The document discusses standards and coding systems used in biomedical and health informatics. It provides background on the speaker and their qualifications in the fields of medicine and health informatics. It then discusses why healthcare information standards are needed, providing examples of different types of standards including unique identifiers, standard data sets, vocabularies and terminologies, and exchange standards for messages and documents.
A brief introduction to SNOMED CT - the ontology based medical terminology. This covers the basic definitions, the difference between SNOMED CT and ICD9, Post co-ordination use-cases and some general information.
This is not an extensive guide for SNOMED CT adoption in a system
Provides an overview of SNOMED CT concentrating on its fundamentals, advantages and disadvantages of use, how its logical model is designed, the relationships and attribute name-value pairing, and pre- & post-coordinated expressions
A brief introduction to SNOMED CT - the ontology based medical terminology. This covers the basic definitions, the difference between SNOMED CT and ICD9, Post co-ordination use-cases and some general information.
This is not an extensive guide for SNOMED CT adoption in a system
Provides an overview of SNOMED CT concentrating on its fundamentals, advantages and disadvantages of use, how its logical model is designed, the relationships and attribute name-value pairing, and pre- & post-coordinated expressions
HL7
Health level 7
What is HL7?
What does it stand for
HL7 Mission
HL7 contains message standards
HL7 in HealthcareManagement System
Standards
Limitations of HL7
Explains about Health Record Standards, ICTs, Standards for Healthcare Sector, Ministry of Health and Family Welfare. For more information visit: http://www.transformhealth-it.org/
Presentation for UP Health Informatics HI201 under Dr. Iris Tan and Dr. Mike Muin. The topic for discussion Interoperability & Standards, a healthcare scenario was given regarding two disparate information systems, one found in a clinic, another with a hospital information system. #MSHI #HI201
Planning & day today management of OT services is very complex and needs to be understood by all Hospital administrators for successfully running a hospital.
Each year the CPT and the HCPCS code sets undergo significant changes, and your staff needs to be aware of the changes in order to ensure a smooth transition into 2023. Join us for a discussion of the new, deleted and revised CPT codes and associated guidelines for 2023. This is part one in a three part series.
During these complimentary webinars, we will empower you to correctly apply the new and revised codes and discuss the rationale behind this year’s changes. This presentation will be geared towards hospital staff with a focus on the non-surgical sections of the CPT book.
Learning Objectives:
Evaluation of the CPT code changes for the radiology, laboratory and medicine sections of the code book
Discussion regarding changes to guidelines and instructional notes affecting these sections of the code book
Review of the rationale behind the identified code changes
Presentation of coding examples related to the new codes for 2023
Usefullness of Speech Coding in Voice BankingCSCJournals
Voice banking is an excellent telephone banking service by which a user can access his account for any service at any time of a day, in a year. The speech techniques involved in voice banking are speech coding and speech recognition. This paper investigates the performance of a speech recognizer for a coded output at 20 bits/frame obtained by using various vector quantization techniques namely Split Vector Quantization, Multi Stage Vector Quantization, Split-Multi Stage Vector Quantization, Switched Split Vector Quantization using Hard decision scheme, Switched Multi Stage Vector Quantization using Soft decision scheme and Multi Switched Split Vector Quantization using Hard decision scheme techniques. The speech recognition technique used for recognition of the coded speech signal is the Hidden Markov Model technique and the speech enhancement technique used for enhancing the coded speech signal is the Spectral Subtraction technique. The performance of vector quantization is measured in terms of spectral distortion in decibels, computational complexity in Kflops/frame, and memory requirements in floats. The performance of the speech recognizer for coded outputs at 20 bits/frame has been examined and it is found that the speech recognizer has better percentage probability of recognition for the coded output obtained using Multi Switched Split Vector Quantization using Hard decision scheme. It is also found that the probability of recognition for various coding techniques has been varied from 80% to 100%.
HL7
Health level 7
What is HL7?
What does it stand for
HL7 Mission
HL7 contains message standards
HL7 in HealthcareManagement System
Standards
Limitations of HL7
Explains about Health Record Standards, ICTs, Standards for Healthcare Sector, Ministry of Health and Family Welfare. For more information visit: http://www.transformhealth-it.org/
Presentation for UP Health Informatics HI201 under Dr. Iris Tan and Dr. Mike Muin. The topic for discussion Interoperability & Standards, a healthcare scenario was given regarding two disparate information systems, one found in a clinic, another with a hospital information system. #MSHI #HI201
Planning & day today management of OT services is very complex and needs to be understood by all Hospital administrators for successfully running a hospital.
Each year the CPT and the HCPCS code sets undergo significant changes, and your staff needs to be aware of the changes in order to ensure a smooth transition into 2023. Join us for a discussion of the new, deleted and revised CPT codes and associated guidelines for 2023. This is part one in a three part series.
During these complimentary webinars, we will empower you to correctly apply the new and revised codes and discuss the rationale behind this year’s changes. This presentation will be geared towards hospital staff with a focus on the non-surgical sections of the CPT book.
Learning Objectives:
Evaluation of the CPT code changes for the radiology, laboratory and medicine sections of the code book
Discussion regarding changes to guidelines and instructional notes affecting these sections of the code book
Review of the rationale behind the identified code changes
Presentation of coding examples related to the new codes for 2023
Usefullness of Speech Coding in Voice BankingCSCJournals
Voice banking is an excellent telephone banking service by which a user can access his account for any service at any time of a day, in a year. The speech techniques involved in voice banking are speech coding and speech recognition. This paper investigates the performance of a speech recognizer for a coded output at 20 bits/frame obtained by using various vector quantization techniques namely Split Vector Quantization, Multi Stage Vector Quantization, Split-Multi Stage Vector Quantization, Switched Split Vector Quantization using Hard decision scheme, Switched Multi Stage Vector Quantization using Soft decision scheme and Multi Switched Split Vector Quantization using Hard decision scheme techniques. The speech recognition technique used for recognition of the coded speech signal is the Hidden Markov Model technique and the speech enhancement technique used for enhancing the coded speech signal is the Spectral Subtraction technique. The performance of vector quantization is measured in terms of spectral distortion in decibels, computational complexity in Kflops/frame, and memory requirements in floats. The performance of the speech recognizer for coded outputs at 20 bits/frame has been examined and it is found that the speech recognizer has better percentage probability of recognition for the coded output obtained using Multi Switched Split Vector Quantization using Hard decision scheme. It is also found that the probability of recognition for various coding techniques has been varied from 80% to 100%.
Class 12th computer science C++ coding for Banking System program.
Features in Program:
1. New Account
2. Deposit Amount
3. Withdraw Amount
4. All Account Holder List
5. Delete Account
6. Edit Account
7. Exit
The Myth of Health Data Integration ComplexityShahid Shah
At Health:Refactored (San Francisco) I presented a practical and technical look at why current health IT systems integrate poorly and how we can fix it.
OSEHRA Summit 2012 Lunch Keynote: Current health IT systems integrate poorly ...Shahid Shah
OSEHRA Summit 2012 Lunch Keynote - The Myth of Health Data Integration Complexity. This is an opinionated look at why current health IT systems integrate poorly and how it’s a big opportunity for the OSEHRA Community.
Background:
* A deluge of healthcare data is being created as we digitize biology, chemistry, and physics.
* Data changes the questions we ask and it can actually democratize and improve the science of medicine, if we let it.
* While cures are the only real miracles of medicine, big data can help solve intractable problems and lead to more cures.
* Healthcare-focused software engineering is going to do more harm than good (industry-neutral is better).
Key takeaways:
* Major opportunity for systems integrators
* Applications come and go, data lives forever. He who owns, integrates, and uses data wins in the end.
* Never leave your data in the hands of an application/system vendor.
* There’s nothing special about health IT data that justifies complex, expensive, or special technology.
* Spend freely on multiple systems and integration-friendly solutions.
Using Case-based Methods for Evaluating Complexity in the Health SectorJSI
Anne LaFond presented as part of a panel at the 2015 Evaluation Conference on using case-based methods for evaluating complexity in the health sector, sharing insights from various JSI case studies.
Non Invasive Health Monitoring with mHealthBart Collet
mHealth Trends and examples of non invasive mobile health devices, organisations and services.
Made as preparation for MoMoAMS #14 about mHealth, Jan 25th 2010, Amsterdam
This report paper contains online banking system in j2ee component of java.also include system requirements,design modules,data flow diagrams, sequence diagrams and the architecture of online banking.
content:Introduction
Project requirements
System modules
User interface specification
Use case and data flow diagram’s
A presentation in February 2011 presented at the Ramathibodi Hospital Administration School, Faculty of Medicine Ramathibodi Hospital, Mahidol University in Bangkok, Thailand. Presentation partly in English and partly in Thai.
Theera-Ampornpunt N. Health informatics: the next “stethoscope” in healthcare. Presented at: Intelligent logistics for innovation hospitals; 2010 Dec 23; Faculty of Engineering, Mahidol University, Thailand. Invited speaker, in Thai.
A presentation in March 2012 presented at the Ramathibodi Hospital Administration School, Faculty of Medicine Ramathibodi Hospital, Mahidol University in Bangkok, Thailand. Presentation partly in English and partly in Thai.
An overview of clinical healthcare data analytics from the perspective of an interventional cardiology registry. This was initially presented as part of a workshop at the University of Illinois College of Computer Science on April 20, 2017.
Healthcare institutions are aggressively moving towards meeting compliance with MU1 and MU2 with the implementation of full-featured Electronic Health Records. Concomitantly, there will be a massive increase in the amount of clinical data captured electronically. Business intelligence (BI) which traditionally has focused on financial data can be leveraged to use clinical data to support providers in delivering high quality, efficient care. In addition, BI coupled with population health analytics can help meet many Accountable Care Organization needs. This presentation will discuss the Denver Health journey in using BI in a variety of was to facilitate the attainment of high quality care.
Dr. Chute will overview progress around data normalization and high throughput clinical phenotyping (recognizing groups of patients for quality, practice, or research use-cases from electronic medical records (EMRs). These techniques were demonstrated to generate comparable and consistent information from multiple academic medical centers with heterogeneous EMR systems and record structures in the NHGRI funded eMERGE consortium (gwas.net). Tools and techniques for data normalization and phenotyping have been generalized and partially commoditized as open-source archetypes software in the ongoing SHARPn (SHARPn.org).
Speech Understanding Dictation To Clinical Data - TEPR 2009Nick van Terheyden
Speech Understanding automatically converts the spoken work into structured and encoded clinical data that provides access to relevant diagnostic support, evidence based medicine and real time alerts.
Unlocking the data tucked away in the vast mountain of documents produced as part of delivering care to patients is possible today with Speech Understanding, the next generation of speech recognition technology that not only improves the overall efficiency of the documentation process by producing higher quality, more accurate clinical data but also produces structured encoded clinical data that can populate EMR’s that are crying out for high quality input. This information is encoded using the HL7’s Clinical Document Architecture (CDA) and Common Document Types (CDA4CDT).
With knowledge of the meaning the output from Speech Understanding is now able to identify concepts, organize documents into meaningful categories and create a semantically interoperable document .
Health research, clinical registries, electronic health records – how do they...Koray Atalag
This is a talk I gave at my own organisation - National Institute for Health Innovation (NIHI) of the University of Auckland on 6 Aug 2014. Abstract as follows:
In this talk I’ll first cover the topic of clinical registry – an invaluable tool for supporting clinical practice but also gaining momentum in research and quality improvement. NIHI has been very active in this space: we have delivered the prestigious and highly successful National Cardiac Registry (ANZACS-QI) together with VIEW research team and also very recently launched the Gestational Diabetes Registry with Counties Manukau DHB & Diabetes Projects Trust. A few others are in likely to come down the line. This is a huge opportunity for health data driven research and NIHI to position itself as ‘the health data steward’ in the country given our independent status and existing IT infrastructure and “good culture” of working with health data . NIHI’s ‘health informatics’ twist in delivering these projects is how we go about defining ‘information’ – using a scientifically credible and robust methodology: openEHR. This is an international (and now national too) standard to non-ambiguously define health information so that they are easy to understand and also are computable. We build software (even automatically in some cases!) using models created by this formalism. I’ll give basics of openEHR approach and then walk you through how to make sense out of all these. Hopefully you may have an idea about its ‘value proposition’ (as business people call) or Science merit as I like to call it ;)
Presented at the BDMS Golden Jubilee Scientific Conference 2022 "BDMS Beyond 50 years: Looking towards the centennial," Bangkok Dusit Medical Services Public Company Limited (BDMS), Bangkok, Thailand on October 19, 2022
Presented at The Thai Medical Informatics Association Annual Conference and The National Conference on Medical Informatics (TMI-NCMedInfo) 2021, Bangkok, Thailand on November 26, 2021
Presented at the Master of Science Program in Medical Epidemiology and the Doctor of Philosophy Program in Clinical Epidemiology, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on November 25, 2021
Presented at the Master of Science and Doctor of Philosophy Programs in Data Science for Healthcare and Clinical Informatics, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on November 15, 2021
Consumer Health Informatics, Mobile Health, and Social Media for Health: Part...Nawanan Theera-Ampornpunt
Presented at the Master of Science and Doctor of Philosophy Programs in Data Science for Healthcare and Clinical Informatics, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on November 10, 2021
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
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Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Standards & Coding Systems in Biomedical and Health Informatics
1. Standards & Coding Systems
in Biomedical and Health Informatics
นพ.นวนรรน ธีระอัมพรพันธุ์
บรรยาย ณ สถาบันทันตกรรม ในหลักสูตรทันตสารสนเทศศาสตร์
24 กุมภาพันธ์ 2555
2. A Few Words About Me...
2003 M.D. (1st-Class Honors) Ramathibodi
2009 M.S. (Health Informatics) University of Minnesota
2011 Ph.D. (Health Informatics) University of Minnesota
Currently
• Medical Systems Analyst, Health Informatics Division, Ramathibodi
Contacts
ranta@mahidol.ac.th
SlideShare.net/Nawanan
www.tc.umn.edu/~theer002
groups.google.com/group/ThaiHealthIT
6. Why Healthcare Isn’t Like Any Others?
Life-or-Death
Many & varied stakeholders
Strong professional values
Evolving standards of care
Fragmented, poorly-coordinated systems
Large, ever-growing & changing body of
knowledge
High volume, low resources, little time
7. Why Healthcare Isn’t Like Any Others?
Large variations & contextual dependence
Input Process Output
Patient Decision- Biological
Presentation Making Responses
8. But...Are We That Different?
Banking
Input Process Output
Transfer
Location A Location B
Value-Add
- Security
- Convenience
- Customer Service
9. But...Are We That Different?
Manufacturing
Input Process Output
Raw Materials Assembling Finished
Goods
Value-Add
- Innovation
- Design
- QC
10. But...Are We That Different?
Healthcare
Input Process Output
Sick Patient Patient Care Well Patient
Value-Add
- Technology & medications
- Clinical knowledge & skills
- Quality of care; process improvement
- Information
12. Types of Healthcare Information
Clinical Information
Demographics, History, Physical Exam
Laboratory tests & Other Investigations (e.g. ECG), Imaging
Diagnoses, Medications, Treatments
Genomics
Information about Healthcare Organizations & Operations
Public Health Information - Epidemiology, Environmental
Research Information - Basic Science, Clinical Research, Public Health
Generic Health Information (e.g. Patient education materials)
Knowledge Bases (e.g. PubMed) & Professional Education Materials
13. Various Forms of Health IT
Hospital Information System (HIS) Computerized Provider Order Entry (CPOE)
Electronic
Health
Records Picture Archiving and
(EHRs) Communication System
(PACS)
14. Still Many Other Forms of Health IT
Health Information
Exchange (HIE)
m-Health
Biosurveillance
Personal Health Records
(PHRs)
Telemedicine &
Information Retrieval Telehealth
Images from Apple Inc., Geekzone.co.nz, Google, PubMed.gov, and American Telecare, Inc.
16. Recap
Healthcare is complex and information-rich
Healthcare information is heterogeneous
Health IT is a tool to add value to care delivery
Health IT comes in many different shapes and
forms, many must integrate with one another
Yet healthcare is highly fragmented...
That’s why we need “STANDARDS”
18. Standards: Why?
The Large N Problem
N = 2, Interface = 1
N = 3, Interface = 3
N = 5, Interface = 10
# Interfaces = N(N-1)/2
N = 100, Interface = 4,950
20. The Goal Is...
Interoperability
Inter-operable systems
21. Types of Standards
De facto (informal/in practice) standards
Dominant custom, convention, product, system
e.g. Microsoft Word, QWERTY keyboard
De jure (formal) standards
Developed by recognized standard developing
organizations
Maybe obligatory/regulatory, or voluntary
22. Standard-Developing Organizations (SDOs)
Develops, coordinates, revises, interprets &
maintains standards that address interests outside its
own organization
Clear scope
Formal standards development process
International, regional, national authorities
Examples: ISO, IEC, ITU, IEEE, IETF, W3C, ANSI, NIST,
HL7, ASTM
23. Sample Standards Development Process
Public
Working Group
Draft Proposal Comment/
Consideration
Balloting
(Additional
Working Group
Test/Trial Use Balloting or
Amendment
Approval)
(Enforcement/ Evaluation/
Deployment
Certification) Maintenance
24. Various Kinds of Standards
Unique Identifiers
Standard Data Sets
Vocabularies & Terminologies
Exchange Standards
Message Exchange
Document Exchange
Functional Standards
Technical Standards: Data Communications, Encryption
27. Unique Identifiers
A unique convention to identify a class of objects
E.g. serial numbers, national citizen ID, HN (MRN), NDC
Unique within scope of intended operations e.g. a hospital, a
company, a city, a country, or globally
May or may not be “smart numbers” (digits with meaning).
Smart numbers are bad practices.
May or may not have “check digits” (digits used to prevent
data entry errors)
In general, not supposed to be confidential (except U.S.
Social Security Numbers, credit card numbers)
28. Standard Data Sets
Sometimes called minimum data sets
Data structure (fields, formats, meanings) for a specific
purpose
E.g. Ministry of Public Health’s 12-file or 18-file reports
29. Vocabularies & Terminologies
Controlled Vocabulary
A set of terms used in a specific area where the use of each term is predefined, and the set
maintained by the responsible party
Taxonomy
A hierarchical system to classify objects in a specific area
Terminology
A system or study of terms used to label concepts and their meanings in a specific area
Ontology
“A formal representation of knowledge as a set of concepts within a domain, and the
relationships between those concepts.” (Wikipedia)
Coding System
A system to identify how to represent an object or concept
30. Examples
ICD-10, ICD-9
Classification System
Coding System
Taxonomy
CPT (Current Procedural Terminology)
Classification System
Coding System
Taxonomy
SNOMED CT (Systematized Nomenclature of Medicine - Clinical Terms)
Controlled Vocabulary
Terminology
LOINC (Logical Observation Identifiers Names and Codes)
Coding System
ICNP, ICPC
31. Exchange Standards
Message
Message
Government
Message
Hospital A Hospital B
Clinic C
Lab Message Patient at Home
Message
32. Exchange Standards
Message Exchange
Goal: Specify format for exchange of data
Internal vs. external messages
HL7 v.2, HL7 v.3 Messaging, DICOM, NCPDP
Document Exchange
Goal: Specify format for exchange of “documents”
HL7 v.3 Clinical Document Architecture (CDA), ASTM
Continuity of Care Record (CCR), HL7 Continuity of Care
Document (CCD)
33. Documents vs. Messages
Clinical Documents
Human Readable
(Ideally) Machine Processable
Messages
Human UnReadable
Machine Processable
36. Functional Standards
Aims for functional interoperability
Example Scenario: Two systems are expected to behave in the same
way with the same trigger event (e.g. once received an electronic
message)
Real-world Example: PDF file viewing by two different viewers
Informatics Example: HL7 EHR Functional Specifications
37. How Standards Support Interoperability
Functional Standards (HL7 EHR
Functional Functional Specifications)
Vocabularies, Terminologies, Coding
Systems (ICD-10, ICD-9, CPT,
SNOMED CT, LOINC)
Semantic Information Models (HL7 v.3 RIM,
ASTM CCR, HL7 CCD)
Standard Data Sets
Unique ID
Syntactic Exchange Standards (HL7 v.2, HL7
v.3 Messaging, HL7 CDA, DICOM)
Technical Standards
(TCP/IP, encryption)
Some may be hybrid: e.g. HL7 v.3, HL7 CCD
38. More Standards for Self-Study
Medications & Pharmaceutical
RxNorm (U.S. National Library of Medicine)
U.S. National Drug Code (U.S. FDA)
Labs (& Others)
LOINC (Regenstrief Institute)
Clinical Terminologies
SNOMED CT
Organizational/Business
ISO 27799 (Information Security Management in Health)
Integration
IHE (Integrating the Healthcare Enterprise)
OpenEHR (a hybrid of standards for health information in EHRs)
And many more!