Interoperability Within E-Health Arena

Cloud Security Alliance, 2022

As healthcare started developing information technology (IT) systems, companies like electronic health record (EHR) and medical device developers created data formats. As information was exchanged between these organizations, it was quickly discovered they could not Communicate with one another. This interoperability problem increased due to the large number of different entities involved with data exchange, all using different and incompatible systems and data structures. Interoperability can be broadly defined as “the ability of two or more systems or components to exchange information and to use the information that has been exchanged.”1 In 2015, the Office of the National Coordinator for Health Information Technology (ONC) released a roadmap for enabling individuals and organizations to share health information securely with any provider. While there have been considerable advancements in interoperability, standardization between systems still needs to be improved. Currently, there are still significant variations in how data is structured and displayed. Despite all the spending, according to the Centers for Disease Control and Prevention (CDC), the percentage of office-based physicians using a certified EHR system is not even 80 percent.2

Journal of Healthcare Engineering, 2011

The standardization of Electronic Health Records (EHR) is a crucial factor for ensuring interoperable sharing of health data. During recent decades, a plethora of initiatives-driven by international organizations-has emerged to define the required models describing the exchange of information between EHRs. These models cover different essential characteristics for building interoperable EHRs, such as architecture, methodology, communication, safety or terminology, among others. In this context, the European reference frame for the standardized exchange of EHR is the recently approved ISO/EN 13606 standard. This multi-part standard provides the syntactic and semantic capabilities (through a dual model approach) as well as terminology, security and interface considerations for the standardized exchange of EHR. This paper provides (a) an introduction to the different standardization efforts related to the interoperable exchange of EHR around the world, and (b) a description of how the ISO/EN 13606 standard provides interoperable sharing of clinical information.

Sharing of health data between independent organizations, each using customized Electronic Health Records (EHR) management systems or Healthcare Information System (HIS) encompasses major concerns. It requires an integrated interoperable environment or interface commonly understood by end-users of healthcare domain. The sheer number of systems, standards, procedures and system developers seriously hinders interoperability. Developers need to adhere to the standards while designing such system. Developing standardized interfaces would enable seamless communication and transfer of required EHR between disparate systems. The paper after giving a detailed overview of interoperability identifies the challenges to Health Informatics data-exchange in interoperable environment and recommends some viable solutions in this direction. This paper provides a glance at different approaches of designing interoperable models and illustrates the healthcare models designed on such approaches. The study also includes available set of vocabularies, formats and standards specifically designed for the purpose. Considering the Health environment, protecting the confidentiality and illegal disclosure during transfer of EHR between organizations, is a serious concern. Vendors incorporate customized and vendor-dependent security attributes while designing the application, resulting in major challenge of securely sharing of data. The paper includes available security controls and gaps accruing due to interoperability and recommends the need of robust security control improving accessibility and availability of EHR at the required place by the authorized user.

electronic Journal of Health …, 2009

Bio-Algorithms and Med-Systems, 2022

Objectives Due to the diversity, volume, and distribution of ingested data, the majority of current healthcare entities operate independently, increasing the problem of data processing and interchange. The goal of this research is to design, implement, and evaluate an electronic health record (EHR) interoperability solution – prototype – among healthcare organizations, whether these organizations do not have systems that are prepared for data sharing, or organizations that have such systems. Methods We established an EHR interoperability prototype model named interoperability smart lane for electronic health record (islEHR), which comprises of three modules: 1) a data fetching APIs for external sharing of patients’ information from participant hospitals; 2) a data integration service, which is the heart of the islEHR that is responsible for extracting, standardizing, and normalizing EHRs data leveraging the fast healthcare interoperability resources (FHIR) and artificial intelligenc...

Digital Ecosystems and …, 2009

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AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium, 2005

Information exchange, enabled by computable interoperability, is the key to many of the initiatives underway including the development of Regional Health Information Exchanges, Regional Health Information Organizations, and the National Health Information Network. These initiatives must include public health as a full partner in the emerging transformation of our nation's healthcare system through the adoption and use of information technology. An electronic health record - public health (EHR-PH)system prototype was developed to demonstrate the feasibility of electronic data transfer from a health care provider, i.e. hospital or ambulatory care settings, to multiple customized public health systems which include a Newborn Metabolic Screening Registry, a Newborn Hearing Screening Registry, an Immunization Registry and a Communicable Disease Registry, using HL7 messaging standards. Our EHR-PH system prototype can be considered a distributed EHR-based RHIE/RHIO model - a principal ...

International Journal of Innovation and Applied Studies, 2013

Information and Communication Technologies (ICTs) play significant roles in the improvement of patient care and the reduction of healthcare cost by facilitating the seamless exchange of vital information among healthcare providers. Thus, clinicians can have easy access to patients' information in a timely manner, medical errors are reduced, and health related records are easily integrated. However, as beneficial as data interoperability is to healthcare, at present, it is largely an unreached goal. This is chiefly because electronic Health Information Systems used within the healthcare organizations have been developed independently with diverse and heterogeneous ICT tools, methods, processes and procedures which result in a large number of heterogeneous and distributed proprietary models for representing and recording patients' information. Consequently, the seamless, effective and meaningful exchange of patients' information is yet to be achieved across healthcare systems. This paper therefore appraises the concepts of interoperability in the context of healthcare, its benefits and its attendant challenges. The paper suggests that the adoption of a standardized healthcare terminology, education strategy, design of useable interfaces for ICT tools, privacy and security issues as well as the connection of legacy systems to the health network are ways of achieving complete interoperability of electronic based Health Information Systems in healthcare.

Electronic Health Records can be seen as a pool for various health related data, where also different types of structured data can be stored. International standards serve as a unified framework for data communication and storage. We take different types of data sources as examples: a pulse oximeter, blood pressure monitor and a simple weighing scale. The data is collected at a single mobile device, where they are converted to corresponding ISO/IEEE 11073 profiles respectively and then communicated to a central EHR server via HL7 messages. The whole communication and storage is done without the classical media break fully electronically.

Enterprise Interoperability II, 2007

Typical healthcare organizations have many proprietary heterogeneous information systems that must exchange data reliably. Seamlessly sharing information among systems is complex. The widely adopted HL7 version 2 messaging standard has helped the process of systems integration. However, using the HL7 standard alone does not ensure system interoperability. The HL7 standard offers a wide range of options. Trading partners, without prior agreement, are not likely to implement options that are compatible.

2007

As an Emergency Physician, I often treat patients without the benefit of any historical clinical information. I do my best by working the patient to develop a list of active medications, calling next of kin to assemble medical history and trying to locate previous treating physicians for insight into previous admissions. It's a bit like flying without radar in the fog. All of this ambiguity could be solved by implementing interoperable electronic health records. Care quality would improve, costs would be reduced and patient satisfaction would increase. From Hillary Clinton to Newt Gingrich, policymakers in Washington are enthusiastic about interoperability. However, no one has crisply defined what it means to be interoperable. If I'm faxed a discharge summary which I can read, is that interoperable, since it's human interpretable? If I'm sent an electronic note via email that notes "Allergy to MS", is that interoperable? Of course MS could mean Morphine Sulfate, Magnesium Sulfate, or even Minestrone Soup. If I'm sent an electronic message which has an agreed upon format, a standard vocabulary, and a set of business rules which enable me to take action, is that interoperable? i.e. Your patient is allergic to medication NDC Code 123456789. Administration will cause a SEVERE reaction with HIGH CONFIDENCE. My e-Prescribing software could use this information to display a warning alerting me to the issue and could suggest an effective alternative medication. In August of 2006, President Bush signed an Executive Order mandating the Federal Government use of interoperable standards. At a high level, this Executive Order defined Interoperability "Interoperability" means the ability to communicate and exchange data accurately, effectively, securely, and consistently with different information technology systems, software applications, and networks in various settings, and exchange data such that clinical or operational purpose and meaning of the data are preserved and unaltered. "Recognized interoperability standards" means interoperability standards recognized by the Secretary of Health and Human Services (the "Secretary"), in accordance with guidance developed by the Secretary, as existing on the date of the implementation, acquisition, or upgrade of health information technology systems under subsections (1) or (2) of section 3(a) of this order. Defining interoperability and its requirements are the first step in creating a connected healthcare system As Chair of the Health Information Technology Standards Panel (HITSP), I facilitate the work of 170 stakeholders selecting the most appropriate interoperable data standards for specific use cases. In 2006, we will issue our first work

Computing Research Repository, 2009

Understanding the importance that the electronic medical health records system has, with its various structural types and grades, has led to the elaboration of a series of standards and quality control methods, meant to control its functioning. In time, the electronic health records system has evolved along with the medical data change of structure. Romania has not yet managed to

International journal of medical informatics, 2005

Problem: Although electronic communication of clinical data between various actors in the healthcare domain seems crucial for a cost-effective patient treatment, it is mostly restricted to paper based documents. In order to meet the growing need for improved data communication, it is necessary to overcome the barriers of software heterogeneity and lack of standards, especially in cross-institutional shared care communication. HL7's clinical document architecture (CDA) is a new and promising tool to exchange any clinical document. In this paper we show how CDA can be used to (1) share electronic discharge letters and other clinical data generated and stored in the hospitals electronic patient record (EPR) with general practitioners and (2) to transfer these clinical data to a personal electronic health record (EHR). The latter scenario is in routine use. Ease-of-use and data security and integrity were the main design principles in both scenarios. Methods: Within the electronic patient record a data extraction and exporting mechanism has been built. For both scenarios appropriate data processing and transmission methods have been developed, and the receiving information systems have been prepared for the CDA based data input. Results: Although there still remain technical and organizational issues to be solved, this is a promising method in order to enhance data exchange between hospital and primary care and to move towards an electronic patient record (EPR) and an electronic health record (EHR) crossing institutional borders. This paper describes the design and current implementation and discusses our experiences.

2005

Information exchange, enabled by computable interoperability, is the key to many of the initiatives underway including the development of Regional Health Information Exchanges, Regional Health Information Organizations, and the National Health Information Network. These initiatives must include public health as a full partner in the emerging transformation of our nation's healthcare system through the adoption and use of information technology. An electronic health record - public health (EHR-PH)system prototype was developed to demonstrate the feasibility of electronic data transfer from a health care provider, i.e. hospital or ambulatory care settings, to multiple customized public health systems which include a Newborn Metabolic Screening Registry, a Newborn Hearing Screening Registry, an Immunization Registry and a Communicable Disease Registry, using HL7 messaging standards. Our EHR-PH system prototype can be considered a distributed EHR-based RHIE/RHIO model - a principal ...