Component 9:

Networking and
Health Information
Exchange
Instructor Manual
Version 3!"#pring $!%$
Notes to Instructors
This Instructor Manual is a resource for instructors using this component. Each
component is broken down into units, which include the following elements:
1. Learning objecties
!. "uggested student readings, te#ts, reference links to supplement the narrated
$ower$oint slides
%. Lectures &oiceoer $ower$oint in 'lash format() $ower$oint slides
&Microsoft $ower$oint format(, lecture transcripts &Microsoft *ord format()
and audio files &M$% format( for each lecture
+. "elf,assessment -uestions reflecting .nit /bjecties with answer ke0s and1or
e#pected outcomes
2. 3pplication 3ctiities &e.g., discussion -uestions, assignments, projects( with
instructor guidelines, answer ke0s and1or e#pected outcomes
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This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
Contents
6otes to Instructors............................................................................................................!
9isclaimer..........................................................................................................................:
5omponent ;1.nit 1...........................................................................................................<
5omponent ;1.nit !.........................................................................................................11
5omponent ;1.nit %.........................................................................................................1+
5omponent ;1.nit +.........................................................................................................!8
5omponent ;1.nit 2.........................................................................................................!2
5omponent ;1.nit =.........................................................................................................!<
5omponent ;1.nit :.........................................................................................................%1
5omponent ;1.nit <.........................................................................................................%2
5omponent ;1.nit ;.........................................................................................................%:
5omponent ;1.nit 18.......................................................................................................+8
5omponent 3cron0m >lossar0........................................................................................+!
5reatie 5ommons 3ttribution,6on5ommercial,"hare3like %.8 .nported.....................2!
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7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
Component &'er'iew
This unit will address the /"I, including the purpose and content of each of its seen
la0ers: ph0sical, data link, network, transport, session, presentation, and application.
$roducts, processes, protocols and tools at each leel will be e#plained. This unit will
also focus on the flow of data through the models as data is transmitted and receie b0
end deices.
Component &()ecti'es
3t the completion of this component, the student will be able to:
E#plain the functions of all la0ers of the I"/ /"I models, including how the0 are
interconnected and supported.
?ecommend components of networking hardware that meet standards and
support information e#change.
3nal0@e standards associated with the E4? functional model, the $4? functional
model, and the famil0 of profiles associated with specific domain functional
re-uirements
E#plain the process and alue of E4? certification.
9escribe data standards re-uired for the interoperable e#change of health care
data, including terminolog0, data elements, document standards, imaging
standards, and medical deice standards.
9escribe components of health IT standards &including 4L: and T5!12( for
health information e#change used b0 arious stakeholders.
E#amine additional standards related to shared and effectie use of data,
including clinical decision support.
9escribe enterprise architecture models) including centrali@ation s federation
and grids, serice oriented architectures, and local implementations with respect
to s0stems from single units to organi@ations, regions &?4I/" and 4IEs(, states,
and nationwide healthcare information s0stems &64I6(.
Incorporate professional and regulator0 standards related to priac0,
confidentialit0, and securit0 when implementing and maintaining networks and
health information e#change s0stems, including 64I6.
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This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
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Component *uthors
*ssigned Institution
9uke .niersit0, 9urham, 6orth 5arolina
+eam ,eads
*. Ed 4ammond, $h.9.
9uke 5enter for 4ealth Informatics
Michele $arrish
9urham Technical 5ommunit0 5ollege
-rimar. Contri(uting *uthors
*. Ed 4ammond, $h.9.
9uke 5enter for 4ealth Informatics
Michele $arrish
9urham Technical 5ommunit0 5ollege
,ecture Narration"#ound Engineer
?aland Technologies LL5
1%<: 'airport ?oad
"uite 1828 'airport, 6A 1++28
http:11www.raland.com1
9aid 'lass , $roject Manager
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+eam Mem(ers
4arr0 Bulbrook
$rogram 9irector1Instructor, 6etworking Technologies
9urham Technical 5ommunit0 5ollege
5harlene *est
3ssistant 9ean19epartment 4ead) Instructor C Information "0stems
9urham Technical 5ommunit0 5ollege
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This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
/isclaimer
These materials were prepared under the sponsorship of an a!ency of the United
States 'overnment& Neither the United States 'overnment nor any a!ency thereof, nor
any of their employees, makes any warranty, e(press or implied, or assumes any le!al
liability or responsibility for the accuracy, completeness, or usefulness of any
information, apparatus, product, or process disclosed, or represents that its use would
not infrin!e privately owned ri!hts& )eference herein to any specific commercial
product, process, or service by trade name, trademark, manufacturer, or otherwise does
not necessarily constitute or imply its endorsement, recommendation, or favorin! by the
United States 'overnment or any a!ency thereof& The views and opinions of authors
e(pressed herein do not necessarily state or reflect those of the United States
'overnment or any a!ency thereof&

*ikewise, the above also applies to the Curriculum Development Centers +includin!
Columbia University, Duke University, ,ohns Hopkins University, Ore!on Health -
Science University, University of "labama at .irmin!ham, and their affiliated entities/&
The information contained in the Health T 0orkforce Curriculum materials is intended
to be accessible to all& To help make this possible, the materials are provided in a
variety of file formats& Some people may not find the 1lash video and &S01 files
accessible and should instead utili2e the 3ower3oint slides to!ether with the &mp4
audio file and5or 0ord transcript to access the lectures& 1or more information, please
visit the website of the National Trainin! and Dissemination Center at http655www&onc7
ntdc&or! or http655www&onc7ntdc&info to set up a profile and view the full accessibility
statement&
4ealth IT *orkforce 5urriculum 6etworking and 4ealth :
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This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
Component 9"0nit %
0nit +itle
I#& &pen #.stems Interconnection 1&#I2
0nit /escription
This unit will address the /"I, including the purpose and content of each of its seen
la0ers: ph0sical, data link, network, transport, session, presentation, and application.
$roducts, processes, protocols and tools at each leel will be e#plained. This unit will
also focus on the flow of data through the models as data is transmitted and receie b0
end deices.
0nit &()ecti'es
B0 the end of this unit the student will be able to:
1. E#plain the /"I representation of the arious la0ers inoled in
networking, including the general functions of each la0er and their
interconnections
!. E#plain the concept of the 3pplication la0er
%. E#plain the concept of the $resentation la0er
+. E#plain the concept of the "ession La0er
2. E#plain the concept of the Transport la0er
=. E#plain the concept of the 6etwork la0er
:. E#plain the concept of the 9ata Link la0er
<. E#plain the concept of the $h0sical la0er
;. E#plain connection,oriented ersus connectionless communication
18. E#plain the use of network addressing including securit0 considerations
and ulnerabilities
0nit +opics " ,ecture +itles
1a 3pplication, $resentation, "ession and Transport La0ers of the /"I model
1b 6etwork, 9ata Link and $h0sical La0ers of the /"I model
0nit 3eferences
&3ll links accessible as of 1121!81!(
,ecture %a
1. **3 7 *ower *ayer 3rotocol. &n.d.(. ?etrieed Danuar0 =, !81!, from
i6TE?'35E*3?EE Inc. website: http:11 www.interfaceware.com1llp.html
!. 8896 8ultipurpose nternet 8ail 9(tensions. &n.d.(. ?etrieed Danuar0 =, !81!,
from 6etwork 9ictionar0 website:
http:11 www.networkdictionar0.com1protocols1mime.php
4ealth IT *orkforce 5urriculum 6etworking and 4ealth <
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
%. 6etwork *orking >roup. &1;<:, Dune(. :D)6 9(ternal Data )epresentation
Standard. ?etrieed from "un Micros0stems website:
http:11 tools.ietf.org1html1rfc181+
,ecture %a Charts4 +a(les and 5igures
1.1 Table: $arrish, Michele. !811.
1.! Table: $arrish, Michele. !811.
1.% Table: $arrish, Michele. !811.
,ecture %a Images
"lide 2: "ource, Medium and ?eceier. 5ourtes0 Michele $arrish. .sed with
permission.
"lide ;: /"I Model showing la0ers and their functions. 5ourtes0 Michele $arrish. .sed
with permission.
"lide 18: Model 5omparison. 5ourtes0 Michele $arrish. .sed with permission.
"lide 11: $9.. 5ourtes0 Michele $arrish. .sed with permission.
"lide 1!: $rotocols. 5ourtes0 Michele $arrish. .sed with permission.
"lide !8: 4andshake. 5ourtes0 Michele $arrish. .sed with permission.
"lide !1: "e-uence. 5ourtes0 Michele $arrish. .sed with permission.
"lide !!: 3cknowledgements. 5ourtes0 Michele $arrish. .sed with permission.
"lide !%: *indow "i@ing. 5ourtes0 Michele $arrish. .sed with permission.
,ecture %(
6one were used for this lecture.
,ecture %( Charts4 +a(les and 5igures
6one were used for this lecture.
,ecture %( Images
"lide =: I$+ 3ddresses. 5ourtes0 Michele $arrish. .sed with permission.
"lide :: "pecial I$ 3ddresses. 5ourtes0 Michele $arrish. .sed with permission.
"lide ;: I$ 3ddress $arts. 5ourtes0 Michele $arrish. .sed with permission.
"lide 11: "ubnetting. 5ourtes0 Michele $arrish. .sed with permission.
"lide 1!: ?outer. 5ourtes0 Michele $arrish. .sed with permission.
"lide 12: $ing. 5ourtes0 Michele $arrish. .sed with permission.
"lide 1=: Tracert. 5ourtes0 Michele $arrish. .sed with permission.
"lide 1:: 9ata Link. 5ourtes0 Michele $arrish. .sed with permission.
"lide 1<: M35 3ddresses. 5ourtes0 Michele $arrish. .sed with permission.
0nit 3e6uired 3eadings
6one.
0nit #uggested 3eadings
4ealth IT *orkforce 5urriculum 6etworking and 4ealth ;
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
1. nternetworkin! .asics& This article includes terminolog0 used in networking,
networking basics and an in,depth look at each la0er of the /"I model.
http:11docwiki.cisco.com1wiki1InternetworkingFTechnolog0F4andbook
!. 3ort Numbers& This is the official I363 document that lists all port numbers and
their associated protocols1applications. http:11www.iana.org1assignments1port,
numbers
%. 1rame )elay& More information about frame rela0.
http:11docwiki.cisco.com1wiki1InternetworkingFTechnolog0F4andbook
+. 333& More information about $$$.
http:11docwiki.cisco.com1wiki1InternetworkingFTechnolog0F4andbook
2. "T8& More information about 3TM. http:11www.telecomspace.com1op,atm.html
=. N); 9ncodin!& More information about 6?G.
http:11www.erg.abdn.ac.uk1users1gorr01course1ph0,pages1nr@.html
:. 8anchester 9ncodin!, More information about Manchester.
http:11www.erg.abdn.ac.uk1users1gorr01course1ph0,pages1man.html
#tudent *pplication *cti'ities
comp;Funit1Factiit0.doc
comp;Funit1Factiit0Fke0.doc
comp;Funit1FselfFassess.doc
comp;Funit1FselfFassessFke0.doc
4ealth IT *orkforce 5urriculum 6etworking and 4ealth 18
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7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
Component 9"0nit $
0nit +itle
Network Media and Hardware Communication /e'ices
0nit /escription
This unit is designed to help the student understand network media, hardware deices,
and how to select appropriate items to meet the guidelines for usage.
0nit &()ecti'es
B0 the end of this unit the student will be able to:
1. "elect appropriate network media t0pes &such as Ethernet and *ireless(
to facilitate networking and data e#change, taking into account access and
regulator0 re-uirements
!. "elect appropriate hardware deices &such as routers, switches, and
access points( to facilitate networking and data e#change, taking into
account access and regulator0 re-uirements
0nit +opics " ,ecture +itles
!a 6etwork media
!b 6etwork media
!c 4ardware deices
0nit 3eferences
&3ll links accessible as of !111!81!(
,ecture $a
?eferences were not used for this lecture.
,ecture $a Charts4 +a(les and 5igures
6one.
,ecture $a Images
"lide %: "ignals. 5ourtes0 Michele $arrish. .sed with permission.
"lide 2: 9ata Modulation. 5ourtes0 Michele $arrish. .sed with permission.
"lide 11: 6I5s. 5ourtes0 Michele $arrish. .sed with permission.
"lide 1!: *ireless 6I5s. 5ourtes0 Michele $arrish. .sed with permission.
,ecture $(
?eferences were not used for this lecture.
,ecture $( Charts4 +a(les and 5igures
4ealth IT *orkforce 5urriculum 6etworking and 4ealth 11
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
!.1 Table: $arrish, Michele. !811.
,ecture $( Images
"lide +: 5oa#ial cable. 5ourtes0 Michele $arrish. .sed with permission.
"lide 2: Ba0onet 6eill,5oncelman &B65( connector. 5ourtes0 Michele $arrish. .sed
with permission.
"lide =: Twisted $air &T$( 5able. 5ourtes0 Michele $arrish. .sed with permission.
"lide :: ?D,+2. 5ourtes0 Michele $arrish. .sed with permission.
"lide <: T2=<3 or T2=<B standards. 5ourtes0 Michele $arrish. .sed with permission.
"lide 18: 'iber /ptic 5able. 5ourtes0 Michele $arrish. .sed with permission.
"lide 11: 5op0right&c( Mr@eon and made aailable under 5reatie 5ommons
3ttribution,"hare 3like %.8 .nported, !.2 >eneric, !.8 >eneric, and 1.8 >eneric
&http:11en.wikipedia.org1wiki1'ile:/pticalFfiberFt0pes.sg(
"lide 1%: $atch. 5ourtes0 Michele $arrish. .sed with permission
"lide 1+: 4ori@ontal *iring. 5ourtes0 Michele $arrish. .sed with permission.
"lide 12: *ork 3rea /utlet. 5ourtes0 Michele $arrish. .sed with permission.
,ecture $c
?eferences were not used for this lecture.
,ecture $c Charts4 +a(les and 5igures
6one.
,ecture $c Images
"lide +: 4ub. 5ourtes0 Michele $arrish. .sed with permission.
"lide 2: "witch. 5ourtes0 Michele $arrish. .sed with permission.
"lide :: Back of ?outer. 5ourtes0 Michele $arrish. .sed with permission.
"lide ;: *3$. 5ourtes0 Michele $arrish. .sed with permission.
"lide 18: 9"L Modem. 5ourtes0 Michele $arrish. .sed with permission.
"lide 11: 5able Modem. 5ourtes0 Michele $arrish. .sed with permission.
0nit 3e6uired 3eadings
6one.
0nit #uggested 3eadings
1. How Di!ital Television 0orks& /n Dune 1!, !88; the .nited "tates transitioned
from analog t signals to all digital t signals. ?ead about the difference between
analog and digital t and wh0 the change was made.
http:11electronics.howstuffworks.com1dt.htm
!. *ist of device bit rates& This article contains listings of the bandwidth for L36s,
*36s, wireless networks and other deices. Bandwidth is important in
determining the HpipeI that 0our data will be able to trael down. The bigger the
bandwidth, the bigger the HpipeI.
http:11en.wikipedia.org1wiki1ListFofFdeiceFbandwidths
4ealth IT *orkforce 5urriculum 6etworking and 4ealth 1!
Information E#change
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This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
%. Cablin!& This article includes information about the different t0pes of network
media including the categories of twisted pair and media connectors.
http:11fcit.usf.edu1network1chap+1chap+.htm
+. 'etConnected 7 Tech Talk 7 9thernet Cables and )outer Speed& This ideo
presents information about Ethernet cables and router speed. It discusses the
t0pe of cabling that 0ou would use in a home or small network. 2 minutes and 28
seconds long. http:11www.0outube.com1watchJKLIibd!'u%bo
2. ntroduction to Structured Cablin!& This paper describes wh0 the structured
cabling standard should be followed and what the standard entails. 6ote: "ince
this is a !888 document some of the bandwidth information ma0 be out of date.
http:11www.dit.go.bt1sites1default1files1cablingstandard.pdf
=. Computer .asics6 0hat s a Computer )outer< This ideo e#plains what a router
does. It includes captions. ! minutes and 2 seconds long.
http:11www.0outube.com1watchJ
K;Lhk*FdkG.MfeatureK$la0ListMpK<B19E1B%253!12B!Mpla0ne#tFfromK$L
Minde#K1+
:. How to 8ake an 9thernet Cat=e5Cat> Cable& This page shows how to make a
twisted pair cable. It shows the tools that are needed to make the cable. It also
includes a ideo showing the process. 7ideo is : minutes and 1< seconds long.
http:11discountlowoltage.blogspot.com1!88;1181how,to,make,ethernet,cat2e,
cable.html
#tudent *pplication *cti'ities
comp;Funit!Factiit0.doc
comp;Funit!Factiit0Fke0.doc
comp;Funit!FselfFassess.doc
comp;Funit!FselfFassessFke0.doc
4ealth IT *orkforce 5urriculum 6etworking and 4ealth 1%
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
Component 9"0nit 3
0nit +itle
National and International #tandards /e'eloping &rgani7ations
0nit /escription
This unit introduces students to the national and international organi@ations that create
standards used in networking and health information e#change
0nit &()ecti'es
B0 the end of this unit the student will be able to:
1. E#plain wh0 standards related to networking and health information
e#change are important in the current enironment.
!. "tandards deelopment
%. 4ow standards are deeloped
+. *ho deelops them
2. 4ow standards are accredited
=. 4ow standards are selected
:. .nderstand different kinds of standards being deeloped and for what
purpose
<. Learn about "tandards 9eeloping /rgani@ations and the standards the0
create
;. 9emonstrate how to find, obtain, and use standards that are needed to
facilitate networking and health information e#change
0nit +opics " ,ecture +itles
%a Importance of standards and their deelopment
%b Ninds of standards
%c "tandard organi@ations
0nit 3eferences
&3ll links accessible as of !111!81!(
,ecture 3a
3dditional resources for information contained in this lecture
1. TC #?= Health nformatics. &n.d.(. ?etrieed Danuar0 18, !81!, from I"/
&International /rgani@ation for "tandardi@ation( website:
www.iso.org1iso1isoFtechnicalFcommitteeJcommidK2+;=8
!. Technical Committees, 0orkshops and other bodies. &n.d.(. ?etrieed Danuar0
18, !81!, from 5E6 &5omitO EuropOen de 6ormalisation( website:
www.cen.eu1cen1"ectors1Technical5ommittees*orkshops15E6Technical5ommitt
ees1$ages1default.asp#JparamK=!%!MtitleK5E61T5P!8!21
4ealth IT *orkforce 5urriculum 6etworking and 4ealth 1+
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
%. Health *evel Seven nternational. &n.d.(. ?etrieed Danuar0 18, !81!, from 4L:
website: www.hl:.org
+. DCO8 +Di!ital ma!in! and Communications in 8edicine/. &n.d.(. ?etrieed
Danuar0 18, !81!, from Medical Imaging M Technolog0 3lliance , a diision of
6EM3 website: http:11medical.nema.org1
2. 999 "dvancin! Technolo!y for Humanity. &n.d.(. ?etrieed Danuar0 18, !81!,
from IEEE website: www.IEEE.org
=. CDSC Stren!th Throu!h Collaboration. &n.d.(. ?etrieed Danuar0 18, !81!, from
5linical 9ata Interchange "tandards 5onsortium website: www.cdisc.org
:. 'S? The !lobal lan!ua!e of business. &n.d.(. ?etrieed Danuar0 18, !81!, from
www.gs1.org
<. 0elcome to HTSDO. &n.d.(. ?etrieed Danuar0 18, !81!, from International
4ealth Terminolog0 "tandards 9eelopment /rganisation website:
www.ihtsdo.org
;. ,oint nitiative on SDO 'lobal Health nformatics Standardi2ation. &n.d.(.
?etrieed Danuar0 18, !81!, from 4ealth Leel "een International website:
www.jointinitiatiecouncil.org1
18. 0orld Health Or!ani2ation. &n.d.(. ?etrieed Danuar0 18, !81!, from *4/
website: www.who.int
11. O8'. &n.d.(. ?etrieed Danuar0 18, !81!, from /bject Management >roup, Inc.
website: www.omg.org
1!. H9 7 0elcome to nte!ratin! the Healthcare 9nterprise. &n.d.(. ?etrieed
Danuar0 18, !81!, from I4E International website: www.ihe.net
1%. open9H) 7 0elcome to open9H). &n.d.(. ?etrieed Danuar0 18, !81!, from
openE4? website: www.openehr.org
1+. O"SS 7 "dvancin! open standards for the information society. &n.d.(. ?etrieed
Danuar0 18, !81!, from /3"I" website: www.oasis,open.org
12. 04C. &n.d.(. ?etrieed Danuar0 18, !81!, from *%5 website: http:11www.w%.org1
1=. The nternet 9n!ineerin! Task 1orce +9T1/. &n.d.(. ?etrieed Danuar0 18, !81!,
from Internet "ociet0 website: www.ietf.org
1:. "ST8 nternational 7 0elcome to "ST8&or!. &n.d.(. ?etrieed Danuar0 18, !81!,
from 3"TM International website: www.astm.org
1<. "SC:?# 7 "bout "SC :?#. &n.d.(. ?etrieed Danuar0 18, !81!, from 3"5 Q1!
website: www.#1!.org
1;. National Council for 3rescription Dru! 3ro!rams . &n.d.(. ?etrieed Danuar0 18,
!81!, from www.ncpdp.org
!8. 8ed.i@uitous "dvancin! Healthcare 9ducation Throu!h Collaboration. &n.d.(.
?etrieed Danuar0 18, !81!, from MedBi-uitous 5onsortium website:
www.medbi-.org
!1. "merican Dental "ssociation. &n.d.(. ?etrieed Danuar0 18, !81!, from 3merican
9ental 3ssociation website: www.ada.org
!!. "NS 7 "merican National Standards nstitute. &n.d.(. ?etrieed Danuar0 18, !81!,
from www.ansi.org
4ealth IT *orkforce 5urriculum 6etworking and 4ealth 12
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
!%. National nstitute of Standards and Technolo!y. &n.d.(. ?etrieed Danuar0 18,
!81!, from ..". 9epartment of 5ommerce website: www.nist.go
!+. National Auality 1orum. &n.d.(. ?etrieed Danuar0 18, !81!, from The 6ational
Lualit0 'orum website: www.-ualit0forum.org
!2. U&S& National *ibrary of 8edicine 7 National nstitutes of Health. &n.d.(. ?etrieed
Danuar0 18, !81!, from ..". 6ational Librar0 of Medicine website:
www.nlm.nih.go
!=. "NS "ccredited U&S& Technical "dvisory 'roups +T"'s/ to SO. &n.d.(. ?etrieed
Danuar0 18, !81!, from
www.ansi.org1standardsFactiities1isoFprograms1tagFiso.asp#
,ecture 3a Charts4 +a(les and 5igures
6one.
,ecture 3a Images
"lide 2 C $hotos courtes0 of 9r. Ed 4ammond
"lide = C $hotos courtes0 of 9r. Ed 4ammond
"lide : C $hotos courtes0 of 9r. Ed 4ammond
"lide < C 1ile6.rue!hel7tower7of7babel&Bp!. &n.d.(. ?etrieed Danuar0 18, !81!, from
*ikipedia, the free enc0clopedia website: http:11en.wikipedia.org1wiki1'ile:Brueghel,
tower,of,babel.jpg
"lide 11 C Image courtes0 of 9r. Ed 4ammond
"lide !% C Image courtes0 of 9r. Ed 4ammond
,ecture 3(
3dditional resources for information contained in this lecture
1. TC #?= Health nformatics. &n.d.(. ?etrieed Danuar0 18, !81!, from I"/
&International /rgani@ation for "tandardi@ation( website:
www.iso.org1iso1isoFtechnicalFcommitteeJcommidK2+;=8
!. Technical Committees, 0orkshops and other bodies. &n.d.(. ?etrieed Danuar0
18, !81!, from 5E6 &5omitO EuropOen de 6ormalisation( website:
www.cen.eu1cen1"ectors1Technical5ommittees*orkshops15E6Technical5ommi
ttees1$ages1default.asp#JparamK=!%!MtitleK5E61T5P!8!21
%. Health *evel Seven nternational. &n.d.(. ?etrieed Danuar0 18, !81!, from 4L:
website: www.hl:.org
+. DCO8 +Di!ital ma!in! and Communications in 8edicine/. &n.d.(. ?etrieed
Danuar0 18, !81!, from Medical Imaging M Technolog0 3lliance , a diision of
6EM3 website: http:11medical.nema.org1
2. 999 "dvancin! Technolo!y for Humanity. &n.d.(. ?etrieed Danuar0 18, !81!,
from IEEE website: www.IEEE.org
=. CDSC Stren!th Throu!h Collaboration. &n.d.(. ?etrieed Danuar0 18, !81!,
from 5linical 9ata Interchange "tandards 5onsortium website: www.cdisc.org
:. 'S? The !lobal lan!ua!e of business. &n.d.(. ?etrieed Danuar0 18, !81!, from
www.gs1.org
4ealth IT *orkforce 5urriculum 6etworking and 4ealth 1=
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
<. 0elcome to HTSDO. &n.d.(. ?etrieed Danuar0 18, !81!, from International
4ealth Terminolog0 "tandards 9eelopment /rganisation website:
www.ihtsdo.org
;. ,oint nitiative on SDO 'lobal Health nformatics Standardi2ation. &n.d.(.
?etrieed Danuar0 18, !81!, from 4ealth Leel "een International website:
www.jointinitiatiecouncil.org1
18. 0orld Health Or!ani2ation. &n.d.(. ?etrieed Danuar0 18, !81!, from *4/
website: www.who.int
11. O8'. &n.d.(. ?etrieed Danuar0 18, !81!, from /bject Management >roup, Inc.
website: www.omg.org
1!. TC #?= Health nformatics. &n.d.(. ?etrieed Danuar0 18, !81!, from I"/
&International /rgani@ation for "tandardi@ation( website:
www.iso.org1iso1isoFtechnicalFcommitteeJcommidK2+;=8
1%. Technical Committees, 0orkshops and other bodies. &n.d.(. ?etrieed Danuar0
18, !81!, from 5E6 &5omitO EuropOen de 6ormalisation( website:
www.cen.eu1cen1"ectors1Technical5ommittees*orkshops15E6Technical5ommi
ttees1$ages1default.asp#JparamK=!%!MtitleK5E61T5P!8!21
1+. Health *evel Seven nternational. &n.d.(. ?etrieed Danuar0 18, !81!, from 4L:
website: www.hl:.org
12. DCO8 +Di!ital ma!in! and Communications in 8edicine/. &n.d.(. ?etrieed
Danuar0 18, !81!, from Medical Imaging M Technolog0 3lliance , a diision of
6EM3 website: http:11medical.nema.org1
1=. 999 "dvancin! Technolo!y for Humanity. &n.d.(. ?etrieed Danuar0 18, !81!,
from IEEE website: www.IEEE.org
1:. CDSC Stren!th Throu!h Collaboration. &n.d.(. ?etrieed Danuar0 18, !81!,
from 5linical 9ata Interchange "tandards 5onsortium website: www.cdisc.org
1<. 'S? The !lobal lan!ua!e of business. &n.d.(. ?etrieed Danuar0 18, !81!, from
www.gs1.org
1;. 0elcome to HTSDO. &n.d.(. ?etrieed Danuar0 18, !81!, from International
4ealth Terminolog0 "tandards 9eelopment /rganisation website:
www.ihtsdo.org
!8. ,oint nitiative on SDO 'lobal Health nformatics Standardi2ation. &n.d.(.
?etrieed Danuar0 18, !81!, from 4ealth Leel "een International website:
www.jointinitiatiecouncil.org1
!1. 0orld Health Or!ani2ation. &n.d.(. ?etrieed Danuar0 18, !81!, from *4/
website: www.who.int
!!. O8'. &n.d.(. ?etrieed Danuar0 18, !81!, from /bject Management >roup, Inc.
website: www.omg.org
!%. National Auality 1orum. &n.d.(. ?etrieed Danuar0 18, !81!, from The 6ational
Lualit0 'orum website: www.-ualit0forum.org
!+. U&S& National *ibrary of 8edicine 7 National nstitutes of Health. &n.d.(. ?etrieed
Danuar0 18, !81!, from ..". 6ational Librar0 of Medicine website:
www.nlm.nih.go
4ealth IT *orkforce 5urriculum 6etworking and 4ealth 1:
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
!2. "NS "ccredited U&S& Technical "dvisory 'roups +T"'s/ to SO. &n.d.(.
?etrieed Danuar0 18, !81!, from
www.ansi.org1standardsFactiities1isoFprograms1tagFiso.asp#
,ecture 3( Charts4 +a(les and 5igures
6one.
,ecture 3( Images
6one
,ecture 3c
1. Clinical Trials Networks .est 3ractices 7 Standards nventory. &n.d.(. ?etrieed
Danuar0 18, !81!, from www.ctnbestpractices.org1standards,inentor01
!. ,oint nitiative for 'lobal Standards Harmoni2ation Health nformatics Document
)e!istry and 'lossary . &n.d.(. ?etrieed Danuar0 18, !81!, from
www.skmtglossar0.org
%. 8ain 3a!e 7 H90iki&wustl&edu6 Support of H9 Connectathons. &n.d.(. ?etrieed
Danuar0 18, !81!, from http:11ihewiki.wustl.edu1wiki1inde#.php1MainF$age
,ecture 3c Charts4 +a(les and 5igures
%.1 Table: created b0 9r. Ed 4ammond
%.! Table: created b0 9r. Ed 4ammond
,ecture 3c Images
"lide !!: courtes0 of 9r. Ed 4ammond
0nit 3e6uired 3eadings
6one
0nit #uggested 3eadings
1. I"/ T5 !12 www.iso.org1iso1isoFtechnicalFcommitteeJcommidK2+;=8
!. 4ealth Leel : www.hl:.org
%. 59I"5 www.cdisc.org
+. 5E6 www.cen.eu1cen1"ectors1"ectors1I"""15ommittees
2. >"1 www.gs1.org
=. 65$9$ www.ncpdp.org
:. 3"5 Q1!6 www.#1!n.org
<. 3"TM E%1 www.astm.org15/MMIT15/MMITTEE1E%1
;. I4E www.himss.org13"$1topicsFihe
18. 9I5/M http:11medical.nema.org1
11. I4T"9/ www.ihtsdo.org
1!. /65 http:11healthit.hhs.go1portal1serer.ptJopenK21!MobjI9K1!88MmodeK!
4ealth IT *orkforce 5urriculum 6etworking and 4ealth 1<
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
#tudent *pplication *cti'ities
comp;Funit%Factiit0.doc
comp;Funit%Factiit0Fke0.doc
comp;Funit%FselfFassess.doc
comp;Funit%FselfFassessFke0.doc
4ealth IT *orkforce 5urriculum 6etworking and 4ealth 1;
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
Component 9"0nit 8
0nit +itle
9asic Health /ata #tandards
0nit /escription
This unit proides an orientation to the important data,related standards that enable
interoperable health data interchange.
0nit &()ecti'es
B0 the end of this unit the student will be able to:
1. .nderstand wh0 it is necessar0 to use a common set of data elements
with common names to be able to e#change and understand data from
other places.
!. .nderstand what is meant b0 semantic interoperabilit0.
%. .nderstand man0 of the sets of controlled ocabularies in use toda0 C
how the0 are used and who re-uires their use.
+. .nderstand the use, purpose and interrelation among sets of controlled
ocabularies in use toda0.
2. Identif0 the more common controlled ocabularies in use toda0: I59, 5$T,
9?>, 695, ?#6orm, and L/I65.
=. Identif0 the more common controlled ocabularies in use toda0: "6/ME9,
ME95I6, Med9?3, 6ursing terminologies, Me"4 and .ML".
:. .nderstand data elements) attributes of data elements.
<. .nderstand contribution of master meta,dictionar0 of data elements to
semantic interoperabilit0.
;. E#plain how data structures can be built from basic data components.
18. E#plain how templates and archet0pes facilitate networking and
information interchange.
11. 9iscuss 5linical 9ata 3rchitecture &593(, 5ontinuit0 of 5are 9ocument
&559(, and 5ontinuit0 of 5are ?ecord &55?( "tandards.
0nit +opics " ,ecture +itles
+a "emantic interoperabilit0
+b 5ontrolled ocabularies
+c 5ommon controlled ocabularies in use toda0
+d 9ata elements
+e 9ata structures
+f 5linical 9ata 3rchitecture &593(, 5ontinuit0 of 5are 9ocument &559(, and
5ontinuit0 of 5are ?ecord &55?( "tandards
0nit 3eferences
4ealth IT *orkforce 5urriculum 6etworking and 4ealth !8
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
&3ll links accessible as of !111!81!(
,ecture 8a
?eferences were not used for this lecture.
,ecture 8a Charts4 +a(les and 5igures
6one.
,ecture 8a Images
"lide <: $hoto courtes0 of 9r. Bets0 4umphre0s of the 6LM.
,ecture 8(
1. "bout Daily8ed. &n.d.(. ?etrieed Danuar0 1!, !81!, from ." 6ational Librar0 of
Medicine, 6ational Institutes of 4ealth, 4ealth M 4uman "erices website:
http:11dail0med.nlm.nih.go1dail0med1about.cfmJ
5'I9K!!%1!21!M5'T/NE6K2<=f!%+f2<!;2f!%,9!B+'3!5,B;=8,'E59,
8=EEEB9'=;!=83%=MjsessionidKca%8bb;;+2e8!b1a=f!;
!. Brown "4, Elkin "T, ?osenbloom "T, etc. 73 6ational 9rug 'ile ?eference
Terminolog0: a cross,institutional content coerage stud0. "tud 4ealth Technol
Inform. !88+)18:&$t 1(:+::,<1.
%. 5imino, DD. 9esiderata for controlled medical ocabularies in the Twent0,'irst
5entur0. Methods of Information in Medicine, 1;;<) %:&+,2() %;+,+8%.
+. )9*8" )e!enstrief *ONC 8appin! "ssistant. &n.d.(. ?etrieed Danuar0 1!,
!81!, from ?egenstrief Institute, Inc. website: http:11loinc.org1relma1inde#Fhtml1J
searchtermK*indows,basedP!8mapping
2. "tandards Task 'orce. &!811(. Healthcare nformatics Or!ani2ations 3articipatin!
in Standards "ctivities. ?etrieed from 4ealthcare Information and Management
"0stems &4IM""( website:
http:11himss.org1content1files14ealthcareInformatics/rgani@ations"9/D36!811.p
df
,ecture 8( Charts4 +a(les and 5igures
6one.
,ecture 8( Images
"lide :: 5ourtes0 of 9r. Dames D. 5imino, 6I4 5linical 5enter
"lide <: 5ourtes0 of 9r. Dames D. 5imino, 6I4 5linical 5enter
"lide 1:: 5ourtes0 of 9r. Dames D. 5imino, 6I4 5linical 5enter
,ecture 8c
1. Lindberg, 9. 3. B., 4umphre0s, B. L., M Mc5ra0, 3. T. &1;;%(. The .nified
Medical Language "0stem. 8ethods nform& 8edicine, 4#, !<1.
,ecture 8c Charts4 +a(les and 5igures
4ealth IT *orkforce 5urriculum 6etworking and 4ealth !1
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
+.! Table. 5ourtes0 of 9r. Dames D. 5imino, 6I4 5linical 5enter.
+.% Table. 5ourtes0 of 9r. Dames D. 5imino, 6I4 5linical 5enter.
,ecture 8c Images
"lide 18: "ource: 5ourtes0 of 9r. Dames D. 5imino, 6I4 5linical 5enter.
,ecture 8d
1. USHC United States Health nformation Cnowled!ebase. &n.d.(. ?etrieed
Danuar0 1!, !81!, from ." 9epartment of 4ealth M 4uman "erices: 3genc0 for
4ealthcare ?esearch and Lualit0 website: http:11ushik.ahr-.go1
!. SO59C ,TC? SC4# 0'# Development58aintenance. &!818, /ctober !2(.
?etrieed Danuar0 1!, !81!, from I"/ &International /rgani@ation for
"tandardi@ation( website: http:11metadata,stds.org1111:;1
%. National Cancer nstitute. &n.d.(. ?etrieed Danuar0 1!, !81!, from 6ational
5ancer Institute at the 6ational Institutes of 4ealth website:
http:11www.cancer.go1
+. ca.i! +Cancer .iomedical nformatics 'rid/. &n.d.(. ?etrieed Danuar0 1!, !81!,
from 6ational 5ancer Institute website:
https:11gforge.nci.nih.go1projects1cadsrgeneral1
,ecture 8d Charts4 +a(les and 5igures
+.+ Table: "ource: 89TeO) 8etadata Online )e!istry6 3erson7se(, code N. &n.d.(.
?etrieed Danuar0 1!, !81!, from 3ustralian >oernment: 3ustralian Institute of 4ealth
and *elfare website: http:11meteor.aihw.go.au1content1inde#.phtml1itemId1!<:%1=
+.2 Table: "ource: 89TeO) 8etadata Online )e!istry6 3erson7se(, code N. &n.d.(.
?etrieed Danuar0 1!, !81!, from 3ustralian >oernment: 3ustralian Institute of 4ealth
and *elfare website: http:11meteor.aihw.go.au1content1inde#.phtml1itemId1!<:%1=
,ecture 8d Images
"lide !:: "ource: *. Ed 4ammond, $h9
,ecture 8e
1. Detailed Clinical 8odels. &n.d.(. ?etrieed from 4L: International website:
http:11wiki.hl:.org1inde#.phpJtitleK9etailedF5linicalFModels
3cknowledgement: Material used in this lecture comes from the following sources
1. Health *evel Seven nternational. &n.d.(. ?etrieed Danuar0 1!, !81!, from 4ealth
Leel "een International website: www.hl:.org
!. open9H). &n.d.(. ?etrieed Danuar0 1!, !81!, from openE4? website:
www.openehr.org
%. nternational Or!ani2ation for Standardi2ation. &n.d.(. ?etrieed Danuar0 1!,
!81!, from I"/ website: www.iso.org1iso1isoFtechnicalFcommitteeJ
commidK2+;=8
+. cen 7 9uropean Committee for Standardi2ation. &n.d.(. ?etrieed Danuar0 1!,
!81!, from 5E6 website:
4ealth IT *orkforce 5urriculum 6etworking and 4ealth !!
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
www.cen.eu1cen1"ectors1Technical5ommittees*orkshops15E6Technical5ommitt
ees1$ages1default.asp#JparamK=!%!MtitleK5E61T5P!8!21
,ecture 8e Charts4 +a(les and 5igures
6one.
,ecture 8e Images
6one
,ecture 8f
3cknowledgement: Material used in this lecture comes from 4L: 593 standards and
3"TM 55? "tandard.
1. Health *evel Seven nternational. &n.d.(. ?etrieed Danuar0 1!, !81!, from 4ealth
Leel "een International website: www.hl:.org
!. 9olin, ?. 4., 3lschuler, L., Bo0er, "., Beebe, 5., Behlen, '. M., M Biron, $. 7.
&!88+(. H*D Clinical Document "rchitecture, )elease #&%. ?etrieed from 4ealth
Leel "eenR, Inc. website: http:11#ml.coerpages.org1593,!88+8<%8%.pdf
%. 4L: "tructured 9ocuments Technical 5ommittee. &!88+, 3ugust !8(. Health
*evel Seven )eleases Updated Clinical Document "rchitecture +CD"/
Specification&. ?etrieed from http:11#ml.coerpages.org1ni!88+,8<,!8,a.html
+. 9olin, ?. 4., 3lschuler, L., Bo0er, "., Beebe, 5., Behlen, '. M., Biron, $. 7. M
"habo &"ho(, 3. 4L: 5linical 9ocument 3rchitecture, ?elease !. &!88=, Dan,
'eb(. ,ournal of the "merican 8edical nformatics "ssociation, ?4&1(, %8,%;.
$M5I9: $M51%<81;+
2. 9olin, ?. 4., 3lschuler, L., Bo0er, "., Beebe, 5., Behlen, '. M., M Biron, $. 7.
&!88+(. H*D Clinical Document "rchitecture, )elease #&%. ?etrieed from 4ealth
Leel "eenR, Inc website: http:11 #ml.coerpages.org1593,?elease!,
.nofficial.htmlS*hatFisFtheF593
=. Boone, N. *., 9olin, ?. 4., Mitchell,Dones, $., $eters, ?., ?ussler, 9., "habo
&"ho(, 3., ... 3uckerman, 3. &!88=, March !=(. H*D5"ST8 mplementation
'uide for CD" )elease # E Continuity of Care Document
&559.82March!88=.9?3'T,1.doc(. ?etrieed from 4L: website: www.hl:.org
,ecture 8f Charts4 +a(les and 5igures
6one.
,ecture 8f Images
"lide 11: 9olin, ?. 4., 3lshuler, L., Bo0er, "., Beebe, 5., Behlen, '., Biron, $. 7., M "ho,
3. ". &!88=(. 4L: 5linical 9ocument 3rchitecture, ?elease !. , "m 8ed nform "ssoc,
?4, %8,%;.
0nit 3e6uired 3eadings
6one.
4ealth IT *orkforce 5urriculum 6etworking and 4ealth !%
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
0nit #uggested 3eadings
1. I"/ T5 !12 www.iso.org1iso1isoFtechnicalFcommitteeJcommidK2+;=8
!. 4ealth Leel : www.hl:.org
%. 59I"5 www.cdisc.org
+. 5E6 www.cen.eu1cen1"ectors1"ectors1I"""15ommittees
2. >"1 www.gs1.org
=. 65$9$ www.ncpdp.org
:. 3"5 Q1!6 www.#1!n.org
<. 3"TM E%1 www.astm.org15/MMIT15/MMITTEE1E%1
;. I4E www.himss.org13"$1topicsFihe
18. 9I5/M http:11medical.nema.org1
11. I4T"9/ www.ihtsdo.org
1!. /65 http:11healthit.hhs.go1portal1serer.ptJopenK21!MobjI9K1!88MmodeK!
#tudent *pplication *cti'ities
comp;Funit+Factiit0.doc
comp;Funit+Factiit0Fke0.doc
comp;Funit+FselfFassess.doc
comp;Funit+FselfFassessFke0.doc
4ealth IT *orkforce 5urriculum 6etworking and 4ealth !+
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
Component 9"0nit :
0nit +itle
EH3 5unctional Model #tandards
0nit /escription
This unit e#plores the functional re-uirements and standards for electronic health
records &E4?s(.
0nit &()ecti'es
B0 the end of this unit the student will be able to:
1. .nderstand linking and aggregating data at all leels,
!. .nderstand how data ma0 be interchanged among heterogeneous
settings without loss of information,
%. .nderstand 4L: !.# messaging communication standards,
+. .nderstand 4L: %.8 messaging standards, and
2. .nderstand other data interchange standards including 9I5/M for
imaging standards, 65$9$ for prescriptions and medication
reimbursement, IEEE for deice interface standards, 3"5 Q1!6 for claims
and reimbursement standards, 3"TM for document e#change, and I4E for
profiles and registr0 standards.
=. E#plain how model,based standards are created,
:. 9efine the methodolog0 deelopment framework,
<. 9escribe 4L: %.8 messaging standards,
;. Imaging standards,
18. "tandards for pharmac0 serices,
11. Interface standards for medical deices,
1!. 5laims and reimbursement standards,
1%. 5oncept of profiling , and
1+. .se and alue of implementation guides.
0nit +opics " ,ecture +itles
2a 4ealth 9ata Interchange "tandards
2b 4ealth 9ata Interchange "tandards
2c 4ealth 9ata Interchange "tandards
0nit 3eferences
&3ll links accessible as of !1121!81!(
,ecture :a
3cknowledgement: Material used in this lecture comes from the web pages of the
arious "tandards 9eeloping /rgani@ations.
4ealth IT *orkforce 5urriculum 6etworking and 4ealth !2
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
,ecture :a Charts4 +a(les and 5igures
6one in this lecture.
,ecture :a Images
"lide 1!: "ource: *. Ed 4ammond, $h9
"lide 1+: "ource: *. Ed 4ammond, $h9
"lide 12: "ource: *. Ed 4ammond, $h9
"lide 1=: "ource: *. Ed 4ammond, $h9
"lide 1:: "ource: *. Ed 4ammond, $h9
"lide 1<: "ource: *. Ed 4ammond, $h9
"lide 1;: "ource: *. Ed 4ammond, $h9
"lide !8: "ource: *. Ed 4ammond, $h9
"lide !1: "ource: *. Ed 4ammond, $h9
"lide !!: "ource: *. Ed 4ammond, $h9
"lide !2: "ource: *. Ed 4ammond, $h9
,ecture :(
1. Beeler, >.*. Fersion 4 ntermediate Tutorial E 0orkin! the H*D Fersion 4
8ethodolo!y& T$ower$oint "lidesU. ?etrieed from http:11www.google.com1urlJ
saKtMrctKjM-KMesrcKsMsourceKwebMcdK1MedK855+L'j33MurlKhttpP%3P!'
P!'www.cas.mcmaster.caP!'V0armanmhP!'?ecommended
P!'7%FIntermediateFMa088.pptMeiK''75T,
uT'AefgwfEg<nB93MusgK3'Lj5645Lhn%EM"lA,
8!/AGu*8F>>"5<uLMsig!K9hM5%DBQ:F=dcp;B"+=*oL
3cknowledgement: Material used in this lecture comes from the following source
1. ntroduction to H*D Standards. &n.d.(. ?etrieed Danuar0 1<, !81!, from 4ealth
Leel "een International website:
http:11www.hl:.org1implement1standards1inde#.cfm
,ecture :( Charts4 +a(les and 5igures
6one in this lecture.
,ecture :( Images
"lide :: 4ammond, *. E. &n.d.(. Image based on the 4L: International ?IM standard
information retrieed from 4ealth Leel "een International website: www.hl:.org
"lide 18: * Ed 4ammond, $h9.
"lide !!: 4ammond, *. E. &n.d.(. Image based on the 4L: % standard and other 4L:
documentation retrieed from 4ealth Leel "een International website: www.hl:.org
"lide !%: Beeler, >.*. H*D Fersion 4 .asics6 )8 to 8essa!e Desi!n. T$9'
documentU. ?etrieed from
http:11www.cas.mcmaster.ca1V 0armanmh1?ecommended14L:7%Basics.pdf
,ecture :c
4ealth IT *orkforce 5urriculum 6etworking and 4ealth !=
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
3cknowledgement: Material used in this lecture comes from the web pages of the
arious "tandards 9eeloping /rgani@ations.
,ecture :c Charts4 +a(les and 5igures
6one in this lecture.
,ecture :c Images
"lide !%: * Ed 4ammond, 9eried from 3"5 Q1!6 documentation. www.#1!.org.
0nit 3e6uired 3eadings
6one in this lecture.
0nit #uggested 3eadings
% Heath *evel Seven nternational& ?ead more about 4L: including standards and
how to implement. http:11www.hl:.org1inde#.cfm
$ "scend H*D nterface Specification& 9escribes 4L: message standards for
4annWs /n "oftware &4/"(.
http:11www.hosinc.com1$roducts1Interfaces1interfaceFdocumentation.htm
3 HL7 ADT Message Overview. +his article pro'ides a simple o'er'iew of
H,; */+ messages http:""knolgooglecom"k"hl<=adt=message=o'er'iew>
8 DCO8& 9igital Imaging and 5ommunications in Medicine homepage.
http:11medical.nema.org1
: H9& Integrating the 4ealthcare Enterprise homepage. http:11www.ihe.net1
? Standardi2ation of Terminolo!y& This article talks about the importance of
creating a standard for terminolog0 so that different healthcare organi@ations can
share information. http:11www.ncbi.nlm.nih.go1pmc1articles1$M5!2!=+1%1J
toolKpubmed
< nformation 0eek E Healthcare& 3rticles about information s0stems and securit0
in the healthcare field. http:11www.informationweek.com1healthcare1inde#.jhtmlX
M35?/B.TT/6 4tml?es3nchor
http:11www.informationweek.com1healthcare1inde#.jhtml
#tudent *pplication *cti'ities
comp;Funit2Factiit0.doc
comp;Funit2Factiit0Fke0.doc
comp;Funit2FselfFassess.doc
comp;Funit2FselfFassessFke0.doc
4ealth IT *orkforce 5urriculum 6etworking and 4ealth !:
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
Component 9"0nit ?
0nit +itle
Health /ata Interchange #tandards
0nit /escription
This unit emphasi@es the importance of adhering to health data interchange these
standards in order to ensure compatibilit0 between s0stems.
0nit &()ecti'es
B0 the end of this unit the student will be able to:
1. .nderstand the definition&s( of an Electronic 4ealth ?ecord
!. .nderstand architecture for an E4?
%. Identif0 and understand ke0 standards for the E4?
+. .nderstand the 4L: E4? 'unctional Model "tandards
2. .nderstand functional profiles
=. .nderstand the standards for 'unctional Models for the $4?
:. .nderstand the certification re-uirements for the E4?, $4? and functional
profile
0nit +opics " ,ecture +itles
=a E4? 'unctional Model "tandards
=b E4? 'unctional Model "tandards
=c E4? 'unctional Model "tandards
0nit 3eferences
&3ll links accessible as of !1!11!81!(
,ecture ?a
1. 9ick, ?. "., "teen, E. B., M 9etmer, 9. E. &Eds.(. 5ommittee on Improing the
$atient ?ecord, Institute of Medicine. &1;;:(. Computer7.ased 3atient )ecord 6
"n 9ssential Technolo!y for Health Care &?e ed.(. *ashington, 9.5.: The
6ational 3cadem0 $ress.
!. 3"TM. &1;;=, 'eb(. Standard 'uide for 3roperties of 9lectronic Health )ecords
and )ecord Systems& 9?D>G7G=.
3cknowledgement:
1. The material presented in this lecture was taken from the web sites of the
arious standards. 9etails of the standards listed here can be obtained from the
arious "9/s. There ma0 be a membership cost or other cost associated with
the standards.
,ecture ?a Charts4 +a(les and 5igures
4ealth IT *orkforce 5urriculum 6etworking and 4ealth !<
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
6one used in this lecture
,ecture ?a Images
"lide =: $hoto of book b0 *. Ed 4ammond, $h9.
,ecture ?(
1. 5ommittee on 9ata "tandards for $atient "afet0 Board on 4ealth 5are "erices.
&!88%(. Cey Capabilities of an 9lectronic Health )ecord System6 *etter )eport&.
?etrieed from I6"TIT.TE /' ME9I5I6E /' T4E 63TI/63L 3539EMIE"
website: http:11www.nap.edu1catalog.phpJrecordFidK18:<1
,ecture ?( Charts4 +a(les and 5igures
6one used in this lecture
,ecture ?( Images
"lide 18: 9ickinson, >., 'ischetti, L., M 4eard, ". &eds(. &!88+, Dul0(. H*D 9H) System
1unctional 8odel Draft Standard for Trial Use. ?etrieed from 4ealth Leel "een
website:
http:11www.proidersedge.com1ehdocs1ehrFarticles14L:FE4?F"0stemF'unctionalFMod
el,9"T..pdf
,ecture ?c
6one used in this lecture
3cknowledgements
1. Much of the material in this lecture is deried from the following websites:
!. http :11 onc,chpl.force.com1ehrcert
%. www.hl:.org
+. www."ource.554IT.org
,ecture ?c Charts4 +a(les and 5igures
6one used in this lecture
,ecture ?c Images
"lide 1+: ?itter, D. &!88<, Ma0(. H*D 3ersonal Health )ecord System 1unctional
8odel and Standard T$ower$oint slidesU. ?etrieed from website:
https:11www.himss.org1content1files1/eriewE4ealthEnabled4ealthcare.pdf
0nit 3e6uired 3eadings
6one.
0nit #uggested 3eadings
1. ?ead more about 4L: including standards and how to implement.
http:11www.hl:.org1inde#.cfm
!. Info and news concerning E4?. http:11www.himss.org13"$1topicsFehr.asp
4ealth IT *orkforce 5urriculum 6etworking and 4ealth !;
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
%. 3n article about choosing an E4?.
http:11www.ahraonline.org19ownloads1onlineinstitute1-uickcredit1oi-cFelechealthr
ecord.pdf.
+. Information about E4? certification. http:11www.cchit.org1
2. 3 resource for information regarding all aspects of health data management
including 4E?, E9I, 4IE and data securit0.
http:11www.healthdatamanagement.com1.
=. Information about openE4? http:11www.openehr.org1home.html.
#tudent *pplication *cti'ities
comp;Funit=Factiit0.doc
comp;Funit=Factiit0Fke0.doc
comp;Funit=FselfFassess.doc
comp;Funit=FselfFassessFke0.doc
4ealth IT *orkforce 5urriculum 6etworking and 4ealth %8
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
Component 9"0nit <
0nit +itle
#upporting #tandards for EH3 *pplications
0nit /escription
This unit presents a set of standards that support the application la0er of the /"I and
e#tend E4? functionalit0
0nit &()ecti'es
B0 the end of this unit the student will be able to:
1. .nderstand the clinical decision support standard 3rden "0nta#,
!. .nderstand standards for clinical guidelines,
%. .nderstand object,oriented e#pression language for clinical decision
support C >ELL/,
+. .nderstand the clinical decision support standard Infobutton,
2. .nderstand disease management, and
=. .nderstand other clinical decision support applications.
:. .nderstand other standards that help to support networking and reporting
re-uirements as well as functionalit0 to optimi@e the connectiit0 among
heterogeneous s0stems deplo0ed within a single enterprise,
<. .nderstand single sign,on standards and the 4L: 5linical 5onte#t /bject
*orkgroup &55/*( standard,
;. .nderstand regulator0 standards, and
18. .nderstand issues relating to person identifiers, master patient indices,
and record locator serices.
0nit +opics " ,ecture +itles
:a "upporting "tandards for E4? 3pplication
:b "upporting "tandards for E4? 3pplication
:c "upporting "tandards for E4? 3pplication
:d "upporting "tandards for E4? 3pplication
0nit 3eferences
&3ll links accessible as of !1!+1!81!(
,ecture <a
3cknowledgement:
1. Material for this lecture was s0nthesi@ed from 4l: International 3rden "0nta#
"tandard. www.hl:.org
,ecture <a Charts4 +a(les and 5igures
4ealth IT *orkforce 5urriculum 6etworking and 4ealth %1
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
6one in this lecture.
,ecture <a Images
"lide :: "ource: *. Ed 4ammond
,ecture <(
3cknowledgement:
These slides were deried from documentation in 4L: standards and 3"TM standards.
,ecture <( Charts4 +a(les and 5igures
6one in this lecture.
,ecture <( Images
"lide 1!: National 'uideline Clearin!house. &n.d.(. ?etrieed !81!, from ."
9epartment of 4ealth M 4uman "erices, 3genc0 for 4ealthcare ?esearch and Lualit0
website: http:11www.guideline.go1
"lide !+: 4L: International documentation and other material.
,ecture <c
1. "lide 1:: "ource: 5ourtes0 of 9r. 5lem Mc9onald
3cknowledgment:
1. "ome of the material in this unit was taken from 4L: at www.hl:.org
,ecture <c Charts4 +a(les and 5igures
6one in this lecture.
,ecture <c Images
"lide <: 0hat are nfobuttons< &n.d.(. ?etrieed 'ebruar0 !+, !81!, from 6I4 Laborator0
for Informatics 9eelopment, 6ational Librar0 of Medicine, .niersit0 of .tah
9epartment of Biomedical Informatics, and 5olumbia .niersit0 9epartment of
Biomedical Informatics website: http:11www.infobuttons.org1
"lide ;: "ource: "lide set from *. Ed 4ammond &original source unaailable(
"lide 18: "ource: 5ourtes0 of 9r. Dames 5imino
"lide 1!: "ource: 9r. *. Ed 4ammond
"lide 12: "ource: 5ourtes0 of 9r. *illiam *. "tead of 7anderbilt 5$/E "0stem
"lide 1=: "ource: 5ourtes0 of 9r. *illiam *. "tead of 7anderbilt 5$/E "0stem
"lide 1<: "ource: "lide set from *. Ed 4ammond &original source unaailable(
"lide 1;: Stroke "fter "trial 1ibrillation. &n.d.(. ?etrieed 'ebruar0 !+, !81!, from
'ramingham 4eart "tud0 website:
http:11www.framinghamheartstud0.org1risk1strokeatrial.html
"lide !1: "ource: *. Ed 4ammond
"lide !!: "ource: "lide set from *. Ed 4ammond &original source unaailable(
"lide !+: "ource: "lide courtes0 of 9r. "u@@ane Bakken &original source unaailable(
4ealth IT *orkforce 5urriculum 6etworking and 4ealth %!
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
"lide !2: .rowse Databases and Tools. &n.d.(. ?etrieed 'ebruar0 !+, !81!, from
Essential Eidence $lus website: http:11www.essentialeidenceplus.com1content1poems
"lide !=:"ource: 5ourtes0 of "u@@ane Bakken, 5olumbia .niersit0
"lide !:: 0elcome to the )isk "ssessment Toolkit. &n.d.(. ?etrieed /ctober !, !88=,
from M9 3nderson 5ancer 5enter website: www.cra.deeloperlabs.net
"lide !<: Cancer )isk Toolkit, 8y Diet. &n.d.(. ?etrieed /ctober !, !88=, from M9
3nderson 5ancer 5enter website: www.cra.deeloperlabs.net
"lide !;: Hour ten7year and lifetime chance of developin! colon cancer. &n.d.(.
?etrieed /ctober !, !88=, from M9 3nderson 5ancer 5enter website:
www.cra.deeloperlabs.net
,ecture <d
3cknowledgement: Material in this section was deried from 4L: and I4E standards.
,ecture <d Charts4 +a(les and 5igures
6one in this lecture.
,ecture <d Images
"lide ;: "ource: 9r. Mike ?ussell, 9uke .niersit0 and 4L:
"lide 11: "ource: 9r. Mike ?ussell, 9uke .niersit0 and 4L:
"lide 1;: "ource: 5ourtes0 of 3mmon "habo, co,chair >enomic *>, 4L:
0nit 3e6uired 3eadings
6one.
0nit #uggested 3eadings
?& Usin! 1eatures of "rden Synta( with ObBect7Oriented 8edical Data 8odels for
'uideline 8odelin& This article contains information about man0 of the clinical
decision support standards. http:11citeseer#.ist.psu.edu1iewdoc1summar0J
doiK18.1.1.!+.2:%:
#& "rden Synta(& 3 table showing information about 3rden s0nta#.
http:11www.openclinical.org1gmmFardens0nta#.html
4& '9**O6 "n ObBect7Oriented Auery and 9(pression *an!ua!e for Clinical
Decision Support& This is a paper that discusses the format of >ELL/ and its
use. http:11www.openclinical.org1docs1int1docs1gello.pdf
$& H*D nfobutton 3roduct nformation& This link proides 4L:Ws product brief about
Infobuttons. http:11wiki.hl:.org1inde#.phpJtitleK$roductFInfobuttonX
M35?/B.TT/6 4tml?es3nchor
=& nfobuttons at ntermountain Healthcare6 Utili2ation and nfrastructure& This article
Hdescribes the infobuttons infrastructure at Intermountain 4ealthcare and
assesses their use after + 0ears of their initial release.I
http:11www.ncbi.nlm.nih.go1pmc1articles1$M51<%;+:+1X M35?/B.TT/6
4tml?es3nchor http:11www.ncbi.nlm.nih.go1pmc1articles1$M51<%;+:+1
4ealth IT *orkforce 5urriculum 6etworking and 4ealth %%
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
>& 'ettin! 3atients to 8eanin!ful Use6 Usin! the H*D nfobutton Standard for
nformation 3rescriptions& This article e#plains the usefulness of Infobuttons and
a particular compan0Ws implementation.
http:11hwinfo.healthwise.org1docs19/5.ME6T1<%!2.pdfX M35?/B.TT/6
4tml?es3nchor http:11hwinfo.healthwise.org1docs19/5.ME6T1<%!2.pdf
D& H*D CCO0 standard& This page is 4L:Ws 55/* standard page proiding
information about 55/*. http:11www.hl:.org.au155/*.htmX M35?/B.TT/6
4tml?es3nchor http:11www.hl:.org.au155/*.htm
I& CCO0 nformation for the Healthcare ndustry& This site proides information
about 55/* including what it is, how it works and its benefits.
http:11www.cr0ptlib.orion.co.n@1X M35?/B.TT/6 4tml?es3nchor
http:11www.cr0ptlib.orion.co.n@1
G& 9ffect of clinical !uidelines on medical practice6 a systematic review of ri!orous
evaluations. This article discusses the effects of clinical guidelines of medical
practices. ?egistration is re-uired to read the article but is free.
http:11www.sciencedirect.com1scienceJFobK3rticle.?LMFudiKB=T1B,+;N5:++,
'8MFuserK2;=1!82MFcoer9ateK11P!'!:P!'1;;%MFrdocK1MFfmtKhighMForig
KsearchMForiginKsearchMFsortKdMFdocanchorKMiewKcMFacctK58888=<;2+MF
ersionK1MFurl7ersionK8MFuseridK2;=1!82Mmd2Kf=a<+2=e%;=d!1%+!%;=<:;a
%;f+cfbdMsearcht0peKa
?%& National 'uideline Clearin!house& 6>5 is a public resource for eidence,based
clinical practice guidelines. Xhttp:11www.guideline.go1X M35?/B.TT/6
4tml?es3nchor http:11www.guideline.go1
#tudent *pplication *cti'ities
comp;Funit:Factiit0.doc
comp;Funit:Factiit0Fke0.doc
comp;Funit:FselfFassess.doc
comp;Funit:FselfFassessFke0.doc
4ealth IT *orkforce 5urriculum 6etworking and 4ealth %+
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
Component 9"0nit @
0nit +itle
Enterprise *rchitecture Models
0nit /escription
This unit addresses different enterprise architecture models that proide an
infrastructure for healthcare networks.
0nit &()ecti'es
B0 the end of this unit the student will be able to:
1. E#plain regional healthcare networks C polic0 and implementation
strategies
!. E#plain the concept of a 6ationwide 4ealthcare Information network
%. E#plain the significance of "erice /riented 3rchitecture in networking and
health information e#change networks
+. E#plain the alue of an Enterprise 3rchitecture in networking and health
information e#change networks
2. 9escribe ke0 elements of arious serice oriented architecture platforms
and infrastructure options
0nit +opics " ,ecture +itles
< ?egional health care networks
< 6ational health care networks
0nit 3eferences
&3ll links accessible as of !1!!1!81!(
,ecture @
6o referenced used in this lecture.
,ecture @ Charts4 +a(les and 5igures
6one in this lecture.
,ecture @ Images
6one in this lecture.
0nit 3e6uired 3eadings
6one in this lecture.
0nit #uggested 3eadings
4ealth IT *orkforce 5urriculum 6etworking and 4ealth %2
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
1. O8' Healthcare Domain Task 1orce& This site contains information about the
4ealthcare "erice "pecification $roject. http:11healthcare.omg.org
!. Health nformation Sharin! 9nvironment& Information about creating a framework
for sharing personal medical information.
http:11www.cisco.com1web1about1ac:;1docs1po14ealthFInformationF"haringFEn
ironmentF82!='I63L.pdf
%. NHN 9nterprise "rchitecture Overview& This document from /65 proides an
oeriew of E3.
http:11healthit.hhs.go1portal1serer.pt1gatewa01$T3?>"F8F11=:%F;18%;<F8F8F
1<164I6Enterprise3rchitecture/eriew.doc
+. SO" Solutions& This article from IBM describes how to deelop "/3 solutions for
health care organi@ations using business,drien deelopment.
http:11www.ibm.com1deeloperworks1webserices1librar01ws,soa,bddhealth1
2. Network for )e!ional Healthcare mprovement& This site is home to The 6etwork
for ?egional 4ealthcare Improement &6?4I(, a 6ational coalition of ?egional
4ealth Improement 5ollaboraties. http:11www.nrhi.org1
=. Nationwide Health nformation Network& This site deeloped b0 /65 coers
information about 4I6. http:11healthit.hhs.go1portal1serer.ptJ
openK21!MobjI9K11+!MparentnameK5ommunit0$ageMparentidK+MmodeK!
: " Service Oriented "rchitecture based 8edical 'rid "pplication& This article
presents a case of using "/3 for different medical entities to share mammogram
images. http:11ar#i+.librar0.cornell.edu1ftp1cs1papers18+8218+828:+.pdf
#tudent *pplication *cti'ities
comp;Funit<Factiit0.doc
comp;Funit<Factiit0Fke0.doc
comp;Funit<FselfFassess.doc
comp;Funit<FselfFassessFke0.doc
4ealth IT *orkforce 5urriculum 6etworking and 4ealth %=
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
Component 9"0nit 9
0nit +itle
-ri'ac.4 Confidentialit.4 and #ecurit. Issues and #tandards
0nit /escription
This unit e#plores issues related to creating an enironment in which to transport data in
a secure manner that ensures priac0 and confidentialit0.
0nit &()ecti'es
B0 the end of this unit the student will be able to:
1. E#plain the concepts of priac0 and confidentialit0 re-uirements and
policies and learn how to implement the re-uirements
!. 9escribe how to secure data storage and transmission using data
encr0ption, signatures, alidation, non,repudiation, and integrit0 &$NI,
certificates, and securit0 protocols(
%. 9efine access control methods
+. 3nal0@e access restrictions to data storage and retrieal &ph0sical and
software(
0nit +opics " ,ecture +itles
;a $riac0, 5onfidentialit0, and "ecurit0 Issues and "tandards
;b $riac0, 5onfidentialit0, and "ecurit0 Issues and "tandards
0nit 3eferences
&3ll links accessible as of !11=1!81!(
,ecture 9a
?eferences were not used for this lecture.
,ecture 9a Charts4 +a(les and 5igures
6one in this lecture.
,ecture 9a Images
"lide 18: Encr0ption. 5ourtes0 Michele $arrish. .sed with permission.
"lide 1<: 5ertificate. 5ourtes0 Michele $arrish. .sed with permission.
"lide 1;: 5ertificate Info. 5ourtes0 Michele $arrish. .sed with permission.
,ecture 9(
?eferences were not used for this lecture.
4ealth IT *orkforce 5urriculum 6etworking and 4ealth %:
Information E#change
7ersion %.81"pring !81!
This material was developed by Duke University funded by the Department of Health and Human Services, Office of the National
Coordinator for Health nformation Technolo!y under "ward Number U#$OC%%%%#$&
,ecture 9( Charts4 +a(les and 5igures
6one in this lecture.
,ecture 9( Images
"lide :: 35Ls. 5ourtes0 Michele $arrish. .sed with permission.
"lide <: Time ?estrictions. 5ourtes0 Michele $arrish. .sed with permission.
"lide 12: "ingle "ign,/n. 5ourtes0 Michele $arrish. .sed with permission.
0nit 3e6uired 3eadings
6one in this lecture.
0nit #uggested 3eadings
1. 8icrosoft E The *atest in Computer Security& This site contains information about
securit0 products, updates, tools and news.
http:11www.microsoft.com1securit01default.asp#
!. Oran!e .ook Certification& This site contains the criteria for obtaining /range
Book certification. The0 also e#plain the different leels of /range Book
certification. ftp:11ftp.all.kernel.org1pub1linu#1libs1securit01/range,
Linu#1refs1/range1/rangeI,II.htmlStoc2
%. 9ncryption& This article contains information about encr0ption, s0mmetric and
as0mmetric. http:11www.encr0ptionanddecr0ption.com1encr0ption1
+. Tutorial: 3n introduction to $ublic Ne0 Infrastructure &$NI(.
2. This ideo is a tutorial about $NI. It e#plains the different pieces of the
infrastructure including certificates and ke0s. ; minutes and %+ seconds long.
http:11www.0outube.com1watchJKEi@eE#sar4<
=. How to Choose a 'ood 3assword +"nd 0hy Hou Should/& This article contains
information about what 0ou should do and what 0ou shouldnYt do with passwords.
It also includes information about wh0 0ou should do these things.
:. http:11www.mit.edu1afs1sipb1project1doc1passwords1passwords.html
<. 'uidelines for Stron! 3asswords& This article discusses how to create strong
passwords along with e#amples of weak passwords.
http:11en.wikipedia.org1wiki1$asswordFstrengthS>uidelinesFforFstrongFpassword
s
;. Security 3olicies& These sites discuss the use of securit0 policies in an
organi@ation. The "36" site includes polic0 templates.
http:11www.sans.org1securit0,resources1policies1
http:11www.s0mantec.com1connect1articles1introduction,securit0,policies,part,one,
oeriew,policies
18. H33"& Information about 4I$$3 including who must follow the law, what
information is protected, what rights does the law proide to consumers and who
can look at 0our health information. http:11www.hhs.go1ocr1priac01
11. "ssurin! the 3rivacy and Security of Transmittin! Sensitive 9lectronic Health
nformation& This article discusses concerns about the securit0 of transferring
4ealth IT *orkforce 5urriculum 6etworking and 4ealth %<
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health information. Includes case studies.
http:11www.ncbi.nlm.nih.go1pmc1articles1$M5!<12+=<1JtoolKpubmed
1!. Social Networkin! and the 8edical 3ractice6 'uidelines for 3hysicians, Office
Staff and 3atients& These guidelines were produced b0 the /hio "tate Medical
3ssociation.http:11www.osma.org1files1documents1tools,and,resources1running,a,
practice1social,media,polic0.pdf
1%. #%%G 'lobal *ife Sciences - Health Care Security Study& 'indings from a !88;
stud0 on c0ber securit0, priac0 and data protection.
http:11it.ouhsc.edu1serices1infosecurit01documents1*$FE?"F"$F>""FL"45Ffi
nalFlow.pdf
1+. 3roposed H33" )ule Chan!e& /n Dul0 <, !818 4I"" announced a proposed
change to 4I$$3 that would affect the priac0, securit0 and enforcement rules.
This pdf is the proposed change.
Xhttp:11www.himss.org1handouts1!8188:1+F$roposed?egs44".pdfX
M35?/B.TT/6 4tml?es3nchor
http:11www.himss.org1handouts1!8188:1+F$roposed?egs44".pdf
#tudent *pplication *cti'ities
comp;Funit;Factiit0.doc
comp;Funit;Factiit0Fke0.doc
comp;Funit;FselfFassess.doc
comp;Funit;FselfFassessFke0.doc
4ealth IT *orkforce 5urriculum 6etworking and 4ealth %;
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Component 9"0nit %!
0nit +itle
Health Information Exchange
0nit /escription
This unit e#plores the networking standards and the standards re-uired for
interoperabilit0 to enable the creation of 4ealth Information E#changes.
0nit &()ecti'es
B0 the end of this unit the student will be able to:
1. .nderstand the purpose and importance of a 4ealth Information E#change
strateg0,
!. .nderstand what an 4IE is,
%. .nderstand the components of an 4IE, and
+. E#plore some e#amples of 4IEs.
0nit +opics " ,ecture +itles
18 4ealth Information E#change
0nit 3eferences
&3ll links accessible as of %11!1!81!(
,ecture %!
?eferences were not used for this lecture.
,ecture %! Charts4 +a(les and 5igures
6one in this lecture.
,ecture %! Images
"lide 2: "ource C *. Ed 4ammond, $h9., !81!.
"lide =: "ource C *. Ed 4ammond, $h9., !81!.
"lide :: "ource C *. Ed 4ammond, $h9., !81!.
"lide 1:: "ource C*. Ed 4ammond, $h9., !81!.
0nit 3e6uired 3eadings
6one in this lecture.
0nit #uggested 3eadings
6one in this lecture.
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#tudent *pplication *cti'ities
comp;Funit;Factiit0.doc
comp;Funit;Factiit0Fke0.doc
comp;Funit;FselfFassess.doc
comp;Funit;FselfFassessFke0.doc
4ealth IT *orkforce 5urriculum 6etworking and 4ealth +1
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Component *cron.m Alossar.
954I 3cron0m >uide &Danuar0 !811(
*cron.m Name
33'$ 3merican 3cadem0 of 'amil0 $h0sicians
3BIM 3merican Board of Internal Medicine
35N 3cknowledgment &9ata networks(
35Ls 3ccess 5ontrol Lists
35M 3ssociation for 5omputing Machiner0
35MI 3merican 5ollege of Medical Informatics
35? 3merican 5ollege of ?adiolog0
39aM 3nal0sis 9ata Model &39aM(
393 3merican 9ental 3ssociation
39Es 3derse 9rug Eents
39? 3derse 9rug ?eaction
39T 3dmissions, 9ischarge, Transfer
34I5 3merican 4ealth Information 5ommunit0
34IM3 3merican 4ealth Information Management 3ssociation
34I$ 3mericaWs 4ealth Insurance $lans
34?L 3genc0 for 4ealthcare ?esearch and Lualit0
3M 3mplitude Modulation
3M3 3merican Medical 3ssociation
3MI3 3merican Medical Informatics 3ssociation
36"I 3merican 6ational "tandards Institute
3$I 3pplication $rogramming Interfaces
3??3 3merican ?ecoer0 and ?einestment 3ct
3"5 Q1! 3ccredited "tandards 5ommittee
3"TM 3merican "ociet0 for Testing 3nd Materials
3"L 3merican "ociet0 for Lualit0
3T3 3merican Telemedicine 3ssociation
3T5B 3uthori@ed Testing and 5ertification Bodies
3TM 3s0nchronous Transfer Mode
3.$ 3cceptable .se $olic0
B5M3 Bar 5ode Medication 3dministration
B5$ Business 5ontinuit0 $lanning
BI" Bispectral Inde#
BMI Bod0 Mass Inde#
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bps Bits $er "econd
B?I9> Biomedical ?esearch Integrated 9omain >roup
B"3 Bod0 "urface 3rea
B"LM Bioinformatic "e-uence Markup Language
53 5ertificate 3uthorit0
5a9"? 5ancer 9ata "tandard ?epositor0
53$ 5ollege of 3merican $athologists
5B3 5abarrus 4ealth 3lliance
559 5ontinuit0 of 5are 9ocument
554IT 5ertification 5ommission for 4ealthcare Information Technolog0
55/* 5linical 5onte#t /bject *orkgroup &4L:(
55? 5ontinuit0 of 5are ?ecord
593 5linical 9ocument 3rchitecture
593"4 5linical 9ata 3c-uisition "tandards 4armoni@ation
595 5enters for 9isease 5ontrol and $reention
59E 5ommon 9ata Elements
59I"5 5linical 9ata Interchange "tandards 5onsortium
59M 5hronic 9isease Management
59" 5linical 9ecision "upport
59"? 5ochrane 9atabase of "0stematic ?eiews
59"" 5linical 9ecision "upport "0stem
5E6 European 5ommittee for "tandardi@ation
5> 5linical >enomics
54' 5ongestie 4eart 'ailure
54I 5onsumer 4ealth Informatics
5I53 5onte#t Inspired 5omponent 3rchitecture
5I" 5linical Information "0stem
5MET 5ommon Message Element T0pe
5MM 5apabilit0 Maturit0 Model
5MMI 5apabilit0 Maturit0 Model Integration
5M" 5enters for Medicare and Medicaid "erices
5/$9 5hronic /bstructie $ulmonar0 9isease
5/T" 5ommercial /ff,the,"helf
5$M 5ommon $roduct Model
5$/E 5omputeri@ed $roider /rder Entr0
5$T 5urrent $rocedural Terminolog0
5LI 5onsumer Lualit0 Initiaties
5?L 5ertificate ?eocation List
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5?T 5athode ?a0 Tube
5"I 5omputable "emantic Interoperabilit0
5"M3153 5arrier "ense Multiple 3ccess15ollision 3oidance
5"M3159 5arrier "ense Multiple 3ccess 1 5ollision 9etection
5T 5omputed Tomograph0
5T3 5enter for Technolog0 and 3ging
5T"3 5linical Translational "cience 3ct
5*M 5ommon *arehouse Model
935 9iscretionar0 3ccess 5ontrol
93M 9omain 3nal0sis Model
9'9s 9ata 'low 9iagrams
945$ 90namic 4ost 5onfiguration $rotocol
944" 9epartment of 4ealth and 4uman "erices
9I5/M 9igital Imaging and 5ommunications in Medicine
9M3I5 9efine, Measure, 3nal0@e, Improe, 5ontrol
9MIM 9omain Message Information Model
96" 9omain 6ame "erice
9o9 9epartment of 9efense
9o" 9enial of "erice
9?> 9iagnosis,related >roup
9"L 9igital "ubscriber Line
9"" 9ecision "upport "0stem
9"T. 9raft "tandard for Trial .se
9T9 9ocument T0pe 9efinition
9.?"3 9ata .se and ?eciprocal "upport 3greement
E3 Enterprise 3rchitecture
EBM Eidence Based Medicine
E5> Electrocardiograph0
E9 Emergenc0 9epartment
E9I Electronic 9ata Interchange
E9M" Electronic 9ocument Management "0stem
EE> Electroencephalogram
E4? Electronic 4ealth ?ecords
E4?,'M Electronic 4ealth ?ecord,"0stems 'unctional Model
E4?," Electronic 4ealth ?ecord,"0stems
E4?73 Electronic 4ealth ?ecord 7endors 3ssociation
eM3? Medication 3dministration ?ecords
EME3 European Medicines 3genc0
4ealth IT *orkforce 5urriculum 6etworking and 4ealth ++
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EMI Electromagnetic Interference
eM? Electronic Medical ?ecords
EM? Electronic Medical ?ecords1 $atient Management
EM?1$M Electronic $rotected 4ealth Information
e$4I Enterprise Master $atient Inde#
E$MI Electronic $rescribing
E,? Entit0,?elationship
E?9s Entit0,?elationship 9iagrams
e?Q Electronic $rescribing
E7" Enterprise 7ocabular0 "erice
'353 'ederal 3disor0 5ommittee 3ct
'93 'ood and 9rug 3dministration
'99I 'iber 9ata 9istributed Interface
'E?$3 'amil0 Educational ?ights and $riac0 3ct
'M 're-uenc0 Modulation
'ME3 'ailure Mode and Effects 3nal0sis
'T$ 'ile Transfer $rotocol
'L45 'ederall0 Lualified 4ealth 5enter
>9"6 >lobal 9ata "0nchronisation 6etwork
>ELL/ an object,oriented e#pression language for clinical decision support
>EM >uideline Elements Model
>I6 >eneric Incident 6otification
>I" >eographic Information "0stem
>LI' >uideLine Interchange 'ormat
459 4uman 5entered 9esign
45I" 4ealth 5are Information "0stem
495 4ealth 9isparities 5ollaboratie
49' 4ierarchical 9ata 'ormat
44" ..". 9epartment of 4ealth and 4uman "erices
4IE 4ealth Information E#change
4IM 4ealth Information Management
4IM"" 4ealth Information and Management "0stems "ociet0
4I$33 4ealth Insurance $ortabilit0 and 3ccountabilit0 3ct
4I" 4ealth Information "0stem or 4ospital Information "0stems
4I"$5 4ealth Information "ecurit0 and $riac0 5ollaboration
4IT 4ealth Information Technolog0
4ITE54 4ealth Information Technolog0 for Economic and 5linical 4ealth
4IT$5 4ealth Information Technolog0 $olic0 5ommittee
4ealth IT *orkforce 5urriculum 6etworking and 4ealth +2
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4IT"5 4ealth Information Technolog0 "tandards 5ommittee
4IT"$ 4ealth Information Technolog0 "tandards $anel
4L: 4ealth Leel "een
4M9 4ierarchical Message 9escriptions
4?"3 4ealth ?esources and "erices 3dministration
4""$ 4ealthcare "erices "pecification $roject
4TT$ 40perte#t Transfer $rotocol
4* 4ardware
4@ 4ert@
I363 Internet 3ssigned 6umbers 3uthorit0
I59 International 5lassification of 9iseases
I59,18,
5M International 5lassification of 9iseases, 18th ?eision, 5linical Modification
I54
International 5onference on 4armonisation of Technical ?e-uirements for
?egistration of $harmaceuticals for 4uman .se
I5M$ Internet 5ontrol Message $rotocol
I5$5 International 5lassification of $rimar0 5are
I5"? Indiidual 5ase "afet0 ?eport
I5T Information and 5ommunication Technologies
I5. Intensie 5are .nit
I9" Intrusion 9etection "0stem
IE Internet E#plorer
IE5 International Electrotechnical 5ommission
IEEE Institute of Electrical and Electronics Engineers
IET' Internet Engineering Task 'orce
I> Implementation >uide &4L:(
I4E Integrating the 4ealthcare Enterprise
I4" Indian 4ealth "erices
I4T"9/ International 4ealth Terminolog0 "tandards 9eelopment /rganisation
II" Internet Information "erices
I6? International 6ormali@ed ?atio
I/M Institute of Medicine
I$ Internet $rotocol
I$1/$ Inpatient1/utpatient
I" Information "0stem
I"96 Integrated "erices 9igital 6etwork
I"/ International /rgani@ation for "tandardi@ation
4ealth IT *orkforce 5urriculum 6etworking and 4ealth +=
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I"/1T5
International /rgani@ation for "tandardi@ationWs &I"/( Technical 5ommittee
&T5( on health informatics
IT Information Technolog0
IT" Implementable Technolog0 "pecifications &4L:(
DI5 Doint Initiatie 5ouncil
L3B Laborator0 9ata Model
L36 Local 3rea 6etwork
L93$ Lightweight 9irector0 3ccess $rotocol
Leapfrog
>roup
5onsortium of major companies and other large priate and public healthcare
purchasers
LIM" Lab Information Management "0stem
LL5 Logical Link 5ontrol
L/I65 Logical /bseration Identifiers 6ames and 5odes
M35 Mandator0 3ccess 5ontrol
M3? Medication 3dministration ?ecord
M9 Medical 9octor
M93 Model 9rien 3rchitecture
M9E Master 9ata Element
M9' Methodolog0 9eelopment 'ramework
M9M Master 9ata Management
ME95I6
"0stem of standardi@ed medical terminolog0 deeloped b0 Medicomp
"0stems
Med9?3 Medical 9ictionar0 for ?egulator0 3ctiities
MI5? Multipurpose Internet Mail E#tensions
MIME Magnetic Ink 5haracter ?ecognition
MI" Management Information "0stem
MLM Medical Logic Module
MLL$ Minimal Lower La0er $rotocol
MM3
Medicare $rescription 9rug, Improement, and Moderni@ation 3ct or Medicare
Moderni@ation 3ct
MMI" Medicaid Management Information "0stem
M/T" Modifiable /ff,the,"helf
M$I Master $atient Inde#
M"4 Message 4eader "egment
M. Meaningful .se
634IT 6ational 3lliance for 4ealth Information Technolog0
63T 6etwork 3ddress Translation
65$9$ 6ational 5ouncil for $rescription 9rug $rograms
4ealth IT *orkforce 5urriculum 6etworking and 4ealth +:
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65I 6ational 5ancer Institute
65I,5BIIT 6ational 5ommittee on 7ital 4ealth "tatistics
6574"
6ational 5ancer Institute 5enter for Bioinformatics and Information
Technolog0
695 6ational 9rug 5odes
69' 6ational 9rug 'ile
69',?T 6ational 9rug 'ile,?eference Terminolog0
6EM3 6ational Electrical Manufacturers 3ssociation
6E9"" 6ational Electronic 9isease "ureillance "0stem
6ET"" 6ational Electronic Telecommunications "0stem for "ureillance
6etB.I 6etBios E#tended .ser Interface
6>5 6ational >uideline 5learinghouse
64IM> 6ational 4ealth Information Management >roup
6I5 6etwork Interface 5ards
6I4 6ational Institutes of 4ealth
6I"T 6ational Institute for "tandards and Technolog0
6I"T,3TL
6ational Institute for "tandards and Technolog0,3danced Technolog0
Laboratories
64I6 6ationwide 4ealth Information 6etwork
6LB 6etwork Load Balancing
6LM 6ational Librar0 of Medicine
6$I 6ational $roider Identifier
6?G 6on ?eturn to Gero
6T'" 6ew Technolog0 'ile "0stem
6L' 6ational Lualit0 'orum
/3"I" /rgani@ation for the 3dancement of "tructured Information "tandards
/55 /ffice of 5are 5oordination
/5L /bject 5onstraint Language
/5? /ffice of 5iil ?ights
/9M /perational 9ata Model or /ptical 5haracter ?ecognition
/I9 /bject Identifier
/L3$ /nline 3nal0tical $rocessing
/M> /bject Management >roup
/65 /ffice of the 6ational 5oordinator for 4ealth Information Technolog0
/65,
3T5B /ffice of the 6ational 5oordinator 3uthori@ed Testing and 5ertification Bod0
//9 /perating ?oom
/? /bject /riented 9esign
/" /perating "0stem
4ealth IT *orkforce 5urriculum 6etworking and 4ealth +<
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/"I /pen "0stems Interconnection
/T$ /ne,Time $asswords
/.I /rgani@ational .ni-ue Identifier
/*L *eb /ntolog0 Language
$35" $icture 3rchiing and 5ommunication "0stems
$BM" $harmac0 Benefit Managers
$5I $eripheral 5omponet Interconnect
$5T $rimar0 5are Trust
$93s $ortable 9igital 3ssistants or $ersonal 9igital 3ssistants
$953 $lanC9oC5heckC3ct
$9"3 $lan,9o,"tud0,3ct
$9.s $rotocol 9ata .nits
$49"5 $ublic 4ealth 9ata "tandards 5onsortium
$4E? $ublic 4ealth Emergenc0 ?esponse
$4I $rotected 4ealth Information
$4II $ersonal 4ealth ?ecord
$4? $ubic 4ealth Informatics Institute
$4?,'M $ersonal 4ealth ?ecord,'unctional Model
$I5 $rocess Improement 5ommittee &4L:(
$IQ $atient Identifier 5ross,?eferencing
$NI $ublic Ne0 Infrastructure
$M $roject Management
$M4 $ast Medical 4istor0
$MI $atient Master Inde#
$M" $ractice Management "0stem
$/$ $ost /ffice $rotocol
$$$ $oint,to,$oint $rotocol
L3$ Lualit0 3ssurance $roject
L'9 Lualit0 'unction 9eplo0ment
LI Lualit0 Improement
?3 ?egistration 3uthorit0
?,39T ?eseration1?egistration,3dmission, 9ischarge, Transfer
?3I9 ?edundant 3rra0 of Independent 9isks
?3M ?andom 3ccess Memor0
?B35 ?ole Based 3ccess 5ontrol
?5?IM ?egulated 5linical ?esearch Information Management
?ELM3 ?egenstrief L/I65 Mapping 3ssistant
?' ?adio 're-uenc0
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Information E#change
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?'I ?adio 're-uenc0 Interference
?'I9 ?adio 're-uenc0 Identifiers
?'$ ?e-uest 'or $roposal
?4I/s ?egional 4ealth Information /rgani@ations
?IM ?eference Information Model
?I" ?adiolog0 Information "0stems
?MIM ?efined Message Information Model
?M$I ?egistr0 Master $atient Inde#
?/I ?eturn /n Inestment
?$M ?emote $atient Monitoring
?$" ?egulated $roduct "ubmission
?"63 ?adiological "ociet0 of 6orth 3merica
?Q $rescription
"3E3' "erices,3ware Enterprise 3rchitecture 'ramework
"3I' "erices 3ware Interoperabilit0 'ramework
"36 "torage 3rea 6etwork
"3T3 "erial 3danced Technolog0 3ttachment
"5/ "9/ 5harter /rgani@ation
"5"I "mall 5omputer "0stem Interface
"9L5 "oftware 9eelopment Life 50cle
"9M "0stems 9eelopment Method
"9/ "tandard 9eelopment /rgani@ation
"9TM "tud0 9ata Tabulation Model
"EI "ubject Matter E#pert
"ME "oftware Engineering Institute
"MT$ "imple Mail Transport $rotocol
"6/ME9 "0stemati@ed 6omenclature of Medicine
"6/ME9
5T "0stemati@ed 6omenclature of Medicine,,5linical Terms
"6/ME9
?T "0stemati@ed 6omenclature of Medicine,,?eference Terminolog0
"6/$ "0stemati@ed 6omenclature of $atholog0
"/3 "erice /riented 3rchitecture
"/3$ "imple /bject 3pplication $rotocol
"/$ "tructured $roduct Labeling
"$5 "tatistical $rocess 5ontrol
"$L "tandard /perating $rocedure
""3 "ocial "ecurit0 3dministration
""I9 "erice "et Identifier
4ealth IT *orkforce 5urriculum 6etworking and 4ealth 28
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""L "ecure "ocket La0er
""6 "ocial "ecurit0 6umber
""/ "ingle "ign,/n
"T$ "hielded Twisted,$air
T5$1I$ Transmission 5ontrol $rotocol 1 Internet $rotocol
TE$? Toward an Electronic $atient ?ecord 5onference
TL" Transport La0er "ecurit0
T/5 Table of 5ontents
T$ Twisted,$air
T$" Transaction $rocessing "0stem
T"5 4L: Technical "teering 5ommittee
TTL Time to Lie
.3T .ser 3cceptance Testing
.9$ .ser 9atagram $rotocol
.ML .niform Modeling Language
.ML" .nified Medical Language "0stem
.?Ls .niersal ?esources Locators
.$I .ni-ue $atient Identifier
.$" .n,interrupted power suppl0
." .ltrasound
."B .niersal "erial Bus
." T3> ..". Technical 3disor0 >roup
.T$ .nshielded Twisted,$air
73 7eterans 3dministration
73F69',
?T 7eterans 3dministration 6ational 9rug 'ile,?eference Terminolog0
M? 7irtual Medical ?ecord
7$6 7irtual $riate 6etwork
7"" 7olume "hadow 5op0 "erice
7.4I9 7oluntar0 .niersal 4ealthcare Identification "0stem
7.M5 7anderbilt .niersit0 Medical 5enter
*%5 *orld *ide *eb 5onsortium
*36 *ide 3rea 6etwork
*3$ *ireless 3ccess $oint
*4/ *orld 4ealth /rgani@ation
*L36 *ireless Local 3rea 6etwork
*/653
*orld /rgani@ation of 6ational 5olleges, 3cademies and 3cademic
3ssociations of >eneral $ractitioners1'amil0 $h0sicians. &*orld /rgani@ation
of 'amil0 9octors(
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*"9L *eb "erices 9escription Language
*** *orld *ide *eb
Q9? E#ternal 9ata ?epresentation
QML E#tensible Markup Language
4ealth IT *orkforce 5urriculum 6etworking and 4ealth 2!
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