Health Care Information System Standards

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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