Standards Harmonization and Recommended Standards

The advancement of interoperable electronic health records in Minnesota depends on the capability of the various health information systems in Minnesota to exchange data seamlessly. Standards are a critical ingredient of this interoperability. Because the health care domain has many standards (~2100) to choose from, there needs to be a process for standardizing the standards. By standards harmonization and utilization of approved standards, the various information systems and software applications will have the ability to work together. For progress on interoperable electronic health records in Minnesota, it is critical to promote standards. Minnesota e-Health must keep track of activities and progress on standards at the national level.

The process of harmonization of standards is headed at the national level by the Health Information Technology Standards Panel (HITSP). The objective of HITSP is to achieve widely accepted and readily-implemented consensus-based standards that will enable and support widespread interoperability among healthcare software applications, as they will interact in a local, regional and national health information network for the United States. HITSP functions as a cooperative partnership between the public and private sectors, operating through a neutral and inclusive governance model with participation by experts from across the health care IT community.

An overview of the standards selection and approval process at HITSP:

The following table presents details of Use Cases, recommended standards, interoperability specifications and requirements, design and standards selection for selected scenarios.
Printer friendly version with full links (pdf 116Kb/9 pgs)

Use Case
Use Case Description
HITSP Harmonization Status
HITSP Requirements, Design and Standards Selection
HITSP Interoperability Specifications
Recommended Standards
Approval by AHIC
Secretary of DHHS
• Acceptance of Standards
• Recognition of Standards
2006 Use Cases
Consumer Empowerment
• Registration
• Medication History
Harmonized Use Case
March 19, 2006
(pdf 259Kb/26 pgs)
Completed
 
Version 2.0
(pdf 765Kb/26 pgs)
October 31, 2006
(pdf 16Kb/1 pg)
Approved
Accepted January 23, 2007
Electronic Health Records (EHR)
• Laboratory Results Reporting
Harmonized Use Case
March 19, 2006
(pdf 269Kb/30 pgs)
Completed
 
Version 2.0
(pdf 765Kb/26 pgs)
October 31, 2006
(pdf 11Kb/1 pg)
Approved
Accepted January 23, 2007
Biosurveillance
• Visit
• Utilization
• Clinical Data
• Lab and Radiology
Harmonized Use Case
March 19, 2006
(pdf 208Kb/20 pgs)
Completed
 
Version 2.0
(pdf 765Kb/26 pgs)
October 31, 2006
(pdf 14Kb/2 pgs)
Approved
Accepted January 23, 2007
Privacy and Security


Consumer Empowerment
• Registration
• Medication History


Electronic Health Records (EHR)
• Laboratory Results Reporting


Biosurveillance
• Visit
• Utilization
• Clinical Data
• Lab and Radiology
   
Version 1.0 Security and Privacy RDSS April 13, 2007
(pdf 1917Kb/128 pgs)

Approved by the panel on October 15, 2007
       
2006 Use Cases Updates


Consumer Empowerment
• Registration
• Medication History


Electronic Health Records (EHR)
• Laboratory Results Reporting


Biosurveillance
• Visit
• Utilization
• Clinical Data
• Lab and Radiology
     
Being updated to reference the new security & privacy constructs & will be released as v3.0
     
2007 Use Cases
Emergency Responder Electronic Health Record
• On-site Care
• Emergency Care
• Definitive Care
• Provider Authentication and Authorization
Detailed Use Case December 20, 2006
(pdf 377Kb/43 pgs)
In process
  • Review Copy of IS constructs (v1.0) released for public comment & inspection testing on Sept 17, 2007

• Scheduled for approval by the Panel on Dec 13, 2007
     
Privacy and Security

Emergency Responder Electronic Health Record
   
Version 1.0 Security and Privacy RDSS May 16, 2007
(pdf 984Kb/59 pgs)
       
Consumer - Empowerment
Consumer Access to Clinical Information
• Access to Clinical Data
• Provider Permissions
• PHR Transfer
Detailed Use Case
June 18, 2007
In process
 
• Review Copy of IS constructs (v1.0) released for public comment & inspection testing on Sept 17, 2007

• Scheduled for approval by the Panel on Dec 13, 2007
     
Medication Management
• Medication Reconciliation
• Ambulatory Prescriptions
• Contra-indications
Detailed Use Case
June 18, 2007
In process
Version 1.0 released for public comment on Sept. 17, 2007
IS constructs scheduled for panel approval on March 27, 2008
     
Quality
• Hospital Measurement and Reporting
• Clinician Measurement and Reporting
• Feedback to Clinicians
Draft Detailed Use Case
June 18, 2007
(pdf 391Kb/44 pgs)
In process
 
• Review Copy of IS constructs (v1.0) released for public comment & inspection testing on Sept 17, 2007

• Scheduled for approval by the Panel on Dec 13, 2007
     
2008 Use Cases
Remote Monitoring
• Remote Monitoring of Vital Signs & Labs (Glucose)
Prototype Use Case
August 31, 2007
           
Remote Consultation
• Structured email
• Reminders
• On-line Consultation
Prototype Use Case
August 31, 2007
           
Personalized Healthcare
• Laboratory
• Genetic/Genomic Data
• Family Medical History
Prototype Use Case
August 31, 2007
           
Consultation and Transfers of Care
• Referrals
• Problem Lists
• Transfer of Care
Prototype Use Case
August 31, 2007
           
Public Health Case Reporting
• Case Reporting
• Bidirectional Communication
• Labs
• Adverse Events
Prototype Use Case
August 31, 2007
           
Immunizations & Response Management
• Resource Identification
• Vaccine
• EHR data
Prototype Use Case
August 31, 2007
           
AHIC Priorities and Use Case Roadmap
2009 and Beyond

CE 3.0 Administrative features
CE 3.1 Appointment scheduling
CE 3.2 Demographic profile
CE 3.3 Editing account profile
CE 3.4 Insurance eligibility & claims
CE 3.5 Financial recordkeeping & management
CE 4.0 Reminders (examples)
CE 4.1 Annual check-ups
CE 4.2 Cancer screening - mammograms
CE 4.3 Cancer screening - colonoscopies
CE 4.4 Immunizations
CE 6.0 Summaries of healthcare encounters
CE 6.1 Dates of services
CE 6.3 Procedure codes
CE 7.0 Educational information
CE 7.1 Evidence based health information
CE 8.0 Decision support
CE 8.1 Shared decision making
CE 8.2 Communications preferences CE 9.0 Patient health outcomes
CE 9.1 Adverse events
CE 9.2 Medical errors
CE 9.3 Patient reported health outcomes

CC 3.0 Glucose monitoring
CC 4.0 Spirometery
CC 5.0 Anticoagulation
CC 7.0 Fall/motion monitoring
CC 11.0 Lesion assessment
CC 12.0 Remote monitoring for chronic conditions
CC 13.0 HIT use in specific populations
CC 15.0 Product and services certification
CC 16.1 State licensure constraints
CC 18.0 Patient identification for authorization and authentication

----------------------------

EHR 5.0 Clinical/encounter notes
EHR 6.0 Anatomic pathology results
EHR 8.0 Radiology reports
EHR 12.0 Machine readable and interoperable
EHR 12.1 Encounter notes
EHR 12.2 Radiology reports
EHR 12.3 Lab results

Q 3.1 Clinical decision support
Q 5.0 Clinical decision support
Q 6.0 Expanded inpatient quality measures
Q 7.0 Expanded ambulatory quality measures

----------------------------

BIO 1.2 Clinical symptomology
BIO 1.3 Integration with EHRs
BIO 1.4 Health alerting (HA)/email alerts
BIO 2.1 Collaborative discussions
BIO 2.2 Web pages
BIO 3.2 Chemoprophylaxis
BIO 3.3 Treatment
BIO 3.4 Isolation/quarantine
BIO 3.6.2 Disease registry
BIO 4.0 Adverse event reporting
BIO 4.1 Devices, drugs, biologic
BIO 5.0 Nosocomial infections
BIO 5.1 Medication errors
BIO 5.1.1 Ordering/ prescribing/ dispensing
BIO 5.1.2 Drug-drug, drug-allergy interaction decision support
BIO 5.1.3 Linkage to FDA structured product labeling database results
BIO 10.0 Public health information network (PHIN) can be leveraged
BIO 14.0 National notifiable disease conditions have been identified

AHIC 1.0 Labs, medications, allergies, immunizations
AHIC 2.0 Secure messaging/online consultation
AHIC 3.0 Bi-directional communications
AHIC 4.0 Adverse event reporting
AHIC 5.0 Case reporting
AHIC 6.0 Clinical decision support systems
AHIC 7.0 Identification / authentication
AHIC 8.0 Problem lists
AHIC 9.0 Clinical encounter notes
AHIC 10.0 Family history / social factors
AHIC 11.0 Vitals signs
AHIC 12.0 Population health / conditions
AHIC 13.0 Minimum data set
AHIC 14.0 Confidentiality, privacy, & security of patient data
AHIC 15.0 Data access / data control
AHIC 16.0 Data aggregation
AHIC 17.0 Infrastructure areas missing
AHIC 17.1 Security, network, repositories
AHIC 18.0 Vital measurements
AHIC19.0 Text documents
AHIC 21.0 Health literacy (multilingual support)
AHIC 23.0 Advance directive / living wills
AHIC 24.0 Social/family history
AHIC 26.0 Medication history

AHIC 27.0 E-prescribing
AHIC 28.0 Standardization of device interfaces
AHIC 29.0 Care plans / clinical flow sheets
AHIC 30.0 Provider list
AHIC 31.0 Adverse events
AHIC 32.0 Nosocomial infections
AHIC 33.0 Clinical data storage for surveillance
AHIC 34.0 Case reporting
AHIC 35.0 Bi-directional communications
AHIC 36.0 Lab results
AHIC 37.0 Anatomic pathology results
AHIC 38.0 Radiology reports
AHIC 39.0 Social history
AHIC 40.0 Procedure reports
AHIC 41.0 Medications
AHIC 43.0 Dental
AHIC 44.0 Workflow integration
AHIC 45.0 Int'l public health collaboration
AHIC 46.0 Legal liability & regulatory barriers
AHIC 47.0 Consumer consent

CCHIT 1.0 Patient safety
CCHIT 2.0 Transfer of care
----------------------------

HITSP 1.1.4 Text reports
HITSP 1.1.5 Numeric results
HITSP 1.1.7 Images
HITSP 1.2 HIPAA covered entities
HITSP 1.2.1 X12 Claims attachment
HITSP 2.0 Secondary uses of data
HITSP 2.1 Clinical research
HITSP 2.2 Clinical trials
HITSP 2.3 Population health
HITSP 3.0 Quality / control measurements
HITSP 3.1 Consistency across uses
HITSP 4.0 Clinical device data
HITSP 4.1 Glucometers
HITSP 4.2 Monitors
HITSP 4.2 Smart pump
HITSP 5.0 Cross use case work on security (standards)
HITSP 5.3 Authentication models to support chain of trust data exchanges

Updated Tuesday, 27-May-2014 08:18:47 CDT