chapter 5 HSCI 4100 Flashcards by Claire Elah Doua

what are the 3 key attributes of standards

promote consistent naming of things that takes place in healthcare
Enhance ability to transfer data among application = better system integration
facilitate interoperability long information systems and users

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What does the ISO stands for?

International Standard Organization

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What does ISO do?

-independent, non-gov International org that brings together experts to :
1. share knowledge
2. develop voluntary consensus-based market relevant international standards.

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standards help facilitate what?

Interoperability. It is made possible by the implantation of standards.

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what does IEEE stand for

Institute of Electronic and Electrical Engineers

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how does IEEE define interoperability?

-ability of a system to work with other systems without special effort on the part of the consumer

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how does the National Committee on Vital and Health statistics define interoperability

-capability of different information systems and software applications to communicate and exchange data

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HIMS defines interoperability as?

-ability of different informatics systems to access, exchange, integrate and cooperatively use data in a coordinated manner, within and across organizations
-provide timely portability of information and optimize the health of populations globally

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levels of interoperability and examples

level 1-no interoperability ex: mail, fax, phone
level 2- machine-transportable (strucutural)- info can’t be manipulated ex: scanned doc and image
level 3-machine-organizable (syntactic)-sender and receiver understand vocab. ex: email
level 4-machine-interpretable (semantic) is structured messages with standardized and coded data. ex: lab, coded results from structured notes.

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limitations of standard

-standards in industries are critical
-there are limitations to standards
-in healthcare we have many standards

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Value of standards

-clinicians can enhance the quality of care they provide, improve operational efficiency and contribute to broader healthcare advancement
-improve patient care
-interoperability (enable systems to share info)

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Other values of standards

-efficiency : reduces time clinicians spend on administrative tasks
-Research and publish health
-cybersecurity : adhering to data standard help protect sensitive patient info
-Error reduction: standardized data entry protocols minis errors

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the stages for development of standards are

-identification
-conceptualization
-discussion
-specification
-early implementation
-conformance
-certification

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types of standards

identifier
transaction
messaging
patient summary
imaging
terminology

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HIPAA established and required unique identifiers for :

providers, employers, health plans and patients

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what does NPI stand for?

National provider Identifier

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what is NPI

assigned to all physicians in the US
Centers for Medicare and Medicaid will not process claims without the use of NPI

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What does EIN stands for ?

Employer Identifier Number. all employers mush have one of those

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what act requires health plans to have either a HPI (health plan identifier) or an OEID(other entity identifier) that is an identifier for use in transactions ?

Affordable Care Act

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attributes of patient identifier

-single standardized
-unique
-non-disclosing of personal info
-permanent
-ubiquitous (everyone has one)
-canonical (each person can only have one)
-invariable (will not change over time)

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benefits of patient identifiers

-easy linkage of records
-reduce problems of both duplicate and overlaid records

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disadvantage of patient identifiers

compromise privacy and confidentiality for the patient
-there is not adopted standard to identify patients

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what is a duplicate record

-occurs when more than one record exists for a patient

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what is overlaid record

more than one patient is mapped to the same record

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who introduced the MATCH IT ACT of 2024

-US House of Representatives Mike Kelly (R-PA) and Bill Foster (D-IL)

what is the goal of MATCH IT ACT of 2024

-address problem of patient misidentification -create an industry standard definition for the "patient match rate". -improve standardization of patient demographic elements entered into EHRs.

who mandated the use of transaction standards for healthcare business electronic data exchange

HIPAA.

what does EDI stands for ?

healthcare business electronic data exchange

EDI was mandated under

administrative simplification

what is ASC X12N?

developed to encourage electronic commerce of health claims. They reduce what was 400 different formats btw insurance companies and others for healthcare transactions

What is a messaging standard for exchanging clinical and administrative data between healthcare applications from various vendors

HL7- it is the org that develops and supports standards and is properly called HL7 international

how is HL7 version 2 different from the 1st version?

is it mostly syntax, the sender and receiver must understand the meaning of the messages

the format of HL7 version 2 messaging standard

each message has segments, each segments has 3 character identifier and then values that follow it

HL7 version 2 message segments identifiers are:

-MSH (message header) -EVN (event type) -PID (patient identifier) -OBR (results header) -OBX (result details)

what is HL7 version 3

an attempt to introduce semantics into messaging

all clinical, administrative financial, activities of healthcare can be expressed in...

constraints

what does FHIR stand for ?

Fast Health Interoperability Resources

was a new robust interoperability is FHIR was established due to the widespread adoption of EHR

emerged as the leading candidate for interoperability, HL7 international too over its development

6 types of FHIR resources

-clinical -identification -workflow -financial -conformance -infrastructure

the need to exchange patient summaries led to the development of

Continuity of Care Record (CCR)

CCR was to be....

a set of basic patient information consisting of the most relevant and timely facts about a patient's condition

what went wrong with CCR?

the original was not compatible with any existing standards, which led to HL7 and several vendors to create the continuity of care document (CCD)

what are the required data set for CCD (continuity of care document)

-header, purpose, problems, procedures -family and social history -payers -advance directives -alerts -medication -immunization -medical equipment -vital signs -functional status -results -encounters -plan of care

what does CDA stand for ?

Clinical Document Architecture

why is CDA important ?

because most health care information is in the form of doc and these are used to allow humans to read them

the CDA is an XML-based markup standard intended to

specify the encoding, structure and semantics of clinical documents for exchange

what's imaging standards ?

we need to move image data from devices that capture the data into record so that they can be viewed

what does DICOM stand for and what was the purpose?

digital imaging and communication standard intended for the transport of images -was developed by the American College of Radiology and the National Electrical manufactures association

terminology standards are important for

establishing reliable terms for transfer and use of data through the computer

the benefit of computerization of clinical data to a consistent and reliable form

to carry out tasks such as aggregation of patient data, clinical decision support and clinical research.

what's International Classification of disease (ICD) and who published it ?

classification system to collect data worldwide on the causes of morbidity and mortality -published by WHO

what's the difference between ICD-9-CM and ICD-10-CM?

the number of diagnostic codes is alot more in the 10. -In the 10, the hospital systems could report procedures on inpatients -in the 10 provides extensive expansion and significantly more specification than 9

what does DRGs and what's the purpose?

Diagnostic Related Groups -categorize multiple different types of diseases that are in the same general body area and require the same amount of resources.

DRGs were originally developed to aggregate ICD-9 codes into

groups that could be used for health services research to look at hospital costs

all hospitalizations are classified by their DRG and that determines

the reimbursement that hospitals receive for the hospitalization

what's RxNorm

recommended standard for medication vocabulary for clinical drugs and drug delivery devices developed by the National Library of Medicine.

that's the standard for e-prescribing ?

RxNorm

RxNorm encapsulates other drug coding system such as

National Drug code (NDC)

what does LOINC mean

Logical observations: identifiers, names and codes

what's LOINC

standard for the electronic exchange of lab results transmitted to hospitals, clinical and payers

what's SNOMED (systematized Nomenclature of medicine )

clinical terminology or medical vocabulary commonly used in EHRs. -covers disease, a more convenient way to index and retrieve medical information -the vocab provides more clinical than ICD and is felt to be more appropriate for EHRs.