09- Networking and Health Information Exchange- Unit 5- Health Data Interchange Standards- Lecture C

8/10/2019 09- Networking and Health Information Exchange- Unit 5- Health Data Interchange Standards- Lecture C

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Networking and Health

Information Exchange

Health Data Interchange Standards

Lecture c

This material Comp9_Unit5c was developed by Duke University funded by the Department of Health and Human Services,

Office of the National Coordinator for Health Information Technology under Award Number IU24OC000024.


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Health Data Interchange StandardsLearning Objectives

1. Understand linking and aggregating data at all levels

(Lecture a)

2. Understand how data may be interchanged among

heterogeneous settings without loss of information(Lecture a)

3. Understand HL7 v2.x messaging communication

standard (Lecture a)

4. Understand HL7 v3.0 messaging standards (Lecture b)5. Understand other data interchange standards - DICOM,

NCPDP, IEEE, X12N, ASTM, IHE (Lecture c)

2Health IT Workforce Curriculum

Version 3.0/Spring 2012

Networking and Health Information Exchange


Lecture c


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Health Data Interchange StandardsLearning Objectives

6. Explain how model-based standards are created

(Lecture b)

7. Define the methodology development framework

(Lecture b)

8. Describe HL7 v3.0 messaging standards (Lecture b)

9. Imaging standards (Lecture c)

10.Standards for pharmacy services (Lecture c)

11. Interface standards for medical devices (Lecture c)12.Claims and reimbursement standards (Lecture c)

13.Concept of profiling (Lecture c)

14.Use and value of implementation guides (Lecture c)





Lecture c


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DICOM





Lecture c

Digital Imaging and Communication in Medicine (DICOM)

Industry standard for transfer of radiologic

images And other medical information between computers

Developed by

American College of Radiology

National Electrical Manufacturers Assn.

Current structure developed in 1993

Current version 3.0


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DICOM

A single DICOM file contains

Header

Stores information about the patient's name, the

type of scan, image dimensions, etc.

All of the image data

Contains information in three dimensions

DICOM is the most common standard forreceiving scans from a hospital



Networking and Health Information ExchangeHealth Data Interchange Standards

Lecture c


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National Council for PrescriptionDrug Programs (NCPDP)




Lecture c

Data interchange standards for pharmacy services

Standards included in meaningful use criteria

Key standards include Telecommunication Standard

Batch Standard

Script for electronic prescribing

Manufacturers Rebate Standard Billing Unit Standard

XML Standard for NCPDP


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NCPDP Implementation Guides

Financial Information Standard IG

Formulary and Benefit Standard IG

Functional Profiles for EHR Systems Pharmacy ID Card IG

Script IG

Specialized standard IG

Telecommunication Standard IG




Lecture c


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Cross standard resources

Data Dictionary

External Code List

NCPDP has a collaborative and

harmonization relationship with HL7 for

electronic prescribing coordination




Lecture c


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Institute of Electrical andElectronic Engineering (IEEE)

Standards Developing Organization

focused primarily on device standards

Works with ISO, HL7, CEN and DICOM tocreate device standards

Standards referred to as point of care

standards

Also creates waveform standards




Lecture c


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IEEE Standards

Family of medical device standards

labeled 11073 nnnnn

ISO rules title is Health Informatics class purpose

10Health IT Workforce CurriculumVersion 3.0/Spring 2012


Lecture c


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IEEE - 2000

30200 Transport profile cable connected



Lecture c


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IEEE 2004

10101 Nomenclature

10201 Domain information model

20101 Application profile basestandard

30200 Transport profile cable

connected 30300 Transport profile infrared

wireless



Lecture c


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IEEE 2007

92001 Medical waveform format

encoding rules



Lecture c


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IEEE - 2008

00101 [TR] Guidelines for the use ofwireless technology

10404 Pulse oximeter

10407 Blood pressure monitor

10408 Thermometer

10415 Weighing scale

10421 Body composition analyzer



Lecture c


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IEEE 2008 (cont)

10441 Cardiovascular fitness and

activity monitor

10442 - Strength fitness equipment 10471 Independent living activity hub

20601 Application profile Optimized

Exchange protocol 90101 analytical instruments, point-of-

care test.



Lecture c


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IEEE - 2009

10417 Glucose monitor

91064 Computer-assisted

electrocardiography



Lecture c


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IEEE - 2010

10420 Body composition analyzer

10421 Peak expiratory flow monitor

10472 Medication monitor

30400 Interface profile cabled Ethernet



Lecture c


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IEEE Under Development

00103 [TR] Overview

10101 [rev] Nomenclature

10102 Nomenclature Annotated ECG

10103 Nomenclature Implantable

device, cardiac

10201 [rev] Domain information model

10202 Domain information model XML

schema format



Lecture c


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10404 [rev] Pulse oximeter

10406 Basic electrocardiogram (1 to 3

lead ECG)

10413 Respiration rate monitor

10417 [rev] Glucose monitor

10418 International normalized ratio

(INR) monitor

10419 Insulin pump



Lecture c


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10441 [rev] Cardiovascular fitness andactivity monitor

20200 Association control function

20201Polling mode

20202 Baseline asynchronous mode

20301 Optional package, remote control

20401 Common networking

infrastructure



Lecture c


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20601a [amendment] Optimized

exchange protocol

30200a [amendment] Transport profile cable connected

30503 Transport profile RF wireless

local area network (wLAN)



Lecture c


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X12n

Creates EDI standards related to claims

and reimbursement

Use required by HIPAA

Standards available from Washington

Publishing Company or purchase CD

version



Lecture c


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The HIPAA Standard Transactions



Lecture c

Source: W Ed Hammond, Derived from ASC X12N documentation


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ASTM

E31 Healthcare Informatics develops

standards related to healthcare and

healthcare decision making.

Two standards relate to data interchange

Properties of a Universal Healthcare Identifier

(UHID)

Continuity of Care Record



Lecture c


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Continuity of Care Record

Core data set of administrative,

demographic and clinical data about a

patient

May be single or multiple encounter-based

Snapshot or summary of patient data

Used to exchange data between

physicians, systems

Uses XML schema



Lecture c


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Integrating the HealthcareEnterprise (IHE)

Is not a standards developing organization

Use standards developed by other SDOs

Provides a common framework for passinghealth information seamlessly: Within the healthcare enterprise

Across multiple healthcare enterprises

For local, regional & nationalhealth information networks

Drives standards adoption to address

specific clinical needs.



Lecture c


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IHE

Drives standards adoption to addressspecific clinical needs

Coordinates implementation of standards

to meet clinical and administrative needs Creates integration profiles to provide end-

to-end interoperability

Sponsor annual Connectathon at HIMSS Provides opportunity for vendors to test and

demonstrate interoperability of their products



Lecture c


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Domains of Activity

IT Infrastructure

Radiology

Laboratory

Cardiology

Patient care coordination

Patient care devices Radiation Oncology

Eye



Lecture c


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Document Exchange Profiles

XDS Document sharing

XDR Document reliable interchange

XDM

Document media interchange PIX Patient identifier cross reference

manager

PDQ

Patient demographic supplier XCA Cross-community access



Lecture c


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XDS

XDS is a document specification that helpsusers manage documents in a consistent

way. The components/actors of XDS are:

Document Source Document repository

Document Registry

Document Consumer Patient Identity Source



Lecture c


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Health Data Interchange StandardsSummary

This unit has introduced you to a series of standards

are used for networking between sites at all levels

Much of the focus was on clinical messaging standards

namely HL7 v2.n and v3 standards

You were also introduced in imaging standards,

pharmacy services standards, medical device

standards, and claims and reimbursement standards

Finally, we looked at an organization that provided

profiles and implementation guides that put these

standards together to support end-to-end

interoperability



Lecture c

Health Data Interchange


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Health Data InterchangeStandards

References

Lecture cReferences

Acknowledgement: Material used in this lecture comes from the web pages of the various Standards Developing

Organizations.

Images

Slide 23: W Ed Hammond, Derived from ASC X12N documentation. www.x12.org

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09- Networking and Health Information Exchange- Unit 5- Health Data Interchange Standards- Lecture C