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The Source for Healthcare Information EHR–System Developing a Functional Model and Standard HIMSS Audio Conferences August 7 and 14, 2003.

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Presentation on theme: "The Source for Healthcare Information EHR–System Developing a Functional Model and Standard HIMSS Audio Conferences August 7 and 14, 2003."— Presentation transcript:

1 The Source for Healthcare Information EHR–System Developing a Functional Model and Standard HIMSS Audio Conferences August 7 and 14, 2003

2 The Source for Healthcare Information 2 Outline History Charter HL7 and IOM Roles and Deliverables HL7 EHR-S Model and Standard IOM EHR-S “Key Capabilities” Report HL7 Balloting Process HIMSS Role and Member Call to Action

3 The Source for Healthcare Information 3 History Health 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 to –Accelerate 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.

4 The Source for Healthcare Information 4 Charter Call to Action: HHS Secretary Tommy Thompson Announcement – @ NHII on 7/1/03 –HHS 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. –http://www.hhs.gov/news/press/2003pres/20030701.html

5 The Source for Healthcare Information 5 HL7 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.

6 The Source for Healthcare Information 6 HL7 EHR System Functional Model and Standard Scope and Definition Framework Content –Functional triplets –Care Setting Profiles –User Profiles Tools –Hierarchy –Submittal Forms

7 The Source for Healthcare Information 7 HL7 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.

8 The Source for Healthcare Information 8 HL7 EHR-S Framework

9 The Source for Healthcare Information 9 HL7 EHR-S Framework

10 The Source for Healthcare Information 10 HL7 EHR Functional Triplets Function –Example drug-to-drug checking Rationale for Use –Prevent adverse drug event through interaction. Conformance Criteria –If a drug is ordered that interacts with currently prescribed drug, system notifies user.

11 The Source for Healthcare Information 11 The HL7 EHR-S Functional Groupings Direct Care Health Information Work Flow and Operations Management Communications Records, Documents and Views Clinical Support Measurement, Analysis, Research and Reports Administrative, Finance

12 The Source for Healthcare Information 12 IOM Letter Report “Key Capabilities of an Electronic Health Record System” – July 31, 2003 –at http://books.nap.edu/html/ehr/NI000427.pdfhttp://books.nap.edu/html/ehr/NI000427.pdf Prepared by the Committee on Data Standards for Patient Safety Defines core functionality of EHR-S in four care settings –Hospital, ambulatory, nursing home, and care in the community (personal health) –Sets time frame (2004-5, 2006-7 and 2008-10)

13 The Source for Healthcare Information 13 The IOM’s Definition of an EHR-S Includes: 1)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 individual 2)immediate electronic access to person- and population- level information by authorized, and only authorized, users; 3)provision of knowledge and decision-support that enhance the quality, safety, and efficiency of patient care; 4)support of efficient processes for health care delivery.

14 The Source for Healthcare Information 14 Primary and Secondary Uses of an Electronic Health Record System Adapted from Institute of Medicine (1997) Primary Uses Patient Care Delivery Patient Care Management Patient Care Support Processes Financial and Other Administrative Processes Patient Self-Management Secondary Uses Education Regulation Research Public Health and Homeland Security Policy Support

15 The Source for Healthcare Information 15 IOM’s Core Functionalities for an Electronic Health Record System Health information and data Results management Order entry / management Decision support Electronic communication and connectivity Patient support Administrative processes Reporting & population health management

16 The Source for Healthcare Information 16 IOM EHR Capabilities High Level Abstraction

17 The Source for Healthcare Information 17 The HL7 Ballot Process ANSI accredited Standards Developer Organization Participation in balloting by any interested party –Does require a $100 administrative fee if not a HL7 member Open meetings to develop consensus and reconcile negatives –Also requires meeting registration fee Draft Standard for Trial Use –Requires 2/3 affirmative vote to pass

18 The Source for Healthcare Information 18 Status of the Draft Ballot Ballot available August 7 th Ballot closes on September 6 th Available on HL7 web site –www.hl7.org/ehrwww.hl7.org/ehr Ballot reconciliation at HL7 Plenary and Working Group Meetings In Memphis –Full meetings September 7 – 12 –EHR SIG September 9 – 11 –Must register at www.hl7.org

19 The Source for Healthcare Information 19 HIMSS Role HIMSS has strongly supported a universal EHR and applauds this effort –Submitted its Definitional Model – June 2003 –Funded HL7 EHR Standard effort (subject matter experts) –Member of EHR Collaborative to promote industry participation in EHR-S standardization process –Will draft a response to the Ballot by August 15 for comment by members

20 The Source for Healthcare Information 20 HIMSS Call to Action Standards development is an inclusive process. – Standards rarely pass on first ballots, but This 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!

21 The Source for Healthcare Information 21 Contacts Charlene Underwood Siemens/ charlene.underwood@siemens.comcharlene.underwood@siemens.com Pat Wise HIMSS/ pwise@himss.orgpwise@himss.org Ed Larsen E. R. Larsen, Inc./ erlarsen@erlinc.comerlarsen@erlinc.com Joyce Sensmeier HIMSS/ jsensmeier@himss.orgjsensmeier@himss.org


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