Vertical standards in healthcare aim to address business problems unique to the healthcare industry. Such standards focus on data structures, document formats, and business processes to promote communication between disparate legacy systems. Examples include standards for electronic patient health records and medical messaging. The development of healthcare vertical standards has been slow but is gaining urgency as more data moves from paper to electronic records and the population ages. These standards are important to fully realize the benefits of health information technology (HIT) in improving care quality and reducing costs.
Contemporary Health Information Technology (HIT): Opportunities and Challenges
Wullianallur Raghupathi1, Viju Raghupathi2, Joseph Tan3*
1Professor, Gabelli School of Business, Fordham University, USA
2Associate Professor, Koppelman School of Business, Brooklyn College of the City University of New York
3Professor, DeGroote School of Business, McMaster University
This document discusses contemporary health information technology opportunities and challenges. It describes how most healthcare organizations have implemented basic HIT like EHRs but must now adopt more transformational applications using technologies like AI, big data analytics, blockchain, cloud computing and more. However, technological issues around interoperability, costs and expertise remain challenges. Managerial challenges also exist regarding security, privacy, governance and demonstrating return on investment of HIT. Overall healthcare organizations need to address both technical and managerial challenges to successfully transform with HIT.
The document discusses recent healthcare reforms in the United States and their potential impacts. It notes that the Patient Protection and Affordable Care Act aims to increase insurance coverage while lowering costs. Additionally, the HITECH Act promotes the meaningful use of IT in healthcare to improve quality and reduce spending. Major effects may include 45-55 million Americans gaining insurance, increased use of electronic health records and pay-for-performance programs between providers and payers. Overall the reforms seek to align financial incentives around improved patient outcomes and care coordination.
The document summarizes insights from a panel discussion on post-Affordable Care Act healthcare M&A trends. Key points include:
- Panelists expect growth in healthcare IT due to increasing demand for electronic records, data analytics, and population health management. However, hospitals may consolidate to cut costs in response to lower reimbursement rates.
- Successful companies will integrate services across the care continuum and leverage technology to improve outcomes and lower costs. The future involves value-based reimbursement models that reward quality over volume.
- Opportunities lie in care coordination, analytics, and population health management. Technology will continue driving consolidation and improvements to the healthcare system.
U.S. Healthcare - Converting Vision to RealityCognizant
The document discusses the ongoing transformation of the U.S. healthcare industry as it works to address rising costs and improve quality of care. It describes several key areas of change: 1) the development of a national healthcare IT infrastructure to share patient data electronically, 2) integrated health management through coordinated care models like patient-centered medical homes and accountable care organizations, and 3) personalized medical care enabled by new diagnostic technologies. Realizing this vision will require overcoming challenges around standards, costs, and adapting to disruptive trends in technology and demographics.
This document discusses enterprise content and record management (ECRM) systems as a bridge technology between paper records and electronic health records (EHRs). It describes how ECRM systems can consolidate different types of medical content like images, videos, and scanned documents. The document outlines risks of hybrid paper-electronic systems and how ECRM systems help create fully electronic records. It also covers ECRM implementation considerations and technologies that have evolved from basic document scanning to integrated content and record management.
Digitization is bringing a sea change to a U.S. healthcare industry already facing waves of uncertainty. By taking the right steps, this can be a major opportunity for industry players.
Forecasting the future of any industry is difficult, none more so right now than healthcare in the United States. There are countless reasons why healthcare will look different in the near future, not least of which being the country's movement toward national coverage. However, digital transformation—the cumulative change that comes when digital technologies are introduced wholesale into an established industry—is poised to have an even bigger impact. For the U.S. healthcare industry, digital technology will be transformational, cutting healthcare delivery costs, eliminating errors through improved electronic medical records, and establishing routinized, evidence-based approaches to treatment.
Digital forces are pulling at the industry and significantly altering services, products, innovation, delivery, and remuneration (see figure). There are digitally integrated healthcare providers, digital medical devices and technologies, and digital delivery and monitoring of home healthcare. In addition, new ideas are emanating from developing markets, agile competitors are embracing technology, and a digital-friendly federal administration is pushing innovation. And don't forget the digital consumer who is used to digital banking, digital retailing, and digital education, and expects digital healthcare.
- See more at: http://www.atkearney.com/paper/-/asset_publisher/dVxv4Hz2h8bS/content/digital-healthcare-or-bust-in-america/10192#sthash.gP6B4uWR.dpuf
Healthcare - Customer-Centric Healthcare Best Practices for CIO and CISOsNicholas Christiano Jr.
The document discusses the challenges healthcare CIOs and CISOs face in providing secure yet accessible patient information in light of new regulations. It notes that while healthcare organizations have traditionally focused on keeping data private, new rules will require all patient data to be online by 2016. This presents a dilemma for technology leaders who must ensure stringent security while supporting more open access. The document provides recommendations for best practices to address this challenge, including looking to other industries like banking that balance security and accessibility well. It stresses the importance of selecting the right technologies and solutions to protect against breaches while meeting patient and regulatory needs.
Contemporary Health Information Technology (HIT): Opportunities and Challenges
Wullianallur Raghupathi1, Viju Raghupathi2, Joseph Tan3*
1Professor, Gabelli School of Business, Fordham University, USA
2Associate Professor, Koppelman School of Business, Brooklyn College of the City University of New York
3Professor, DeGroote School of Business, McMaster University
This document discusses contemporary health information technology opportunities and challenges. It describes how most healthcare organizations have implemented basic HIT like EHRs but must now adopt more transformational applications using technologies like AI, big data analytics, blockchain, cloud computing and more. However, technological issues around interoperability, costs and expertise remain challenges. Managerial challenges also exist regarding security, privacy, governance and demonstrating return on investment of HIT. Overall healthcare organizations need to address both technical and managerial challenges to successfully transform with HIT.
The document discusses recent healthcare reforms in the United States and their potential impacts. It notes that the Patient Protection and Affordable Care Act aims to increase insurance coverage while lowering costs. Additionally, the HITECH Act promotes the meaningful use of IT in healthcare to improve quality and reduce spending. Major effects may include 45-55 million Americans gaining insurance, increased use of electronic health records and pay-for-performance programs between providers and payers. Overall the reforms seek to align financial incentives around improved patient outcomes and care coordination.
The document summarizes insights from a panel discussion on post-Affordable Care Act healthcare M&A trends. Key points include:
- Panelists expect growth in healthcare IT due to increasing demand for electronic records, data analytics, and population health management. However, hospitals may consolidate to cut costs in response to lower reimbursement rates.
- Successful companies will integrate services across the care continuum and leverage technology to improve outcomes and lower costs. The future involves value-based reimbursement models that reward quality over volume.
- Opportunities lie in care coordination, analytics, and population health management. Technology will continue driving consolidation and improvements to the healthcare system.
U.S. Healthcare - Converting Vision to RealityCognizant
The document discusses the ongoing transformation of the U.S. healthcare industry as it works to address rising costs and improve quality of care. It describes several key areas of change: 1) the development of a national healthcare IT infrastructure to share patient data electronically, 2) integrated health management through coordinated care models like patient-centered medical homes and accountable care organizations, and 3) personalized medical care enabled by new diagnostic technologies. Realizing this vision will require overcoming challenges around standards, costs, and adapting to disruptive trends in technology and demographics.
This document discusses enterprise content and record management (ECRM) systems as a bridge technology between paper records and electronic health records (EHRs). It describes how ECRM systems can consolidate different types of medical content like images, videos, and scanned documents. The document outlines risks of hybrid paper-electronic systems and how ECRM systems help create fully electronic records. It also covers ECRM implementation considerations and technologies that have evolved from basic document scanning to integrated content and record management.
Digitization is bringing a sea change to a U.S. healthcare industry already facing waves of uncertainty. By taking the right steps, this can be a major opportunity for industry players.
Forecasting the future of any industry is difficult, none more so right now than healthcare in the United States. There are countless reasons why healthcare will look different in the near future, not least of which being the country's movement toward national coverage. However, digital transformation—the cumulative change that comes when digital technologies are introduced wholesale into an established industry—is poised to have an even bigger impact. For the U.S. healthcare industry, digital technology will be transformational, cutting healthcare delivery costs, eliminating errors through improved electronic medical records, and establishing routinized, evidence-based approaches to treatment.
Digital forces are pulling at the industry and significantly altering services, products, innovation, delivery, and remuneration (see figure). There are digitally integrated healthcare providers, digital medical devices and technologies, and digital delivery and monitoring of home healthcare. In addition, new ideas are emanating from developing markets, agile competitors are embracing technology, and a digital-friendly federal administration is pushing innovation. And don't forget the digital consumer who is used to digital banking, digital retailing, and digital education, and expects digital healthcare.
- See more at: http://www.atkearney.com/paper/-/asset_publisher/dVxv4Hz2h8bS/content/digital-healthcare-or-bust-in-america/10192#sthash.gP6B4uWR.dpuf
Healthcare - Customer-Centric Healthcare Best Practices for CIO and CISOsNicholas Christiano Jr.
The document discusses the challenges healthcare CIOs and CISOs face in providing secure yet accessible patient information in light of new regulations. It notes that while healthcare organizations have traditionally focused on keeping data private, new rules will require all patient data to be online by 2016. This presents a dilemma for technology leaders who must ensure stringent security while supporting more open access. The document provides recommendations for best practices to address this challenge, including looking to other industries like banking that balance security and accessibility well. It stresses the importance of selecting the right technologies and solutions to protect against breaches while meeting patient and regulatory needs.
This document discusses health information exchange (HIE), including the role of health information organizations in facilitating HIE. It describes the importance of interoperability in healthcare and the four types of interoperability. The document outlines federal legislation supporting HIE, such as the HITECH Act, and discusses benefits and barriers to implementing health information technology and HIE. It also provides an overview of meaningful use incentives for using certified electronic health record technology.
The document discusses electronic claim objects to support India's health insurance sector. It proposes using standardized electronic objects based on FHIR resources to enable interoperable and automated claim processing. This would allow faster claims processing, reduced costs, and improved data for monitoring. The electronic objects would include minimum required coded data elements in a JSON format to represent claims, payments, and clinical summaries like discharge records.
Application Outsourcing (AO) in the Healthcare Provider Industry - Annual ReportEverest Group
This report provides an overview of the ITO market for the healthcare provider industry. Analysis includes key trends in market size & growth, demand drivers, adoption & scope trends, emerging themes, key areas of investment, and implications for key stakeholders. The report also provides specific insights on the importance of technology enablement across the healthcare provider value-chain and how both, reforms and digitization, are becoming paramount for driving key strategic initiatives in this industry
Healthcare informatics involves the intersection of business, information systems, and healthcare to support clinical care, health administration, and patient/provider care. Information systems help automate and digitize the healthcare industry by increasing data availability and meeting regulatory compliance. McKesson Technology Solutions (MTS) is a market leading firm that provides enterprise software solutions and services to over 52% of health systems and 20% of physician practices. As a core part of each MTS business unit, the information systems department develops products that support trends in healthcare informatics, such as clinical decision support and electronic pharmacy systems. Recently, MTS expanded its product offerings through a new distribution agreement while also facing several lawsuits.
Health Delivery Information Systems (HDIS) provide applications and software to record and manage healthcare data for every patient encounter. The document discusses designing a scalable and standards-based HDIS, including implementing it using a microservices architecture approach adhering to design principles from the National Digital Health Blueprint. Key elements include using interoperability standards, a mobile-first design, and building modules focused on core functionality for initial implementation.
Unstructured Data into EHR Systems: Challenges and SolutionsDATAMARK
This document discusses the challenges healthcare organizations face in managing unstructured data within electronic health record (EHR) systems. Unstructured data, such as scanned reports, medical images, and handwritten notes, accounts for around 80% of healthcare data but is difficult to incorporate into EHRs which are designed for structured data. Electronic document management systems (EDMS) that use technologies like automated data capture and document management can help healthcare organizations bring unstructured data into EHR systems and create a complete patient record. However, implementing an EDMS is a complex process that requires expertise to develop an enterprise content management strategy and properly integrate the necessary technologies.
This document discusses strategies for implementing eBusiness initiatives in the healthcare industry. It notes that while modern medicine utilizes advanced technologies, healthcare organizations still rely heavily on paper-based systems. eBusiness can bridge this gap by bringing parties together electronically to complete transactions. However, healthcare organizations must address special considerations like HIPAA compliance and protecting sensitive patient information when moving to eBusiness models. Proper planning of user roles, infrastructure, security features, and agreements with business partners is needed.
The document provides an overview and update on the Direct Project including:
- Background on what Direct is and why it is needed to provide secure electronic health information exchange.
- Examples of live Direct implementations across several states that are demonstrating use cases related to Meaningful Use criteria.
- Technology providers involved in the various pilot implementations, including health information service providers (HISPs) and electronic health record (EHR) vendors.
- Major findings from the pilot implementations including positive feedback on Direct's ability to facilitate health information exchange and support Meaningful Use goals.
There are three key forms of health information exchange:
1) Directed exchange allows providers to electronically send and receive secure information like lab results between providers involved in a patient's care.
2) Query-based exchange allows providers to find and request information on a patient from other providers, often used for emergency care.
3) Consumer mediated exchange allows patients to aggregate and manage their health information online and help transfer it between providers.
A presentation about the role of informatics standards in facilitating electronic data interchange, and a framework for service-oriented semantic interoperability among data systems.
SOA enabled next generation EMR/EHR systems provide a solution to the challenges and complexities of healthcare IT by adopting a service-oriented architecture. This allows for standardized information exchange, shared master data, and a unified information access layer. This foundational approach supports rapid application development by decoupling information consumers from providers and minimizing changes across systems.
The document provides an overview of health information technology (HIT). It discusses what HIT is, including the creation, design, development, use and maintenance of healthcare information systems. The electronic health record is the central component of HIT and includes an individual's health record that is shared among multiple facilities. Benefits of HIT include improved quality, reduced costs, and improved provider and patient convenience. Health information exchange allows for the sharing of patient health information among authorized individuals and organizations to improve patient care. Key components of HIT discussed include electronic health records, electronic medical records, personal health records, and regional health information organizations.
This document is a summary of the 2012 HIMSS Leadership Survey results regarding healthcare IT executives' opinions on key IT priorities, issues, security concerns, and budgets. Some of the top findings include that over 70% of respondents identified meeting meaningful use and ICD-10 requirements as top priorities. Nearly half of organizations participate in health information exchanges, and over 90% expect to meet the 2013 ICD-10 deadline. IT staffing shortages were also a concern.
From Chaos to Catalyst: Five Imperatives for HealthcareCognizant
The document discusses five imperatives for healthcare providers and payers in response to the COVID-19 pandemic. It summarizes each imperative as follows:
1. Take out costs - Providers and payers must reduce costs due to financial pressures from rising supply costs, decreased utilization of services, and changes in insurance coverage.
2. Deliver care@home - The pandemic accelerated adoption of telehealth and more services can now be delivered virtually. This allows decoupling of care from physical infrastructure.
3. Implement low-touch healthcare - Providers must reduce physical contact to ensure safety while maintaining a personalized experience through contactless processes and virtual care.
4. Accelerate digital transformation - Changes in consumer behavior
The document discusses challenges and opportunities in the medical industry, focusing on improving document workflow and meeting regulations like HIPAA. It notes medical spending accounts for 18% of GDP and will continue outpacing overall economic growth. Within the industry, color printing, scanning, and document sharing are still evolving. The document also provides an overview of key terms, regulations, and areas where medical facilities generate revenue through billing.
"Healthcare Services at Merck & Co". Presentation by Guy Eiferman, President of Healthcare Services and Solutions, Merck & Co., made at the mHealth Israel Investors Summit, June 29, 2015, in Jerusalem
The document discusses the HITECH Act and the criteria for meaningful use of electronic health records (EHRs) in order to qualify for Medicare and Medicaid reimbursement bonuses starting in 2011. It outlines three stages of meaningful use criteria that providers must meet over multiple years to receive incentive payments. Stage one focuses on basic EHR usage and data capture, while stages two and three emphasize more advanced usage like clinical decision support and electronic data sharing. The criteria become more stringent over time to encourage higher levels of EHR utilization.
Value-Based Care and Healthcare Consumerism: Opportunities for Health IT and ...Cognizant
Health IT and technology solutions are central in the shift to value-based care and to meeting the demands of patient consumerism. Hurdles remain, but all primary players in the healthcare ecosystem, patients, providers and payers, are seeking more and better data, platform interoperability, real-time and actionable analytical insights, and more effective engagement.
1. The healthcare informatics industry utilizes information technologies and management strategies to improve processes and efficiency in healthcare. McKesson Technology Solutions is a major player providing clinical software, pharmacy automation, and other IT services to hospitals.
2. McKesson's revenues have increased each year from $108 billion in 2008 to $112 billion in 2009. They are ranked 14th on the Fortune 500 list. McKesson provides solutions for electronic health records, computerized physician order entry, and decision support systems.
3. Trends in the industry include a focus on digitizing paper records, developing automated decision support systems using electronic data, and automating patients' medical histories. Regulatory acts are also driving increased IT adoption,
1. The document discusses the advantages and disadvantages of implementing an electronic health record (EHR) system to replace a paper-based system.
2. A key disadvantage is the high cost of implementation, with the cost of Alberta's new clinical information system estimated at $1.6 billion over 10 years.
3. Another disadvantage is a lack of interoperability between existing EHR systems, which prevents patient information from being shared and understood across health settings.
Digital health is about electronically connecting up the points of healthcare so that health information can be shared securely.
This is the first step to understanding how digital health can help deliver safer, better and quality healthcare.
“My Health Record” is the new name of the digital health record system.
This document discusses health information exchange (HIE), including the role of health information organizations in facilitating HIE. It describes the importance of interoperability in healthcare and the four types of interoperability. The document outlines federal legislation supporting HIE, such as the HITECH Act, and discusses benefits and barriers to implementing health information technology and HIE. It also provides an overview of meaningful use incentives for using certified electronic health record technology.
The document discusses electronic claim objects to support India's health insurance sector. It proposes using standardized electronic objects based on FHIR resources to enable interoperable and automated claim processing. This would allow faster claims processing, reduced costs, and improved data for monitoring. The electronic objects would include minimum required coded data elements in a JSON format to represent claims, payments, and clinical summaries like discharge records.
Application Outsourcing (AO) in the Healthcare Provider Industry - Annual ReportEverest Group
This report provides an overview of the ITO market for the healthcare provider industry. Analysis includes key trends in market size & growth, demand drivers, adoption & scope trends, emerging themes, key areas of investment, and implications for key stakeholders. The report also provides specific insights on the importance of technology enablement across the healthcare provider value-chain and how both, reforms and digitization, are becoming paramount for driving key strategic initiatives in this industry
Healthcare informatics involves the intersection of business, information systems, and healthcare to support clinical care, health administration, and patient/provider care. Information systems help automate and digitize the healthcare industry by increasing data availability and meeting regulatory compliance. McKesson Technology Solutions (MTS) is a market leading firm that provides enterprise software solutions and services to over 52% of health systems and 20% of physician practices. As a core part of each MTS business unit, the information systems department develops products that support trends in healthcare informatics, such as clinical decision support and electronic pharmacy systems. Recently, MTS expanded its product offerings through a new distribution agreement while also facing several lawsuits.
Health Delivery Information Systems (HDIS) provide applications and software to record and manage healthcare data for every patient encounter. The document discusses designing a scalable and standards-based HDIS, including implementing it using a microservices architecture approach adhering to design principles from the National Digital Health Blueprint. Key elements include using interoperability standards, a mobile-first design, and building modules focused on core functionality for initial implementation.
Unstructured Data into EHR Systems: Challenges and SolutionsDATAMARK
This document discusses the challenges healthcare organizations face in managing unstructured data within electronic health record (EHR) systems. Unstructured data, such as scanned reports, medical images, and handwritten notes, accounts for around 80% of healthcare data but is difficult to incorporate into EHRs which are designed for structured data. Electronic document management systems (EDMS) that use technologies like automated data capture and document management can help healthcare organizations bring unstructured data into EHR systems and create a complete patient record. However, implementing an EDMS is a complex process that requires expertise to develop an enterprise content management strategy and properly integrate the necessary technologies.
This document discusses strategies for implementing eBusiness initiatives in the healthcare industry. It notes that while modern medicine utilizes advanced technologies, healthcare organizations still rely heavily on paper-based systems. eBusiness can bridge this gap by bringing parties together electronically to complete transactions. However, healthcare organizations must address special considerations like HIPAA compliance and protecting sensitive patient information when moving to eBusiness models. Proper planning of user roles, infrastructure, security features, and agreements with business partners is needed.
The document provides an overview and update on the Direct Project including:
- Background on what Direct is and why it is needed to provide secure electronic health information exchange.
- Examples of live Direct implementations across several states that are demonstrating use cases related to Meaningful Use criteria.
- Technology providers involved in the various pilot implementations, including health information service providers (HISPs) and electronic health record (EHR) vendors.
- Major findings from the pilot implementations including positive feedback on Direct's ability to facilitate health information exchange and support Meaningful Use goals.
There are three key forms of health information exchange:
1) Directed exchange allows providers to electronically send and receive secure information like lab results between providers involved in a patient's care.
2) Query-based exchange allows providers to find and request information on a patient from other providers, often used for emergency care.
3) Consumer mediated exchange allows patients to aggregate and manage their health information online and help transfer it between providers.
A presentation about the role of informatics standards in facilitating electronic data interchange, and a framework for service-oriented semantic interoperability among data systems.
SOA enabled next generation EMR/EHR systems provide a solution to the challenges and complexities of healthcare IT by adopting a service-oriented architecture. This allows for standardized information exchange, shared master data, and a unified information access layer. This foundational approach supports rapid application development by decoupling information consumers from providers and minimizing changes across systems.
The document provides an overview of health information technology (HIT). It discusses what HIT is, including the creation, design, development, use and maintenance of healthcare information systems. The electronic health record is the central component of HIT and includes an individual's health record that is shared among multiple facilities. Benefits of HIT include improved quality, reduced costs, and improved provider and patient convenience. Health information exchange allows for the sharing of patient health information among authorized individuals and organizations to improve patient care. Key components of HIT discussed include electronic health records, electronic medical records, personal health records, and regional health information organizations.
This document is a summary of the 2012 HIMSS Leadership Survey results regarding healthcare IT executives' opinions on key IT priorities, issues, security concerns, and budgets. Some of the top findings include that over 70% of respondents identified meeting meaningful use and ICD-10 requirements as top priorities. Nearly half of organizations participate in health information exchanges, and over 90% expect to meet the 2013 ICD-10 deadline. IT staffing shortages were also a concern.
From Chaos to Catalyst: Five Imperatives for HealthcareCognizant
The document discusses five imperatives for healthcare providers and payers in response to the COVID-19 pandemic. It summarizes each imperative as follows:
1. Take out costs - Providers and payers must reduce costs due to financial pressures from rising supply costs, decreased utilization of services, and changes in insurance coverage.
2. Deliver care@home - The pandemic accelerated adoption of telehealth and more services can now be delivered virtually. This allows decoupling of care from physical infrastructure.
3. Implement low-touch healthcare - Providers must reduce physical contact to ensure safety while maintaining a personalized experience through contactless processes and virtual care.
4. Accelerate digital transformation - Changes in consumer behavior
The document discusses challenges and opportunities in the medical industry, focusing on improving document workflow and meeting regulations like HIPAA. It notes medical spending accounts for 18% of GDP and will continue outpacing overall economic growth. Within the industry, color printing, scanning, and document sharing are still evolving. The document also provides an overview of key terms, regulations, and areas where medical facilities generate revenue through billing.
"Healthcare Services at Merck & Co". Presentation by Guy Eiferman, President of Healthcare Services and Solutions, Merck & Co., made at the mHealth Israel Investors Summit, June 29, 2015, in Jerusalem
The document discusses the HITECH Act and the criteria for meaningful use of electronic health records (EHRs) in order to qualify for Medicare and Medicaid reimbursement bonuses starting in 2011. It outlines three stages of meaningful use criteria that providers must meet over multiple years to receive incentive payments. Stage one focuses on basic EHR usage and data capture, while stages two and three emphasize more advanced usage like clinical decision support and electronic data sharing. The criteria become more stringent over time to encourage higher levels of EHR utilization.
Value-Based Care and Healthcare Consumerism: Opportunities for Health IT and ...Cognizant
Health IT and technology solutions are central in the shift to value-based care and to meeting the demands of patient consumerism. Hurdles remain, but all primary players in the healthcare ecosystem, patients, providers and payers, are seeking more and better data, platform interoperability, real-time and actionable analytical insights, and more effective engagement.
1. The healthcare informatics industry utilizes information technologies and management strategies to improve processes and efficiency in healthcare. McKesson Technology Solutions is a major player providing clinical software, pharmacy automation, and other IT services to hospitals.
2. McKesson's revenues have increased each year from $108 billion in 2008 to $112 billion in 2009. They are ranked 14th on the Fortune 500 list. McKesson provides solutions for electronic health records, computerized physician order entry, and decision support systems.
3. Trends in the industry include a focus on digitizing paper records, developing automated decision support systems using electronic data, and automating patients' medical histories. Regulatory acts are also driving increased IT adoption,
1. The document discusses the advantages and disadvantages of implementing an electronic health record (EHR) system to replace a paper-based system.
2. A key disadvantage is the high cost of implementation, with the cost of Alberta's new clinical information system estimated at $1.6 billion over 10 years.
3. Another disadvantage is a lack of interoperability between existing EHR systems, which prevents patient information from being shared and understood across health settings.
Digital health is about electronically connecting up the points of healthcare so that health information can be shared securely.
This is the first step to understanding how digital health can help deliver safer, better and quality healthcare.
“My Health Record” is the new name of the digital health record system.
Healthcare Interoperability: The Key to Leveraging Health TechMityung
Despite some setbacks, the digitalization of healthcare holds great promise for global health improvements. Health information technology (HIT) systems are taking over the healthcare industry.
For further information click here
https://www.mityung.com/
HI300 Unit 5 Standards for Electronic Data and Data Interchange -.docxAbramMartino96
HI300 Unit 5: Standards for Electronic Data and Data Interchange - Discussion
Standard Development Organizations
Identify and research standard development organizations listed in the text on pp. 165–166
.
Select one of the organization’s websites and identify at least 3-4 facts about this organization and explain what it does.
Do not duplicate your classmates’ information. Note: You may explore the internet for recent articles about the organization and include this information as well.
When responding to your classmates describe similarities and differences between the organizations you researched.
Discussion responses should be strictly on topic, original with scholar references, and contribute to the quality of the discussion by making frequent informed references to lesson material.
NO PHARGIARISM!!
Below is the Chapter 4 reading for this assignment.
Standards for Electronic Data and Electronic Data Interchange
The original uniform data sets such as the UHDDS and the UACDS were created for use in paper-based (manual) health record systems. They were not designed to accommodate the data needs of the current healthcare delivery system or the demands of EHRs and clinical information systems.
Standards are needed in order for data to be easily, accurately, and securely communicated and exchanged electronically among various computer systems. This is referred to as interoperability. Without standards for interoperability, EHRs and the NHIN will not realize their full benefits (Thompson and Brailer 2004).
Many types of standards are being developed to support the EHR and health information exchange. Some involve defining record structure and content, others specify technical approaches for transmitting data, and still others provide rules for protecting the privacy and security of data.
Public and private organizations have been actively engaged in the process of developing healthcare informatics standards to support EHR development, interoperability, and information exchange. The federal government supports this work in a variety of ways. One example is the S&I Framework. According to Fridsma (2010 slide 4), the Framework “is the mechanism by which ONC will manage the implementation of specifications and the harmonization of existing health IT standards to promote interoperability nationwide.”
Definition of Data Standard for Electronic Data Exchange
Data standards provide the ability to record a certain data item in accordance with the agreed upon standard (Giannangelo 2007). Data content standards are “clear guidelines for the acceptable values for specified data fields” (Fenton et al. 2007). Data exchange standards are protocols that help ensure that data transmitted from one system to another remain comparable.
One of the purposes of HIPAA’s Administrative Simplification rules was to standardize information exchange and in August 2000, the Department of Health and Human Services (HHS) published regulations for electronic trans.
The document discusses questions regarding a healthcare system's vendor selection process for an IT project. It recommends the types of information an organization should provide to vendors in a Request for Information (RFI) and gather from vendors in the early planning stages. This includes vendor background, technical requirements, functionality, implementation processes, and training. An RFP with more specific details is issued to a select few vendors.
Discuss the benefits of in-built coding software within the Health I.pdffashionfolionr
Discuss the benefits of in-built coding software within the Health Information Managements
Systems?
Note: Mention your references
words limit: 500 words no plagiarism
Solution
Health information management (HIM) is information management applied to health and health
care. It is the practice of acquiring, analyzing and protecting digital and traditional medical
information vital to providing quality patient care. With the widespread computerization of
health records, traditional (paper-based) records are being replaced with electronic health records
(EHRs). The tools of health informatics and health information technology are continually
improving to bring greater efficiency to information management in the health care sector. Both
hospital information systems and health human resources information systems (HRHIS) are
common implementations of HIM.
Paper-based records have been in existence for centuries* and their gradual replacement by
computer-based records has been slowly underway for over twenty years in western healthcare
systems. Computerised information systems have not achieved the same degree of penetration in
healthcare as that seen in other sectors such as finance, transport and the manufacturing and retail
industries. Further, deployment has varied greatly from country to country and from speciality to
specialty and in may cases has revolved around local systems designed for local use.
In record time and at an unprecedented pace, the electronic health record (EHR) has spurred a
revolutionary change in HIM that\'s modifying the profession as each day passes.EHRs and
accompanying technology like health information exchange, computer-assisted coding, voice
recognition software, and patient portals-along with revamped government quality and EHR
incentive programs-are modifying many aspects of HIM.
An information system consists of four interrelated components—data, information technology,
process, and users.14 HIM professionals’ traditional job roles make them the experts in
managing data and processes in an information system. With the digitizing of information
systems in healthcare organizations, the roles of HIM professionals have expanded into
information technology (IT) and user support, which usually are the functions of IT supporting
services. HIM professionals’ training and experience in the intersection of clinical and
management sciences as well as their knowledge about data quality equip them with the
capability to maintain the integrity and accessibility of health information, although they may not
necessarily have the particular skills to support technical operations of a health information
system.
Electronic medical record systems lie at the center of any computerised health information
system. Without them other modern technologies such as decision support systems cannot be
effectively integrated into routine clinical workflow. The paperless, interoperable, multi-
provider, multi-specialty, multi-discipline computerised.
The document discusses Access Health Digital's Social Entrepreneurship Accelerator (SEA) program and key objectives. The SEA program aims to accelerate adoption of India's National Digital Health Blueprint (NDHB) standards and drive a federated technology model across stakeholders. It will provide mentorship and technical support for implementing minimum viable products based on NDHB standards. The SEA program also aims to help position compliant products for relevant opportunities and provide early adopters with a "stamp of confidence". Access Health Digital intends to facilitate the SEA community in these areas to help transition the healthcare industry to a standardized, secure model.
IntroductionHealthcare Information Systems are defined as Comp.docxvrickens
Introduction:
Healthcare Information Systems are defined as “Computerized systems designed to facilitate the management and operation of all technical (biomedical) and administrative data for the entire healthcare system, for a number of its functional units, for a single healthcare institution, or even for an institutional department or unit” [9]. The employment of computers in the healthcare sector can be traced back to the 1960s. During the early 1970s, the first attempts to adopt HIS were made [10]. However, in the past, HIS initiatives were limited to the automation of business processes related to (a) administration and (b) healthcare tools and techniques related to various medical procedures as: diagnostic, therapeutic and surgical. During the 80s, innovative patterns in database designs and applications related to HIS, concluded to developments in planning and administration of the healthcare data. In parallel, HIS also introduced low cost financial systems for hospitals under 200 beds in size [11]. It should be noted that the early computerized systems were limited in big hospitals and government projects (military).
As the IT industry flourish the HIS technology was populated with various network applications. The ‘net period with the internet, intranet and extranet affected the communication of data in hospitals especially in the 1990's. In the middle of the same decade the interface engine emerged as a product to support the integration of applications, as best-of-breed applications became harder to manage [12]. New experience and knowledge in applications such as Internet-based telemedicine, personal health records, asynchronous healthcare communication systems, m-health and picture archiving communication systems (PACS) have been applied in the healthcare sector [13]. The growth of the aforementioned applications has lead to the development of healthcare services that have been characterized as complex, redundant and transcriptive [14].
In shedding some light on the underlined services that exist in healthcare organizations, we reviewed the normative on HIS classification. Based on the services that HIS support, Mantzana [7] categorized them into: (a) clinical, (b) non-clinical, (c) pharmaceutical and (d) laboratory. The authors adopt this classification and extend it, by proposing that the patient record category should be added, as it refers to medical records that can be maintained by the citizen or the health professional. This category can be further broken down into (a) Electronic Patient Records Systems (EPR), which are detailed records of encounters between patients and their healthcare providers and (b) Electronic Personal Health Records (ePHR) that are citizen self-maintained health and healthcare records
Extensive and serious quality problems exist in health care delivery processes, resulting in tremendous harms and losses to stakeholders. An increasing concern for improving health care quality has been expressed fro ...
Chapter 6 Health Information ExchangeRobert Hoyt MDWilliam .docxrobertad6
Health information exchange (HIE) allows electronic sharing of patient health data between organizations according to national standards. HIE can improve care coordination but faces challenges such as cost and competition between organizations. Emerging models like FHIR and blockchain may address these challenges by using open source approaches and distributed ledgers. Standards are crucial for HIE and interoperability by establishing common rules for data sharing through identifiers, transactions, messages, imaging and terminology.
The document discusses the challenges public health services face with information systems. It notes that public health works at the population level to address health determinants and prevent illness through partnerships. However, information systems are often designed for personal health records and clinical management rather than public health's broader evidence base and longer timeframes. Standardization can override flexibility if not carefully managed. The document proposes several principles for effective public health information systems, including having business needs drive systems, enabling information exchange through standards, and keeping line-level data close to where it is used.
Connected Health Interoperability Platform_White Paper_Cisco UCSF_2016Wernhard Berger
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Consideration the relationship between ict and ehealthAlexander Decker
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This document provides an overview of electronic health record systems (EHRs). It discusses how EHRs are used by various healthcare professionals and departments to longitudinally collect and share patient health information. Key features of EHRs discussed include providing access to patient data, clinical decision support, supporting efficient healthcare processes, and enabling remote access to patient records. Several examples of early EHR systems developed by the VA, DoD, and IHS in the 1970s are provided. The role of government agencies and standards organizations in facilitating EHR adoption is also summarized.
Because putting patients’ needs first is essential in the healthcare industries, many healthcare systems
face health information technology (HIT) related challenges and a patient service dilemma.We will firstpresent
the patient service dilemma and provide a high-leveloverview of technologies that have increased the productivity,
efficiency in providing care, and clinical collaboration across their various healthcare campuses. Then, we will
suggest changesto current HIT practice that will enableHealth Systems to be Health Insurance Portability and
Accountability Act (HIPAA) compliant, while meeting the needs of patients, their expectations of care, and the
changing healthcare industry.
Addressing the Healthcare Connectivity ChallengeTodd Winey
In healthcare, information accessibility can impact the outcome of a medical decision, or the success of a bundled payment initiative. To ensure that the right information is available at the right place and time, healthcare organizations typically have used HL7® interface engines to share data among clinical applications. But the demands on healthcare information technology are changing so rapidly that these simple engines are no longer sufficient.
This document contains information about a health management applications course. It includes the course calendar, grading breakdown, resources, contact information, homework deadlines, and course content. The course covers e-health domains and applications, with a focus on internal and external integration. It discusses the emergence of e-health and the benefits of using technology in healthcare, including reduced costs and improved communication. The document provides learning objectives and outlines components of an e-health system and strategies for planning e-health.
This document outlines strategies for building a person-centered health system in New Zealand, including:
1) Shifting from a provider-centric to person-centric model organized around individual needs.
2) Developing interoperable health IT systems to improve information sharing across settings and support personalized care.
3) Addressing challenges like fragmented information and a lack of consistency through initiatives like a national health information architecture and infrastructure.
Healthcare Document Management Systems Market Size, Share, Growth Analysis & ...GQ Research
Global Healthcare Document Management Systems market was experiencing steady growth due to the increasing adoption of electronic health records (EHR) and the need for efficient data management in the healthcare industry.
Healthcare Document Management Systems Market Size, Share, Growth Analysis & ...GQ Research
Global Healthcare Document Management Systems market was experiencing steady growth due to the increasing adoption of electronic health records (EHR) and the need for efficient data management in the healthcare industry.
Running Head Stage 2 Sharing Data1Stage 2 Sharing Data3.docxjeanettehully
Running Head: Stage 2: Sharing Data1
Stage 2: Sharing Data3
Stage 2: Sharing Data
Alesix Tieku
Dr.Lindsey hopper
IFSM 305
July 11th, 2019
Table of Contents
A.Introduction2
B.Need to Share Data2
C.Types of Data to be shared3
D.Data Interchange Standards4
E.Summary4
Stage 2: Sharing DataA. Introduction
Medical care institutions have provided care for their patients since old times before the digital technology era that we are in today. Medical institutions like clinics and hospitals which existed during those previous times, used paper based methods to get most of their basic operations done within the institutions. Operations like obtaining, saving and updating customer details, keeping appointment schedules, and sharing customer data with other institutions. Now in the modern era of technology, the same operations are needed but are simpler now than back then, thanks to digital technology.
The sharing of data between institutions is necessity in the medical profession in for various reasons. The institutions that require such data have different reasons for that as well. For these reasons, data sharing between institutions needs to be properly set and streamlined process for maximum efficiency.B. Need to Share Data
Of the many institutions that exist in the medical industry, two institutions are very crucial to the process of administering medical help to patients; Laboratories and Insurance companies.
Laboratories are essential to the process of diagnosing and treating an illness in a patient for various reasons. First of all, a patient’s diagnosis process can be a difficult problem and a rather complicated one too. When a doctor listens to a patient describe the symptoms of an illness, he/she gets a general idea of what a patient is suffering from and may need further information from a laboratory to confirm his findings. In such a scenario, the doctor sends the patient to a laboratory either within the institution or outside the institution. The laboratory will most definitely require accurate information about the patient to understand the basic nature of the condition of which the patient is required to be tested on, background information like allergies and any other relevant information. This information is usually given by the doctor or retrieved from data storage facilities like a file or a digital database.
Insurance companies are also essential in the process of treating a patient for various reasons. The major reason however is for the purposes of billing of patients expenses. These companies need information about the expenses incurred by a patient during treatment. Such information may include: laboratory test costs, drugs and medicine costs and doctor consultation fees. Proper communication and data sharing frameworks need to be put in place for this purpose as well.
C. Types of Data to be shared
Medical care institutions often need to share patient information with external institutions for the purposes of sa ...
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Health care vertical open standards
1. UNIT 4 - Health Care Vertical Open Standards
1. Introduction to Industry Vertical Open Standards
Broadly two types of standards are notable, generic and specific standards. Generic also called horizontal or technical standards
apply to almost all organizations, because they do not give any information on underlying business processes. For example XML is
a generic standard. Generic open standards facilitate competition, if we follow SQL standard (ISO 90750) we can easily swap
databases as we want.
In contrast to horizontal IT standards, which is concerned with the characteristics of IT products and applies to users in many
industries, Vertical IT standards focus on data structures & definitions, document formats, business processes and addresses
business problems unique to a particular industry. Vertical IT standards (also called specific or Semantic) are designed to promote
communication and coordination among the organizations comprising a particular industry sector and to promote interoperability.
For example HR-XML is vertical standard for the Human Resources industry to meet the common messaging needed to enable
communication between all the disparate and legacy systems. Similarly XBRL (eXtensible Business Reporting Language) is a
standard for the electronic communication of business and financial data. There are XML schemas that define how information is
represented in electronic patient health care records, but we would not use those same schemas to build the XML messages that
are part of an automotive supply chain.
Vertical industry standards guide the integration of common systems components with industry-specific components, and guide the
creation of industry solutions for targeted customer problems within a particular industry. They should be developed and owned by
the users and not by vendors. Standardization in this area is necessary on semantic level as well.
Not all standards are applicable to many industries; vertical standards are needed to address business problems unique to particular
industries. For example, when the chemical industry began to expand its EDI (Electronic Data interchange) document standards for
e-commerce, standards developers took RosettaNet (XML-based) B2B protocol standards in the electronics industry to customize
them to unique chemical industry processes, such as the shipment of hazardous materials.
Vertical standards such as RosettaNet and CIDX (Chemical Industry Data exchange ) standards differ from horizontal standards,
not only in their narrower applicability, but also in their technical content.
IT product standards (Horizontal) focus on rudimentary levels of interconnection, such as telecommunications protocols, by
difference, vertical standards focus on data and business processes. Because vertical standards are not much concerned on
technology nuances, but, on how it is used.
The development and adoption of vertical standards exhibits very different characteristics than those of horizontal IT standards.
Normally technology firms and governments are the leaders in horizontal standardization; their role in vertical standardization efforts
is likely to depend on such things as, degree of adoption of IT in a particular sector and the extent of regulation in the industry.
2. Health Care Vertical
Hippocrates started a revolution in healthcare, by calling for the cautious collection and recording of evidence about patients and
their illnesses. This introduced sharing of data among physicians to provide the best possible care for patients and established a
foundation for the evolution of modern healthcare. Although 25 centuries have passed since Hippocrates suggestion, we have not
yet attained true evidence-based healthcare. Huge quantities of data about wellness and illness continue to be dropped, rather than
collected and utilized to optimize patient care.
We now stand at the brink of a potential revolution in data-centric healthcare, aided by advances in information & communication
technology. This promises to improve the quality of healthcare by cutting costs, and enabling physicians to do the very best with
available resources. In fact this supports the oath that all physicians make when they solemnly raise their hand and recite the
Hippocratic oath upon receipt of their medical degree.
Paper-based records have been in existence for centuries and their gradual replacement by computer-based records has been
slowly underway for over twenty years in western healthcare systems. Computerized information systems have not achieved the
same degree of penetration in healthcare as that seen in other sectors such as finance, transport and the manufacturing and retail
2. industries. Further, deployments have varied greatly from country to country and from specialty to specialty and in many cases have
revolved around local systems designed for local use.
Today, health care industry is one of the world's largest and fastest-growing industries consuming over 10 percent of gross domestic
product (GDP) of most developed nations, health care can form an enormous part of a country's economy also health care is
becoming the fastest growing Vertical in IT. The need for health care IT gets more urgent as the population of people aged 55 and
over grows and records move from paper to electronic. Meanwhile, spending on wireless connectivity by health care enterprises will
increase by about 12 percent. Also spending on wireless will be fueled by a large market for wireless health-monitoring devices,
according to a recent study. [Source: http://www.eweek.com Health care IT news]
3. Health Information Technology (HIT)
HIT consists of an enormously diverse set of technologies for transmitting and managing health information for use by consumers,
providers, payers, insurers, and other groups with an interest in health and health care. In general it includes the capture, storage,
use and/or transmission of health information through electronic processes.
3.1 Components of HIT
3.1.1 Applications
These are the ―programs‖ that are used to perform HIT functions. These applications include but are not limited to: Patient
Registries, Accounting/Practice Management Systems (PMS), CPOE/CDS (Computerized Physician Order Entry with Clinical
Decision Support), ePrescribing, Electronic Medical Records (EMRs), Electronic Health Records (EHRs), Patient Health Records
(PHRs), Results Reporting, Electronic Documentation, Appointment Scheduling, Patient Kiosks, Telemedicine, Interface Engines.
Electronic Medical Record: ―An electronic record of health-related information on an individual that can be created, gathered,
managed, and consulted by authorized clinicians and staff within one health care organization.‖
Electronic Health Record: ―An electronic record of health-related information on an individual that conforms to nationally
recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across
more than one health care organization.
Personal Health Record: ―An electronic record of health-related information on an individual that conforms to nationally
recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled
by the individual.
Health Information Exchange: ―The electronic movement of health-related information among organizations according to
nationally recognized standards.‖
Health Information Organization: ―An organization that oversees and governs the exchange of health-related information
among organizations according to nationally recognized standards.‖
Regional Health Information Organization: ―A health information organization that brings together health care stakeholders
within a defined geographic area and governs health information exchange among them for the purpose of improving health and
care in that community.‖
3.1.2 Communications Standards
These are the various sets of standards that are necessary in order for HIT systems to communicate with each other in a uniform
manner. These standards encompass
Messaging Standards
HL7, ADT, NCPDP, X12, DICOM, UB92, HCFA, ASTM, EDIFACT, etc.
Messaging standards are the form and structure that is required for the information to move and be tracked from one system to
another; and
Coding Standards
LOINC, ICD-9, CPT, NDC, RxNorm, Snomed CT, etc.
3. Coding standards are the form and structure of the procedure codes that are necessary to communicate what procedure was
performed for a particular patient during a visit.
3.1.3 Processes
These are the actual steps necessary to obtain, retrieve, send, and receive data from one computer to another, from one system to
another and from many systems in an integrated fashion.
MPI (Message Passing Interface) – these interfaces guide the transfer of the message from one system to another
HIE (Health Information Exchanges) – there has been recent debate as to whether HIE is a verb or a noun i.e. is it a process or
an entity? There are organizations that are called health information exchanges at the present time who provide the backbone
systems and hardware that allows and facilitates the process of health information exchange, however, as per current definitions
as referenced above HIE is a process
RHIOs (Regional Health Information Organizations) – although RHIOs are indeed entities that provide similar functions to the
HIE a RHIO usually has a much larger governance role in a specific area than does an HIE. Even this is changing as RHIOs no
longer only cover small geographic areas. RHIOs now cross state lines and provide services in multi states. This is a reason that
the ―Alliance‖ added a category and definition for Health Information Organizations (HIO) taking out ―regional‖.
3.1.4 Security/Privacy
This plays an important role in all exchange of health information using HIT. Healthcare providers, institutions and vendors must
comply with HIPAA in any and all exchange of personal health information (PHI). There is also much debate at the present time with
regard to HIPAA being or not being stringent enough to protect privacy in an all HIT world. A balance will need to be developed that
allows for health care information to be exchanged in order to provide improved quality of care for the patient and still maintain
his/her confidentiality.
3.1.5 Devices
These are the various hardware components that make HIT work and include such things as: Desktops, Laptops, Tablet PCs,
Servers, Mice, Pens, Bar Coding devices and more. As HIT continues to develop and we continue to exchange information with our
providers we will see in-home devices such as blood pressure monitors and scales have the ability to transmit data directly to our
provider for him/her to review and monitor our care. This is available and is occurring now.
4. HL7
In today’s healthcare industry, goal is to exchange patient data freely across various systems in the industry. Health IT standards
provide the necessary foundation for institutional data sharing and integration of this data with home care. Security, privacy and
regulatory issues need to be addressed while ensuring end to end delivery and accessibility. Healthcare is an information intensive
industry and persistent information losses are costly, economically, as well, in terms of human life.
The purpose of using standards in health information systems is to facilitate the integration of component parts and support
interoperability, for example, by making data generated in one part of a system accessible, meaningful and reusable where different
technology may be in use.
In health informatics, standards development is concentrated in such areas as data exchange, medical terminologies, documents,
architectures.
p<>To address the standards in health IT, today there are various SDO’s and SIG’s already in existence.
The US National Committee on Vital and Health Statistics describes three levels of interoperability:
4. Basic interoperability—allowing a message from one computer to be received by another, but not requiring the receiving
computer to be able to interpret the data.
Functional interoperability—an intermediate level defining the format of messages. This ensures messages between computers
can be interpreted at the level of data fields, so that data can pass from a structured field in one system to a comparably
structured field in another. Neither system, however, has understanding of the meaning of the data within the field(s).
Semantic interoperability—provides common interpretability, that is, information within the data fields can be used intelligently.
In addition to the standard methods for systems to communicate (chiefly Health Level 7 [HL7]) and those required for submission of
claims (Current Procedural Terminology [CPT]-4, International Classification of Diseases, Ninth Revision, Clinical Modification [ICD9-CM], and X12N), there are several other available standards that are clinically useful and can greatly improve the ability to access
and exchange patient information. Major advances in the Unified Medical Language System of the National Library of Medicine have
made the patient medical record information standards (Systematized Nomenclature of Medicine [SNOMED], Logical Observation
Identifiers, Names, and Codes [LOINC], RxNorm) easily accessible. Detailed knowledge of the arcana associated with the technical
aspects of the standards is not needed (or desired) by clinicians to use standards-based systems. However, some knowledge about
the commonly used standards is helpful in choosing an EDIS, interfacing the EDIS with the other hospital information systems,
extending or upgrading systems, and adopting decision support technologies.
Electronic Medical Records, Electronic Health Records ...
The replacement of healthcare systems reliant on paper-based medical records or generally localised clinical information systems
by very large scale health information infrastructures centred on interoperable electronic patient record systems (and/or electronic
heath cards) is now underway in many countries. Some countries are well-advanced in the implementation of electronic patient
records and national network infrastructures - particularly the Scandinavian countries of Denmark, Finland, Norway and Sweden.
But most aren't. However, governments in France, Canada, Australia, England, New Zealand and the USA, for example, have now
committed to deliver national electronic networks and medical record systems to support healthcare delivery for their populations,
typically by the end of the current decade.
These national programmes, all established within the last few years, are so extensive they constitute a healthcare technology
revolution in each country where they have been announced. In Europe, the European Commission took a lead in publishing in
2004 an action plan for a European e-Health Area. The plan specifies a sequential set of actions to be taken by EU member states
over the period 2004-2010. The investment committed in one case - NHS England on its wholly publicly funded Connecting for
Health programme - is unprecedented. Some other countries, including France, are also funding their programmes exclusively with
public money. Other governments, including the USA, Australia and Canada, are promoting collaborations between the private and
public sectors. Finland's FinnWell programme is focusing on promoting healthcare technology development to create opportunities
for Finnish business and research, while at the same time aiming to improve the Finnish healthcare system.
Interest in implementing e-Health technologies is not limited to the most highly developed countries of the world. In Asia, countries
such as Hong Kong, Singapore, South Korea, Thailand and Taiwan are developing and implementing e-Health policies. e-Health
projects focusing on telemedicine in particular are running in many of the countries of Central and South America and the
Caribbean. Some countries in Africa are starting to develop e-Health policies and strategies and are receiving impetus and support
from various global and regional organisations from the United Nations, the World Health Organisation, UNESCO to the recently
inaugurated Digital Solidarity Fund (which aims to support implementation of ICT - including e-Health - in Africa) and NEPAD (the
New Partnership for Africa’s Development). . National penetration of EMRs may have reached over 90% in primary care practices in
Norway, Sweden and Denmark (2003), but has been limited to 17% of physician office practices in the USA (2001-2003) [HHS,
2005]. Those EMR systems that have been implemented however have been used mainly for administrative rather than clinical
purposes.
Electronic medical record systems lie at the center of any computerized health information system. Without them other modern
technologies such as decision support systems cannot be effectively integrated into routine clinical workflow. The paperless,
interoperable, multi-provider, multi-specialty, multi-discipline computerized medical record, which has been a goal for many
researchers, healthcare professionals, administrators and politicians for the past 20+ years, is however about to become reality in
many western countries.
Over the past decade, the political impetus for change in almost all western countries has become stronger and stronger.
Incontrovertible evidence has increasingly shown that current systems are not delivering sufficiently safe, high quality, efficient and
cost effective healthcare (see Public Reports section on OpenClinical), and that computerization, with the EMR at the centre, is
5. effectively the only way forward. As Tony Abott (Australian Minister for Heath and Ageing) said in August 2005: "Better use of IT is
no panacea, but there's scarcely a problem in the health system it can't improve". For the first time, the responses have been
national and co-ordinated. Governments in Australia, Canada, Denmark, Finland, France, New Zealand, the UK, the USA and other
countries have announced - and are implementing - plans to build integrated computer-based national healthcare infrastructures
based around the deployment of interoperable electronic medical record systems. And many of these countries aim to have EMR
systems deployed for their populations within the next 10 years.
Terms used in the field include electronic medical record (EMR), electronic patient record (EPR), electronic health record (EHR),
computer-based patient record (CPR) etc. These terms can be used interchangeably or generically but some specific differences
have been identified. For example, an Electronic Patient Record has been defined as encapsulating a record of care provided by a
single site, in contrast to an Electronic Health Record which provides a longitudinal record of a patient’s care carried out across
different institutions and sectors. But such differentiations are not consistently observed.
The 1997 Institute of Medicine report: The Computer-Based Patient Record: An Essential Technology for Health Care, provides the
following more extensive definition: "A patient record system is a type of clinical information system, which is dedicated to collecting,
storing, manipulating, and making available clinical information important to the delivery of patient care. The central focus of such
systems is clinical data and not financial or billing information. Such systems may be limited in their scope to a single area of clinical
information (e.g., dedicated to laboratory data), or they may be comprehensive and cover virtually every facet of clinical information
pertinent to patient care (e.g., computer-based patient record systems)." [IOM, 1997]
The three essential capabilities of an electronic health record as follows:
To capture data at the point of care
To integrate data from multiple internal and external sources
To support caregiver decision making.
The eight core capabilities that EHRs should possess are:
Health information and data.
Having immediate access to key information - such as patients' diagnoses, allergies, lab test results, and medications - would
improve caregivers' ability to make sound clinical decisions in a timely manner.
Result management.
The ability for all providers participating in the care of a patient in multiple settings to quickly access new and past test results would
increase patient safety and the effectiveness of care.
Order management.
The ability to enter and store orders for prescriptions, tests, and other services in a computer-based system should enhance
legibility, reduce duplication, and improve the speed with which orders are executed.
Decision support.
Using reminders, prompts, and alerts, computerized decision-support systems would help improve compliance with best clinical
practices, ensure regular screenings and other preventive practices, identify possible drug interactions, and facilitate diagnoses and
treatments.
Electronic communication and connectivity.
Efficient, secure, and readily accessible communication among providers and patients would improve the continuity of care,
increase the timeliness of diagnoses and treatments, and reduce the frequency of adverse events.
Patient support.
Tools that give patients access to their health records, provide interactive patient education, and help them carry out homemonitoring and self-testing can improve control of chronic conditions, such as diabetes.
6. Administrative processes.
Computerized administrative tools, such as scheduling systems, would greatly improve hospitals' and clinics' efficiency and provide
more timely service to patients.
Reporting.
Electronic data storage that employs uniform data standards will enable health care organizations to respond more quickly to
federal, state, and private reporting requirements, including those that support patient safety and disease surveillance."
This list of key capabilities will be used by Health Level Seven (HL7) ... to devise a common industry standard for EHR functionality
that will guide the efforts of software developers.
Benefits of EMRs
Replace paper-based medical records which can be incomplete, fragmented (different parts in different locations), hard to read
and (sometimes) hard to find. Provide a single, shareable, up to date, accurate, rapidly retrieveable source of information,
potentially available anywhere at any time. Require less space and administrative resources.
Potential for automating, structuring and streamlining clinical workflow.
Provide integrated support for a wide range of discrete care activities including decision support, monitoring, electronic
prescribing, electronic referrals radiology, laboratory ordering and results display.
Maintain a data and information trail that can be readily analysed for medical audit, research and quality assurance,
epidemiological monitoring, disease surveillance .... Support for continuing medical education.
Widespread implementation of EMRs has been hampered by many perceived barriers including:
Technical matters (uncertain quality, functionality, ease of use, lack of integration with other applications,
Financial matters - particularly applicable to non-publicly funded health service systems (initial costs for hardware and software,
maintenance, upgrades, replacement, ROI ...)
Resources issues, training and re-training; resistance by potential users; implied changes in working practices.
Certification, security, ethical matters; privacy and confidentiality issues Doubts on clinical usefulness
Incompatibility between systems (user interface, system architecture and functionality can vary significantly between suppliers'
products).
Issues
Integrated systems require consistent use of standards in e.g. medical terminologies and high quality data to support information
sharing across wide networks
Ethical, legal and technical issues linked to accuracy, security confidentiality and access rights are set to increase as national
EMR systems come online. These issues become more pressing with the current movement to promoting consumer
empowerment and information ownership, championed by the European Commission for example, which is leading towards
patient records accessible by patients (Personal Health Records).
Common record architectures, structures
Clinical information standards and communications protocols
Security and confidentiality of information
Patient data quality; data sets, data dictionaries.
Interoperability aims to support :
Data transfer and sharing on much more than a local or enterprise-wide scale Knowledge transfer and integration
Medical terminology transfer, mapping and integration
Image transfer
Integration with clinical and non-clinical applications
EMR / EHR-related standards
7.
8. Health information exchange (HIE) is the transmission of healthcare-related data among facilities, health information organizations
(HIO) and government agencies according to national standards. HIE is an integral component of the health information technology
(HIT) infrastructure under development in the United States and the associated National Health Information Network (NHIN).
To meet requirements, HIE technology must enable reliable and secure transfer of data among diverse systems and also facilitate
access and retrieval data. The purpose of HIE development is to improve healthcare delivery and information gathering.
Syntatic interoperability is a prerequisite for semantic interoperability. Syntatic interoperability refers to the packaging and
transmission mechanisms for data. In healthcare, HL7 has been in use for over thirty years (which predates the internet and web
technology), and uses the unix pipe (|) as a data delimiter. The current internet standard for document markup is XML, which uses
"< >" as a data delimiter. The data delimiters convey no meaning to the data other than to structure the data. Without a data
dictionary to translate the contents of the delimiters, the data remains meaningless. While there are many attempts at creating data
dictionaries and information models to associate with these data packaging mechanisms, none have been practical to implement.
This has only perpetuated the ongoing "babelization" of data and inability to exchange of data with meaning
9.
10. 5. REFERENCES
http://www.ask.com/wiki/Enterprise_software
http://en.wikipedia.org/wiki/Enterprise_application_integration
http://en.wikipedia.org/wiki/Web_service
6. Disclaimer
The contents of this report reflect the views of the author and do not necessarily reflect the official views or policy of the International
Business Machines Corporation in the United States and/or other countries. This report does not constitute a standard, specification
or regulation.
IBM is a registered trademark of International Business Machines Corporation in the United States and/or other countries.
Other company, product, and service names may be trademarks or service marks of others.
Microsoft is a registered trademark of Microsoft Corporation