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HL7 Survival Guide - Chapter 3 - The Heart of the Matter: Data Formats, Workflows, and Meaning
HL7 Survival Guide - Chapter 3 - The Heart of the Matter: Data Formats, Workflows, and Meaning
HL7 Survival Guide - Chapter 3 - The Heart of the Matter: Data Formats, Workflows, and Meaning
HL7 Survival Guide - Chapter 3 - The Heart of the Matter: Data Formats, Workflows, and Meaning
HL7 Survival Guide - Chapter 3 - The Heart of the Matter: Data Formats, Workflows, and Meaning
HL7 Survival Guide - Chapter 3 - The Heart of the Matter: Data Formats, Workflows, and Meaning
HL7 Survival Guide - Chapter 3 - The Heart of the Matter: Data Formats, Workflows, and Meaning
HL7 Survival Guide - Chapter 3 - The Heart of the Matter: Data Formats, Workflows, and Meaning
HL7 Survival Guide - Chapter 3 - The Heart of the Matter: Data Formats, Workflows, and Meaning
HL7 Survival Guide - Chapter 3 - The Heart of the Matter: Data Formats, Workflows, and Meaning
HL7 Survival Guide - Chapter 3 - The Heart of the Matter: Data Formats, Workflows, and Meaning
HL7 Survival Guide - Chapter 3 - The Heart of the Matter: Data Formats, Workflows, and Meaning
HL7 Survival Guide - Chapter 3 - The Heart of the Matter: Data Formats, Workflows, and Meaning
HL7 Survival Guide - Chapter 3 - The Heart of the Matter: Data Formats, Workflows, and Meaning
HL7 Survival Guide - Chapter 3 - The Heart of the Matter: Data Formats, Workflows, and Meaning
HL7 Survival Guide - Chapter 3 - The Heart of the Matter: Data Formats, Workflows, and Meaning
HL7 Survival Guide - Chapter 3 - The Heart of the Matter: Data Formats, Workflows, and Meaning
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HL7 Survival Guide - Chapter 3 - The Heart of the Matter: Data Formats, Workflows, and Meaning

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This guide is for healthcare integration analysts and their managers. In this chapter, learn how to tackle data challenges. The real problem is not with the plumbing (the interface engine); it's with …

This guide is for healthcare integration analysts and their managers. In this chapter, learn how to tackle data challenges. The real problem is not with the plumbing (the interface engine); it's with the data. Read about how to address issues with format, workflows, and semantics.

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  • 1. HL7 SURVIVALGUIDECHAPTER 3A publication ofA supplement to the HL7 Survival Guide, available athttp://caristix.com/blog/category/hl7-survival-guide/
  • 2. WWW.CARISTIX.COM SHARE THE SLIDEDECKHL7 SURVIVAL GUIDE CHAPTER 3Caristix software brings your whole interfacingprocess together in a single, powerful platform.2ABOUT CARISTIXVENDOR-AGNOSTICWork with anyinterface engine.NO MORE TRIALAND ERRORScope it right. Managerequirements.CUT TIME-TO-GO-LIVEUp to 50%.CLEAR YOURINTERFACINGBACKLOGSimplify dramatically.Align teams.REQUEST A DEMOhttp://promo.caristix.com/demo/
  • 3. WWW.CARISTIX.COM SHARE THE SLIDEDECKCHAPTER 3: The Heart of the Matter: Data Formats, Workflows, andMeaning
  • 4. WWW.CARISTIX.COM SHARE THE SLIDEDECKHL7 SURVIVAL GUIDE CHAPTER 3Chapter 2 in the Caristix HL7 Survival Guide looked at differentapproaches to interfacing. But:4Your main challenges are not with the plumbing,or with the methods used to transportor route date.Interface and integration engines handlethis quite well.
  • 5. WWW.CARISTIX.COM SHARE THE SLIDEDECKHL7 SURVIVAL GUIDE CHAPTER 3• The Real Issues:– Date formats– Workflows– Meaning or data semantics• Examples:– Departments using different definitions to indicate the sameinformation– Interpretations: NA – not applicable or no allergies?– Non-recognition of terms– Procedure definitions – just what does an order include?– Data-time entry – AM or PM, time zones5INTERFACE ENGINES DON’T ADDRESS THE REAL ISSUE
  • 6. WWW.CARISTIX.COM SHARE THE SLIDEDECKHL7 SURVIVAL GUIDE CHAPTER 3• Real Challenge: At the information level– Who needs the information, when and in what format.• Once identified, validate that the information beingtransferred is using the same semantics6DATA AND INFORMATION CHALLENGES
  • 7. WWW.CARISTIX.COM SHARE THE SLIDEDECKHL7 SURVIVAL GUIDE CHAPTER 3Issue ExampleData Structure Data structure isspecified based ontrigger events,segments, fields, anddata types. Therecommended structuremust account forcomplex clinicalworkflows and datarepresentations.Gaps based on themaximum length of dataelements. One hospitalsystem specifies amaximum length of 50characters. The samefield in the systemunder implementation isset at a maximum of 20.7DATA AND INFORMATION CHALLENGES (cont.)
  • 8. WWW.CARISTIX.COM SHARE THE SLIDEDECKHL7 SURVIVAL GUIDE CHAPTER 3Issue ExampleData Tables HL7 provides arecommended set ofdata values, which canbe modified.HL7 2.6 “suggests” sixdifferent values forpatient gender.8DATA AND INFORMATION CHALLENGES (cont.)
  • 9. WWW.CARISTIX.COM SHARE THE SLIDEDECKHL7 SURVIVAL GUIDE CHAPTER 3Issue ExampleData Semantics Good data semanticsimplies that themeaning or intent of thedata is exchangedaccurately – not simplythe data value itself.HL7 interfaces mustconvey theirinterpretation of the HL7standard in use.Patient identification isthe classic example.Determine which fieldsare in use. Possibilitiesinclude: PID-2 PatientID, PID-3 PatientIdentification List, PID-18 Patient AccountNumber, PV1-19 VisitNumber, or acombination thereof9DATA AND INFORMATION CHALLENGES (cont.)
  • 10. WWW.CARISTIX.COM SHARE THE SLIDEDECKHL7 SURVIVAL GUIDE CHAPTER 3Issue ExampleZ-segments Custom messagesegments used forinformation outside thescope of the HL7standard.All z-segments result ingaps. If not mappedaccurately, criticalinformation can be lost.10DATA AND INFORMATION CHALLENGES (cont.)
  • 11. WWW.CARISTIX.COM SHARE THE SLIDEDECKHL7 SURVIVAL GUIDE CHAPTER 3Bottom Line: Understand the data, the source systems involved andhow each system handles the data semantics.1. Understand the message/interface specification provided by yourvendor. Ask the vendor to provide details about:• Messages, segments, fields,• The need for z-segments, etc.• How they handle data semantics. What does the data mean andwhat is it used for?• Understand workflow-related information, event timing,vocabulary definitions, and who will use the information and how116 QUESTIONS & TIPS TO BETTER UNDERSTAND HEALTHCARE DATA
  • 12. WWW.CARISTIX.COM SHARE THE SLIDEDECKHL7 SURVIVAL GUIDE CHAPTER 32. Understand the type of message that will be generated based on theevent (e.g., a patient admission, patient visit, cancelling a transfer, sendinga partial lab result). Understand what data is provided with the event,including the various code sets.Watch this video for a 4-minute overview of an HL7 message:• http://www.youtube.com/watch?feature=player_embedded&v=Wyp_4XgzP7A126 QUESTIONS & TIPS TO BETTER UNDERSTAND HEALTHCARE DATA
  • 13. WWW.CARISTIX.COM SHARE THE SLIDEDECKHL7 SURVIVAL GUIDE CHAPTER 33. How do the code sets and content evolve over time, and who handles theupdates and how?4. Where does the data go? Is there a need to protect sensitive data?5. How does the new system manage errors? What happens to messagesthat aren’t understood by the destination system? What happens to rejectedmessages. How would users and the overall workflow be impacted in sucha situation? How can you mitigate the risk?136 QUESTIONS & TIPS TO BETTER UNDERSTAND HEALTHCARE DATA
  • 14. WWW.CARISTIX.COM SHARE THE SLIDEDECKHL7 SURVIVAL GUIDE CHAPTER 36. How do you handle workflow changes? If adapting the interface, how isthis handled, how much time does it take, what does it cost, and who pays?• Avoid Frozen Interface Syndrome, which occurs when you are trying toimplement a new interface and need all participants to switch over at thesame time but can’t get their cooperation.• Worse yet is Interface Black Box Syndrome, when you lack full visibilityinto all the work that has gone into interface development handled by athird party, making it nearly impossible to upgrade, tweak, and managethe interface without spending lots of money and time.With these details, you need to pinpoint the gaps with the receivingsystem(s) so you can bridge them with an interface.146 QUESTIONS & TIPS TO BETTER UNDERSTAND HEALTHCARE DATA
  • 15. WWW.CARISTIX.COM SHARE THE SLIDEDECKHL7 SURVIVAL GUIDE CHAPTER 3From the details collected from the previous 6 questions, you need topinpoint the gaps with the receiving system(s) so you can bridge them withan interface.1. Map out the message process or workflow2. Map out the business impacts of the interface3. What information does the destination system need? Where in themessage structure is the information found?4. Is the vocabulary used in the destination system different from thatused in the source system?5. Is all of this information documented? If not, how will the vendor keepyou updated on changes?155 QUESTIONS FOR HIT VENDORS AND INTERNAL INTERFACING TEAMS
  • 16. WWW.CARISTIX.COM SHARE THE SLIDEDECKHL7 SURVIVAL GUIDE CHAPTER 3• Chapter 4 in the HL7 Survival Guide• Your EHR Strategy and Working with Vendors– With meaningful use in full swing, it’s likely you’re in themiddle of implementation, migration or upgrading andworking with a 3rd party vendor. Make sure you stay incontrol. Learn more in Chapter 4.– Blog link: http://caristix.com/blog/2012/11/hl7-survival-guide-chapter-4/– Slide deck on Slideshare: coming soon.16UP NEXT: CHAPTER 4
  • 17. WWW.CARISTIX.COM SHARE THE SLIDEDECKHL7 SURVIVAL GUIDE CHAPTER 3Is a recommendation unclear?Disagree with something we said?Let us know! We thrive on feedback.Contact Ussupport@caristix.com1-877-872-002717QUESTIONS? FEEDBACK?© Caristix 2013. All rights reserved.

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