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Antepartum Record Profile. HIMSS 2009 Interoperability Showcase IHE Patient Care Coordination Tone Southerland Greenway Medical Technologies. Value Proposition. Over 4 million live births per year in the US alone.
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Antepartum Record Profile HIMSS 2009 Interoperability Showcase IHE Patient Care Coordination Tone Southerland Greenway Medical Technologies
Value Proposition • Over 4 million live births per year in the US alone. • Average cost of pregnancy care*: (medical- 84.1%, lab and imaging- 11.2%, drugs- 4.7%) • vaginal delivery: $7,737 • cesarean delivery: $10,958 • $4,000,000 x $9,347 = $37,388,000,000 (That’s billion with a B) *Thomson Healthcare. The Healthcare Costs of Having a Baby. Santa Barbara, CA: Thomson Healthcare; June 2007
Problem • The patient’s data pertaining to the pregnancy that is being transmitted is often: • Incomplete • Incorrect • Not sent • This can result in • Repeating unnecessary labs/imaging studies • Inadequate treatment • Undesirable outcomes
Use Case • Pregnant patient is seen by obstetric care provider for initial visit and subsequent visits. • Obstetric provider transmits patient’s antepartum information to central data repository or directly to the intended delivery facility. • Patient’s record is accessed when she arrives at the birthing facility.
Scope Capability to electronically communicate the following type of information to care providers and institutions: • Antepartum History and Physical • Antepartum Summary • Antepartum Laboratory • Antepartum Education
Standards Used • Industry Standards: • American College of Obstetrician and Gynecologists (ACOG) Antenatal Form • Clinical Document Architecture Release 2.0 (CDA R2) • Logical Observation Identifiers Names and Codes (LOINC) • Systemized Nomenclature of Medicine – Clinical Terms (SNOMED CT) • IHE Standards: • Medical Summary (MS) • Sharing Laboratory Reports (XD-LAB) • Cross Enterprise Document Sharing (XD*) • Document Digital Signature (DSG) • Notification of Document Availability (NAV)
Key Technical Properties • Use of technologies such as: • HTTP • TLS • XML/XSLT • Use of XDS folder construct to contain one or more of the antepartum documents • Use of an inheritance model with existing IHE profiles • Use of a replace model for all of the antepartum documents • Data is both human and machine readable
References • Antepartum Record http://wiki.ihe.net/index.php?title=PCC_TF-1/APR • American College of Obstetrics and Gynecology http://www.acog.org/acb-custom/aa128.pdf