Session 9 Syntactic Interoperability and The Role of Standards

• List and describe the diferent levels of interoperability and the role of each in health information exchange (HIE).

• • Describe the principles of messaging and its role in

Schemas and templates constrain the vast array of possible message types and information that could potentially be put into any given message. Being compliant with constraints

  

Fig. 8.1 An example section from an

  

XML-based message representing

guardian information for a fctitious HEALTH INFORMATION MESSAGING

STANDARDS

  Syntactic interoperability is achieved through the use of standards. Standards in health IT are broadly organized in four categories:

  

_{Health Level Seven (HL7) is the leading and most widely recognized syntactic}

Structure and Content Standards

_{and standardizes interactions within a computer system regardless of its underlying}

_{OSI (Open Systems Interconnection) model, a conceptual model that characterizes}

standard in health IT. The “level 7” in its name refers to the application layer of the

  Fig. 8.2 A sample HL7 v2.3 Admission Discharge Transfer (ADT) message.

  

Benefts of V3 as Provided on The HL7

• Focuses on semantic interoperability by specifying that information be presented in a complete clinical context that assures that the sending and receiving systems share the

  Fig. 8.3 The HL7 Reference Information Model (RIM) core classes and the relationships between them.

  

Fig. 8.4 Example scenario using HL7

modeling for a participation involving

diferent entities and their roles in a

  

Digital Imaging and Communications in

Medicine (DICOM

  DICOM (Digital Imaging and Communications in Medicine) is the most widely adopted standard in the world for the

  National Council for Prescription Drug

Programs (NCPDP)

  The National Council for Prescription Drug Programs (NCPDP) standardizes electronic exchange of data for prescribing,

  

Standards for HIE Services

  A valid, well-constructed message is a major step towards HIE, yet it is only one component of syntactic interoperability. To

  Integrating the Health-Care Enterprise

_{There are four major services provided by IHE to address}

(IHE)

interoperability issues in health care globally:

  

Cont.

• Connectathon Testing: After developing systems using IHE profles, vendors participate in a carefully planned and

  

eHealth Exchange

  The eHealth Exchange formerly known as the Nationwide Health Information Network (NwHIN) is the foundation for

  

Standards & Interoperability (S&I)

_{provides a collaborative environment in the United States among public}

_{The Standards & Interoperability (S&I) Framework, established by ONC,}

Framework

_{interoperability in health care. Like IHE, the S&I Framework brings clinical}

and private sectors to develop tools, services, and guidelines to facilitate

  

SUMMARY

  Technical standards provide a foundation for interoperability in HIE. While necessary, standards are not sufcient for achieving the goal of seamless HIE among health-care