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Posted on: April 29-2013 | By : Harish Rijhwani | In: Healthcare Informatics | 2 Comments

The Healthcare industry is facing tremendous pressure to transform and adapt to new information technology systems. Automation of clinical information in healthcare is vital to this transformation. Healthcare information exchange standards value communication, prevention, and organization of patient information and put it to Meaningful Use.

 

ICD-10, Meaningful Use, ACOs, and the likes are mandated compliances for data exchange. These standards assist physicians, providers, payers, pharmacists, and others to keep track of patient medical history, update records, link insurance covers, process claims, aid treatment, etc.

 

Healthcare providers now need to re-align their IT initiatives to meet the recent changes in these compliances with minimal disruption in existing IT setup. Some of the changes proposed under Meaningful Use, ICD 9-10 conversion, and ACO mandate major changes that need introspection.

 

The major standards used for data transmission in the healthcare industry are:

  • EDI (Electronic Data Interchange): EDI is primarily used for interactions between care providers and health insurers.
  • HL7 (Health Level Seven): HL7 is similar to EDI; it is mainly used for transmitting data for all events that occur within a hospital. See Sample here
  • DICOM (Digital Imaging and Communications in Medicine):  Medical Images (X-Ray, MRI, etc.) are stored/transmitted/printed in a PACS (picture archiving and communication system) system using DICOM.
  • CCR/CCD (Continuity of Care Record / Document): CCD/CCR is a compact form with Patient’s health status summary. Under Meaningful Use a new format—CDA—which is a combination of the best features of CCD and CCR, is proposed. See Sample here

 

Other standards used are:

  • NCPDP (National Council for Prescription Drug Programs): Family of pharmacy data standards
  • HITSP (Healthcare Information Technology Standards Panel): Related to transmission of immunization data, bio surveillance, clinical research, etc.

 

The following workflow shows the standards used at various stages for data transmission:

Healthcare Data Transmission

Figure 1 Healthcare Data Transmission within Stakeholders

 

With more than a decade’s experience in providing integration solutions for the healthcare industry, Syntel has worked on various standards for payers and provider alike.

Sample HL7 Message

Figure 2: Sample HL7 Message- Admission of Karen Jones

 

Sample CCR Message

Figure 3: Sample CCR File – Physician John Lester treating a patient having Pressure ulcer

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Harish Rijhwani


Harish C. Rijhwani is a Delivery Manager at Syntel with 14+ years of experience in Healthcare...

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  1. Neeraj on August 21, 2013 at 7:58 am Says:

    Concise and very informative…thanks for sharing. I just wonder if ACO is a “standard”…i believe it is much more than that…it is a new business model that will not only help lower the cost but also improve the quality of care…standards and newer ways of data exchange will be a key and like you pointed out, IT will play an “enabler” role leveraging newer technologies that would not have been possible ealier. Hope to see more such blogs…happy blogging:)

  2. Amit on August 22, 2013 at 9:27 am Says:

    Informative article on HIE…though at high level overview of HIE. HIE is the backbone of any provider without having mature HIE system, providers are not able to operate efficiently outside of their network. Looking forward to see more articles in-detail & in-depth on the same topic.

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