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EHR Standards
EHR STANDARD INITIATIVES
For more detailed information on standards (and other EHR related information) Register now!.
| EHR Initiative Driver |
Background on Agency |
Discussion or Explanation of Standard |
Registered Users Only |
| Institute of Medicine |
The nation turns to the Institute of Medicine (IOM) of the National Academies
for science-based advice on matters of biomedical science, medicine,
and health. A nonprofit organization specifically created for this purpose
as well as an honorific membership organization, the IOM was chartered in
1970 as a component of the National Academy of Sciences. The Institute provides a vital
service by working outside the framework of government to ensure scientifically
informed analysis and independent guidance. The IOM's mission is to serve
as adviser to the nation to improve health. The Institute provides unbiased,
evidence-based, and authoritative information and advice concerning health
and science policy to policy-makers, professionals, leaders in every sector
of society, and the public at large |
A committee of the Institute
of Medicine of the National Academies has identified a set of 8 core care
delivery functions that electronic health records (EHR) systems should
be capable of performing in order to promote greater safety, quality and
efficiency in health care delivery. Detailed in a new report, this
list of key capabilities will be used by Health Level Seven (HL7), one
of the world's leading developers of healthcare standards, to devise a
common industry standard for EHR functionality that will guide the efforts
of software developers.
The eight core functions are
- health information and data,
- result management,
- order management,
- decision support,
- electronic communication and connectivity,
- patient support,
- administrative processes and reporting,
- Reporting and population health.
The report was sponsored by
the U.S. Department of Health and Human Services and is one part of a
public and private collaborative effort to advance the adoption of EHR
systems. |
The Drive for an EHR Standard Picks Up Speed
Key Capabilities of an Electronic Health Record System: Letter Report
Patient Safety: Achieving a New Standard for Care |
| EHR
Collaborative |
The EHR Collaborative is a group
of organizations representing key stakeholders in healthcare, including
practicing clinicians, payers, purchasers, researchers, healthcare providers,
IT suppliers, information and technology managers, accrediting groups,
public health organizations, manufacturers, and public sector partners.
The goal of the EHR Collaborative is to facilitate rapid input from the
healthcare community in this and other development initiatives that advance
the adoption of information standards for healthcare.
The EHR Collaborative is made
up of the following organizations:
- American Health Information Management Association (AHIMA)
- American Medical Association (AMA)
- American Medical Informatics Association (AMIA)
- College of Healthcare Information Management Executives (CHIME)
- eHealth Initiative(eHI)
- Healthcare Information and Management Systems Society (HIMSS)
- National Alliance for Health Information Technology (NAHIT)
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The EHR Collaborative sponsored a series of open forum meetings across
the country since 2003. These forums served as an opportunity for people
to provide input into the development of a functional model and standards
for the electronic health record (EHR). While work on such standards had
a rich tradition and had been unfolding in an evolutionary sense, what is
now different is the level of support and encouragement for such standards
at the national level and by key federal agencies and the immediacy with
which this work is being urged forward.
The open forum meetings were designed
to gather feedback on the EHR model and standards being developed by HL7
before they were delivered to DHHS. Participant feedback was compiled
in a summary report for HL7 and DHHS. A copy of the report was also made
available for public review (see next column). |
Reports developed from the EHR collaborative forum meetings
Electronic Health Record Functional Descriptors |
| HL7 |
Health Level Seven is one of several American National Standards Institute
(ANSI) -accredited Standards Developing Organizations (SDOs) operating in
the healthcare arena. Headquartered in Ann Arbor, MI, Health Level Seven
is like most of the other SDOs in that it is a not-for-profit volunteer
organization. Its members-- providers, vendors, payers, consultants, government
groups and others who have an interest in the development and advancement
of clinical and administrative standards for healthcare—develop the standards.
Like all ANSI-accredited SDOs, Health Level Seven adheres to a strict and
well-defined set of operating procedures that ensures consensus, openness
and balance of interest. A frequent misconception about Health Level Seven
(and presumably about the other SDOs) is that it develops software. In reality,
Health Level Seven develops specifications, the most widely used being a
messaging standard that enables disparate healthcare applications to exchange
keys sets of clinical and administrative data. Members of Health Level Seven are
known collectively as the Working Group, which is organized into technical
committees and special interest groups. The technical committees are directly
responsible for the content of the Standards. Special interest groups
serve as a test bed for exploring new areas that may need coverage in
HL7's published standards. A list of the technical committees and special
interest groups as well as their missions, scopes and current leadership
is available on this web site. |
HL7 established an EHR special
interest group in 2001 to begin efforts focused on EHR Systems. The ability
to leverage and expand on the existing work of the HL7 EHR special interest
group made HL7 a logical choice to organize the accelerated EHR initiative
lead by the Center for Medicare and Medicaid Services (CMS).
The goal of the EHR Technical
Committee is to further the HL7 mission of designing standards to support
the exchange of information for clinical decisions and treatments, and
help lay the groundwork for nationwide interoperability by providing common
language parameters that can be used in developing systems that support
electronic records.
The HL7 EHR System Functional
Model provides a reference list of functions that may be present in an
Electronic Health Record System (EHR-S). The function list is described
from a user perspective with the intent to enable consistent expression
of system functionality. This EHR-S Model, through the creation of Functional
Profiles, enables a standardized description and common understanding
of functions sought or available in a given setting (e.g. intensive care,
cardiology, office practice in one country or primary care in another
country). This Draft Standard for Trial Use (DSTU) has received an unprecedented
amount of feedback from hundreds of reviewers from the standards community,
the provider community, the international community, and others. Continued
involvement during the DSTU period, which will help establish a milestone
for electronic health records systems, is to be reviewed the entire HL7
team.
The Clinical Context Object
Workgroup (CCOW) joined HL7 as the Special Interest Group on Visual Integration
(SIGVI) in September 1998 and was recently designated as the HL7 CCOW
Technical Committee. Since joining HL7, the group's work has been approved
as an American National Standard. HL7 has
more information on CCOW standards.
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HL7's EHR Technical Committee Enhances System Functional Model: New Public Comment to Open This Summer
Health Level Seven Supports EHR Interoperability Collaboration Process to Promote Industry-Proven Options
HL7's Electronic Health Record System Functional Model and Standard, Draft Standard for Trial Use |
| Continuity of Care Record (CCR) |
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The ASTM CCR standard is a patient health summary standard, a way to
create flexible documents that contain the most relevant and timely core
health information about a patient, and to send these electronically from
one care giver to another. It contains various sections -- such as
patient demographics, insurance information, diagnosis and problem list,
medications, allergies, care plan, etc. This article explains the details
of the CCR. |
Unofficial FAQ of the ASTM Continuity of Care Record (CCR) Standard |
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