Standards are critical components in the

development and implementation of an

electronic health record (EHR).

The effectiveness of healthcare delivery is

dependent on the ability of clinicians to
access critical health information when and
where it is needed.

Standards can be further categorized:

Those that support the generic
infrastructure and are not domainspecific
Support the exchange of information
and are domain-specific
Support activities and practices within
a specific domain

 Healthcare

is fundamentally a process of
communication

The

term data standards is generally

used to describe those standards having
to do with the structure and content of
health information.

Data interchange standards address,

primarily, the format of messages that are
exchanged between computer systems,
document architecture, clinical templates,
user interface, and patient data linked.

It is necessary to have prior agreement on

the syntax of the messages to be
exchanged.

Four broad classes of message format

standards have emerged in the healthcare
sector:

Medical device communications

Digital imaging communications
Administrative data exchange
Clinical data exchange

NCVHS was called on to study the issues related

to the adoption of uniform data standards for
patient medical record information (PMRI) and
the electronic exchange of such information.

Has developed a series of standards known

collectively as P1073 Medical Information Bus
(MIB), which support real-time, continuous, and
comprehensive capture and communication of
data from bedside medical devices.

802.11- most widely known standard and

commonly referred to as Wi-Fi, allows to connect
to the Internet wirelessly through a myriad
access points installed.

Many healthcare organizations are currently

evaluating and implementing wireless solutions
that support point-of-care technology.

In collaboration with the American College

of Radiologists(ACR) and others, the
NEMA formed the DICOM to develop a
generic digital format and a transfer
protocol for biomedical images and imagerelated information.

DICOM standard is the dominant

international data interchange message
format in biomedical imaging.

Developed a broad range of electronic data

interchange (EDI) standards to facilitate
electronic business transactions.

X12N standards have been adopted as national

standards for such administrative transaction as
claims, enrollment, and eligibility in health
plans, and first report of injury under the
requirements of the HIPAA.

The policies for protection of personal health

information from country to country are
primarily used in the United States due to the
uniqueness of health insurance.

It has become clear to both public and

private sector standards development
efforts that no one entity has the
resources to create an exhaustive set of
health data standards that will meet all
needs.

 ISO

is an organization that develops

and publishes standards internationally.

Developed

from standards brought

forth by member countries, and through
liaison activities with other SDOs.

CEN TC 251 works to develop a wide

variety of standards in the area of
healthcare data management and
interchange.

CEN standards are adopted by its

member countries in Europe and are
also submitted for development into ISO
standards.

ANSI serves as the coordinator for

voluntary standards activity in the U.S.

1991- the ANSI Healthcare Informatics

Standards Planning Panel was convened
to act as a coordinating forum for both
SDOs and other stakeholders in the area
of health information standards.

OMG is an international consortium of

over 800 organizations, primarily forprofit vendors of information systems
technology, who are interested in the
development of standards based on
object-oriented technologies.

Administrative overhead includes:

Tasks as enrolling an individual in a health plan
Paying health insurance premiums
Checking insurance eligibility

Getting authorization to refer a patient to a specialist

Filing a claim for insurance reimbursement for

delivered healthcare
Requesting additional information to support a claim
Coordinating the processing of a claim across different
insurance company
Notifying the provider about the payment of a claim

The healthcare industry has been

attempting to develop standards to allow
these transactions to be accomplished
electronically, but it has been very difficult
to get voluntary agreement from all of the
competing parties involved to adopt a
uniform set of such standards.

The administrative simplification subtitle of

the HIPAA represents the first time that the
federal government has mandated health
data standards on a national level.

The administrative simplification provisions

also begin the process of addressing the
broader standards issues of electronic
healthcare records in general.

The goal of this project is to develop and

implement a standard means of
exchanging and managing health
information across federal health
providers.

It is focusing on creating interoperability

between health information systems in
terms of how data are defined,
structured, and exchanged.

Dr. Brailer has submitted a report that outlines a

framework for a strategic plan that will help the nation
to realize a new vision for healthcare made possible
through the use of information technology.
These goals convey the vision for consumer-centric
and information-rich healthcare.

Goal 1: Inform clinical practice

Incentive EHR adoption
Reduce risk of EHR investment
Promote EHR diffusion in rural and underserved areas
Goal 2 : Interconnect clinicians
Foster regional collaborations

Develop a national health information network

Coordinate federal health information systems

Goal 3: Personalize care

Encourage use of PHRs
Enhance informed consumer choice
Promote use of telehealth information systems

Goal 4: Improve population health

Unify public health surveillance architectures
Streamline quality and the health status monitoring
Accelerate research and dissemination of evidence

Having data standards for data

interchange and information modeling
will provide a mechanism against which
deployed systems can be validated.

Defining information exchange

requirements will enhance the ability to
automate interaction with external
partners which in turn will decrease a
costs.