HIT Standards Development
The Healthcare Information Technology standards development process is the result of a multi-enterprise world wide effort of many governments, private, non-profit and international communities. Our work flow and what we do at these Standards Development Organization (SDO) meetings involves reaching consensus on how healthcare data elements can be designed for transmission in EHR messages, so that all stakeholders can utilize the data accurately. The underlying problem is that the actual contents of each healthcare providers' databases are not interpretable by a different hospital system's computers.
The data stored in the second hospitals' records is coded in different ways. For the same data field, such as your blood type, one might store a coded number, others might store text, and still others may store coded text or a list of keywords. Only an exhaustive study of every single data element can resolve these problems. If they want to share data, years of work has to be done.
We are liaisons sent by clients to international standards meetings. As these meetings are attended by people from all over the world, they are held quarterly. Each quarter the SDOs convene as a body and as small sessions called working groups which focus on a particular area like medical devices, CDAs or immunizations. To productively use the time in between the face to face working groups, we hold the meetings by phone with GoTo Meeting. The hours in our day are spent in these GotoMeeting Calls (referred to as “calls”) and in following up on action items which result from any previous meetings. Each project taken on by an HL7 working group may have a weekly or monthly “call” which many people attend. In these calls we are attendees just like a Congressman would attend a session of the Ways and Means committee.
These SDOs are very much like a legislative body in that they draw up ballots (what the IT data standard should be) just as Congress draws up proposed laws. SDO members analyze, debate, comment, and then vote on the ballots. This cycle repeats after a ballot is passed. More changes are proposed, a discussion is held, all ramifications are debated, and the next ballot is complied and voted on. We act like the “Congressman” from our client representing their best interests for their IT assets. Just as no one Congressman controls the Congress’s meetings, we do not control the HL7 meetings. The standards are not only U.S. standards but worldwide. The same HIT standards in the ballot has to work for New Zealand, Brazil. Germany, the UK, and Japan as well. Thus progress of our team alone is hard to measure as literally the whole world has input to these standards.
Other projects unrelated to HL7, such as the Federal Health Information Model, www.FHIMS.org information model have several weekly calls in which technical design work is done. Other calls we run are for the purpose of reaching out to other agencies like the FDA or the CDC. Still other calls and research we do gather information for white papers on HIT on HIT policy and strategy. In addition to our calls, we explain the benefit of data standards to all who will listen.
The Model Driven Health Tools project is the software piece which is developed in conjunction with Open Health Tools. It is a very powerful and cutting edge system which can be likened to a tool factory which creates a Home Depot-like supply of standards development tools and utilities.
Unfortunately medical data is a lot more complicated than banking transactions. Data standards are the foundation of Standards Development. These standards include semantics standards, with terminology to implement them, message standards of a practical nature, (such as those developed by HL7), to send the data and cause the desired resulting actions, and also standard protocols. Message standards encompass much more than just ordinary emails as many messages require a response of a specific nature. A laboratory order message requests that a lab test is done. A prescription message sent to a pharmacy requires that a prescription is filled.
C Sharp and its web services have different protocols than Java and J2EE. Finally security standards are a major issue. A part of security policy involves who is allowed to see what in an electronic healthcare data record and when and how should that be overridden in an emergency. Many countries are cooperating to make these standards a reality.
Links & Downloads
- HHS ONC Healthcare IT and Standards Development
- What are Standards Development Organizations, SDOs?
- Why is Data Standards Adoption so important?
- The Role of Information Modeling in Achieving Interoperability
- Introuction to HL7 Message Standards