Presentation on theme: "EHR–System Developing a Functional Model and Standard"— Presentation transcript:
1EHR–System Developing a Functional Model and Standard HIMSS Audio ConferencesAugust 7 and 14, 2003
2Outline History Charter HL7 and IOM Roles and Deliverables HL7 EHR-S Model and StandardIOM EHR-S “Key Capabilities” ReportHL7 Balloting ProcessHIMSS Role and Member Call to Action
3HistoryHealth and Human Services (HHS) and CMS want to pilot “pay for performance”Provide financial incentives for better quality care.How to measure quality?Focused on use of EHR System toAccelerate rate of adoption of clinical systems to achieve better quality at lower cost.Support adoption of message and content standards for secure and private transmission of medical information.Provide for consumer use of interconnected health systems.
4CharterCall to Action: HHS Secretary Tommy Thompson Announcement NHII on 7/1/03HHS has licensed SNOMED medical vocabulary and made available for free to providers.Enlisted Institute of Medicine and HL7 to develop a functional model for a standardized electronic health record.
5HL7 and IOM Roles and Deliverables CMS and Veterans Health Administration approached HL7 and its EHR Special Interest Group (SIG) at spring HL7 meeting.Asked them to meet challenging goal of an ANSI balloted EHR System (EHR-S) Functional Model and Standard by January 2004.HL7 EHR SIG directed to create EHR-S Functional Model and Standard.IOM directed to provide EHR-S Functional Needs and Priority by Care Settings.
6HL7 EHR System Functional Model and Standard Scope and DefinitionFrameworkContentFunctional tripletsCare Setting ProfilesUser ProfilesToolsHierarchySubmittal Forms
7HL7 EHR-S Scope and Definition Discovery uncovered definitions of EHR and EHR-S from many standards groups including IOM, ISO, ASTM and HIMSS.Did not define the EHR but accepted the concept of the EHR-S as a set of functions for primary and secondary users.Note that it is a “System” not just an EHR.CMS wants advanced functions such as CPOE with decision support not just access to a record in electronic form.
10HL7 EHR Functional Triplets Example drug-to-drug checkingRationale for UsePrevent adverse drug event through interaction.Conformance CriteriaIf a drug is ordered that interacts with currently prescribed drug, system notifies user.
11The HL7 EHR-S Functional Groupings Direct Care Health InformationWork Flow and Operations ManagementCommunicationsRecords, Documents and ViewsClinical SupportMeasurement, Analysis, Research and ReportsAdministrative, Finance
12IOM Letter Report“Key Capabilities of an Electronic Health Record System” – July 31, 2003atPrepared by the Committee on Data Standards for Patient SafetyDefines core functionality of EHR-S in four care settingsHospital, ambulatory, nursing home, and care in the community (personal health)Sets time frame (2004-5, and )
13The IOM’s Definition of an EHR-S Includes:longitudinal collection electronic health information for and about persons, where health information is defined as information pertaining to the health of an individual or health care provided to an individualimmediate electronic access to person- and population-level information by authorized, and only authorized, users;provision of knowledge and decision-support that enhance the quality, safety, and efficiency of patient care;support of efficient processes for health care delivery.
14Primary and Secondary Uses of an Electronic Health Record System Adapted from Institute of Medicine (1997)Primary UsesPatient Care DeliveryPatient Care ManagementPatient Care Support ProcessesFinancial and Other Administrative ProcessesPatient Self-ManagementSecondary UsesEducationRegulationResearchPublic Health and Homeland SecurityPolicy Support
15IOM’s Core Functionalities for an Electronic Health Record System Health information and dataResults managementOrder entry / managementDecision supportElectronic communication and connectivityPatient supportAdministrative processesReporting & population health management
16High Level Abstraction IOM EHR CapabilitiesHigh Level Abstraction
17The HL7 Ballot ProcessANSI accredited Standards Developer OrganizationParticipation in balloting by any interested partyDoes require a $100 administrative fee if not a HL7 memberOpen meetings to develop consensus and reconcile negativesAlso requires meeting registration feeDraft Standard for Trial UseRequires 2/3 affirmative vote to pass
18Status of the Draft Ballot Ballot available August 7thBallot closes on September 6thAvailable on HL7 web siteBallot reconciliation at HL7 Plenary and Working Group Meetings In MemphisFull meetings September 7 – 12EHR SIG September 9 – 11Must register at
19HIMSS RoleHIMSS has strongly supported a universal EHR and applauds this effortSubmitted its Definitional Model – June 2003Funded HL7 EHR Standard effort (subject matter experts)Member of EHR Collaborative to promote industry participation in EHR-S standardization processWill draft a response to the Ballot by August 15 for comment by members
20HIMSS Call to Action Standards development is an inclusive process. Standards rarely pass on first ballots, butThis is a major opportunity for the healthcare and the HCIT industry.We want to be part of the ongoing dialogue and solution.We also want to insure that whatever standard CMS adopts has gone through a open consensus process.Use HIMSS resources and participate!
21Contacts Charlene Underwood Pat Wise Ed Larsen Joyce Sensmeier Siemens/Pat WiseHIMSS/Ed LarsenE. R. Larsen, Inc./Joyce SensmeierHIMSS/