Special Topics in Vendor- Specific Systems Unit 6 Vendor strategies for terminology, knowledge...

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Special Topics in Vendor-Specific Systems

Unit 6Vendor strategies for terminology, knowledge management, and data

exchange

Objective

• Evaluate EHR strategies for terminology management, knowledge management and data exchange

Component 14/Unit 6Health IT Workforce Curriculum

Version 1.0/Fall 20102

After this completing this unit, you should be able to:

• Define interoperability

• Describe vendor strategies for terminology and knowledge management, and how these impact interoperability

• Describe processes and requirements for exchanging data with personal health records

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InteroperabilityIf I’m faxed a discharge summary which I can read, is that interoperable, since it’s human interpretable? If I’m sent an electronic note via email that notes “Allergy to MS”, is that interoperable? Of course MS could mean Morphine Sulfate, Magnesium Sulfate, or even Minestrone Soup. If I’m sent an electronic message which has an agreed upon format, a standard vocabulary, and a set of business rules which enable me to take action, is that interoperable? i.e. Your patient is allergic to medication NDC Code 123456789. Administration will cause a SEVERE reaction with HIGH CONFIDENCE. My e-Prescribing software could use this information to display a warning alerting me to the issue and could suggest an effective alternative medication.

» John D. Halamka MD, MS, Chair, Health Information Technology Standards Panel (HITSP)

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Three Types of Interoperability:

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Technical InteroperabilityIf I’m faxed a discharge summary which I can read, is that interoperable, since it’s human interpretable? If I’m sent an electronic note via email that notes “Allergy to MS”, is that interoperable? Of course MS could mean Morphine Sulfate, Magnesium Sulfate, or even Minestrone Soup. If I’m sent an electronic message which has an agreed upon format, a standard vocabulary, and a set of business rules which enable me to take action, is that interoperable? i.e. Your patient is allergic to medication NDC Code 123456789. Administration will cause a SEVERE reaction with HIGH CONFIDENCE. My e-Prescribing software could use this information to display a warning alerting me to the issue and could suggest an effective alternative medication.

» John D. Halamka MD, MS, Chair, Health Information Technology Standards Panel (HITSP)

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Technical Interoperability: Messaging Standards

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MSH|^~\&|GHH LAB|ELAB-3|GHH OE|BLDG4|200202150930||ORU^R01|CNTRL-3456|P|2.4<cr> PID|||555-44-4444||EVERYWOMAN^EVE^E^^^^L|JONES|19620320|F|||153 FERNWOOD DR.^ ^STATESVILLE^OH^35292||(206)3345232|(206)752-121||||AC555444444||67-A4335^OH^20030520<cr> OBR|1|845439^GHH OE|1045813^GHH LAB|15545^GLUCOSE|||200202150730||||||||| 555-55-5555^PRIMARY^PATRICIA P^^^^MD^^|||||||||F||||||444-44-4444^HIPPOCRATES^HOWARD H^^^^MD<cr> OBX|1|SN|1554-5^GLUCOSE^POST 12H FST:MCNC:PT:SER/PLAS:QN||^182|mg/dl|70_105|H|||F<cr>

Semantic Interoperability

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MSH|^~\&|GHH LAB|ELAB-3|GHH OE|BLDG4|200202150930||ORU^R01|CNTRL-3456|P|2.4<cr> PID|||555-44-4444||EVERYWOMAN^EVE^E^^^^L|JONES|19620320|F|||153 FERNWOOD DR.^ ^STATESVILLE^OH^35292||(206)3345232|(206)752-121||||AC555444444||67-A4335^OH^20030520<cr> OBR|1|845439^GHH OE|1045813^GHH LAB|15545^GLUCOSE|||200202150730||||||||| 555-55-5555^PRIMARY^PATRICIA P^^^^MD^^|||||||||F||||||444-44-4444^HIPPOCRATES^HOWARD H^^^^MD<cr> OBX|1|SN|1554-5^GLUCOSE^POST 12H FST:MCNC:PT:SER/PLAS:QN||^182|mg/dl|70_105|H|||F<cr>

Semantic Interoperability (cont.)

If I’m faxed a discharge summary which I can read, is that interoperable, since it’s human interpretable? If I’m sent an electronic note via email that notes “Allergy to MS”, is that interoperable? Of course MS could mean Morphine Sulfate, Magnesium Sulfate, or even Minestrone Soup. If I’m sent an electronic message which has an agreed upon format, a standard vocabulary, and a set of business rules which enable me to take action, is that interoperable? i.e. Your patient is allergic to medication NDC Code 123456789. Administration will cause a SEVERE reaction with HIGH CONFIDENCE. My e-Prescribing software could use this information to display a warning alerting me to the issue and could suggest an effective alternative medication.

» John D. Halamka MD, MS, Chair, Health Information Technology Standards Panel (HITSP)

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Semantic Interoperability: Terminology Standards

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ICD-9 Codes

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Transition to ICD-10

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LOINC

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MSH|^~\&|GHH LAB|ELAB-3|GHH OE|BLDG4|200202150930||ORU^R01|CNTRL-3456|P|2.4<cr> PID|||555-44-4444||EVERYWOMAN^EVE^E^^^^L|JONES|19620320|F|||153 FERNWOOD DR.^ ^STATESVILLE^OH^35292||(206)3345232|(206)752-121||||AC555444444||67-A4335^OH^20030520<cr> OBR|1|845439^GHH OE|1045813^GHH LAB|15545^GLUCOSE|||200202150730||||||||| 555-55-5555^PRIMARY^PATRICIA P^^^^MD^^|||||||||F||||||444-44-4444^HIPPOCRATES^HOWARD H^^^^MD<cr> OBX|1|SN|1554-5^GLUCOSE^POST 12H FST:MCNC:PT:SER/PLAS:QN||^182|mg/dl|70_105|H|||F<cr>

Process InteroperabilityIf I’m faxed a discharge summary which I can read, is that interoperable, since it’s human interpretable? If I’m sent an electronic note via email that notes “Allergy to MS”, is that interoperable? Of course MS could mean Morphine Sulfate, Magnesium Sulfate, or even Minestrone Soup. If I’m sent an electronic message which has an agreed upon format, a standard vocabulary, and a set of business rules which enable me to take action, is that interoperable? i.e. Your patient is allergic to medication NDC Code 123456789. Administration will cause a SEVERE reaction with HIGH CONFIDENCE. My e-Prescribing software could use this information to display a warning alerting me to the issue and could suggest an effective alternative medication.

» John D. Halamka MD, MS, Chair, Health Information Technology Standards Panel (HITSP)

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Version 1.0/Fall 201014

Process Interoperability (cont.)

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Example: Cerner

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Example: Eclipsys

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Example: eClinicalWorks

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Examples of Third-party Terminology Products

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Personal Health Records

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Accuracy of EHR->PHR Data

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Benefits of PHRs

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Barriers to Linking EHR and PHR Data

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