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2. Outline. Standards Development ProcessStandards that support Health Care Information System InteroperabilityClassification, Vocabulary and Terminology StandardsData Interchange StandardsHealth Record Content StandardsImpact of HIPAANational Health Information Infrastructure. 3. Standards De
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1. 1 Health Care Information System Standards Chapter 9
2. 2 Outline Standards Development Process
Standards that support Health Care Information System Interoperability
Classification, Vocabulary and Terminology Standards
Data Interchange Standards
Health Record Content Standards
Impact of HIPAA
National Health Information Infrastructure
3. 3 Standards Development Process Four Methods (Hammond & Cimino, 2001)
Ad hoc—no formal adoption process
De facto—vendor or other has a very large segment of the market
Government mandate
Consensus—volunteers from organizations come together to reach a formal agreement
4. 4 Formal Standards Development Organizations
International Organization for Standardization (ISO) www.iso.org
American National Standards Institute (ANSI) www.ansi.org
Standards Development Organizations (SDOs)
ASTM International www.astm.org
Health Level 7 www.hl7.org
ANSI ASC X12 www.x12.org
5. 5 ISO Facts
Members are national standards bodies from many countries
ANSI is the US national body member
Oversees the flow of documentation and international approval of standards developed by its member bodies
6. 6 ANSI Facts
US member of ISO
Accredits SDOs from a wide range of industries (including health care)
Oversees work of SDOs
Does NOT develop standards
Publishes the 10,000+ standards developed by SDOs
7. 7 SDOs Facts
Must be accredited by ANSI
Develops standards in accordance with ANSI criteria
Can use the label “Approved American National Standard”
270+ ANSI-accredited SDOs representing many industries, including health care
8. 8 Classification, Vocabulary and Terminology Standards To date no single vocabulary has emerged
Common coding and classification systems
ICD-9-CM (chapter 1)
CPT (chapter 1)
DRGs (chapter1)
9. 9 Classification, Vocabulary and Terminology Standards National Committee on Vital and Health Statistics identified a core set of patient medical record information (PMRI) terminology standards
SNOMED CT
LOINC
Several federal drug terminology including RxNorm
10. 10 SNOMED CT Systemized Nomenclature of Medicine– Clinical Terms
340,000+ concepts with unique meanings
900,000+ English language descriptions or synonyms
~1.3 million semantic relationships
Maps to other systems, such as ICD-9-CM, ICD-10, LOINC, and others
11. 11 LOINC Logical Observation Identifiers Names and Codes
Developed to facilitate the electronic transmission of laboratory results
~32,000 observational terms
Applies to equivalent tests, not unique to companies
12. 12 RxNorm RxNorm is a developing project within the National Library of Medicine Unified Medical Language System (UMLS)
Purpose is to define a nonproprietary drug vocabulary
13. 13 Data Interchange Standards Examples of Data Interchange standards that impact health care
Health Level 7 standards (HL7)
Digital Imaging and Communications in Medicine (DICOM)
National Council for Prescription Drug Programs (NCPDP)
ANSI X12N standards
14. 14 HL7 HL7 is an ANSI-accredited SDO
develops HL7 messaging standards to allow interoperability among health care applications
Involved in other standards activities, but the messaging standard is referred to as HL7
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