization, or regionally, among aligned providers, have tremendous potential to improve patient care and satisfaction.
Now that the majority of innovative healthcare organizations have invested the capital, time and effort to install electronic medical records, many are looking to fully leverage the technology and meet Meaningful Use requirements by connecting to an HIE.