This document provides an overview of common informatics standards, including HL7, ANSI, CDA, and FHIR. It describes HL7 as an organization formed in 1987 to develop standards for exchanging electronic health information internationally. HL7 standards regulate how data is packaged and exchanged, and can be normative or informative. Primary HL7 standards include CDA, Context Management, HL7 Version 2 and 3, and CCD. FHIR is presented as aiming to replace HL7 Version 3 with a new ground-up standard to better support integration. ANSI is described as the organization that regulates standards development organizations.

1. RESOURCE GUIDE TO
INFORMATICS STANDARDS
Wayne Homan
INLS 770
Informatics
Seminar

2. INTRODUCTION
Two semesters of seminar
There have been quite a few acronyms
What are we talking about?
 Ed Hammond from Duke
What I used to think informatics was like

3. HEALTH LEVEL 7 (HL7)
What is HL7?
 Standard?
 Programming language?
 Type of Cylon?

4. HL7
Actually none of these:
 It is an organization that was formed in 1987 to develop standards for exchanging, sharing, and
retrieval of electronic health information
 International in nature
 Has 1600 members
 What happened to the first six health levels?
 Regulated by ANSI
Not a governmental organization!

5. ANSI
American National Standards Institute
A private organization that regulates organizations that are developing voluntary
standards
Founded in 1918
Validates the procedures of its members
Not limited by technology -> hundreds of thousands of companies
Not a governmental organization!

6. HL7
HL7 standards regulate how data is packaged and exchanged
 Can be either normative or informative
Standards are grouped by reference categories:
 1) Primary standards
 2) Foundational standards
 3) Clinical and administrative domains
 4) Electronic health record (EHR) profiles
 5) Implementation guidelines
 6) Rules and preferences
 7) Education & awareness

7. HL7
Section 1: Primary standards
 Most important standard (most used)
 1) CDA (clinical documentation architecture) release 2
 Document markup standard
 Structure and semantics of clinical documents
 2) Context management documentation
 Aims to support integration of applications
 3) HL7 Version 2 Product Suite
 Used by 95% of US healthcare systems
 Is a messaging standard

8. HL7
Section 1: Primary standards
 4) HL7 Version 3 Product Suite
 Designed to replace HL7 Version 2 but some parts are still in development
 Trying to be the “universal” standard for integrating EHRs
 5) HL7 Version 3 Labeling Standards
 An SPL (structured Product Labeling) standard
 Basically seeks to ensure that all documents use same “language”
 6) Continuity of care document (CCD)
 Joint project with ASTM International (American Society for Testing and Materials)
 Encourages physicians to advocate

9. FHIR
We heard a lot about this during the semester
What is it?
Fast Healthcare Interoperability Resources (FHIR)
Is designed to replace HL7 version 3
 Starts from the ground up to create a new standard
 Hopes to be the future (internet seems to like it)

10. PATHWAY/CONCLUSION
HL
7
Section
s
Standard
s
ANSI
AST
M

11. ACRONYMS/CONCLUSION
HL7
ANSI
ASTM
CDA
FHIR
EHR
CCD
-This is only the voluntary
standards organizations
-There is a whole other
governmental section with the
power of coercion (Office of the
National Coordinator for Health
Information Technology)

12. REFERENCES
Costa Teixeira J, Chronaki C. Smart Medications & the Internet of Things.
Stud Health Technol Inform. 2016;221:116.
Dolin RH, Rogers B, Jaffe C. Health level seven interoperability strategy: big
data, incrementally structured. Methods Inf Med. 2015;54(1):75-82.
Health Level Seven International - Homepage. (n.d.). Retrieved April 27,
2016, from http://www.hl7.org/index.cfm?ref=nav
Li YC, Yen JC, Chiu WT, Jian WS, Syed-abdul S, Hsu MH. Building a national
electronic medical record exchange system - experiences in Taiwan.
Comput Methods Programs Biomed. 2015;121(1):14-20.
Mandel JC, Kreda DA, Mandl KD, Kohane IS, Ramoni RB. SMART on FHIR: a
standards-based, interoperable apps platform for electronic health records.
J Am Med Inform Assoc. 2016.
Neofytou MS, Neokleous K, Aristodemou A, et al. Electronic Health Record
Application Support Service Enablers. Conf Proc IEEE Eng Med Biol Soc.
2015;2015:1401-4.
What is 'FHIR' and why should you care? - iNTERFACEWARE Inc. (2013).
Retrieved April 27, 2016, from http://www.interfaceware.com/blog/what-