|
It is the ability of software and hardware on different machines from different vendors to share data.
From an electronic health records standpoint interoperability is the ability to exchange clinical patient data between providers and systems to achieve continuity of care, and to be able to USE the data once it has been exchanged.
In order to illustrate how emr interoperability varies from product to product, we will use the Levels of Interoperability that are classified in "The Value of Health Care Information Exchange and Interoperability", as seen in Healthcare Affairs, January 19, 2005.
4 Levels of Interoperability in EHR Systems
Level 1 Interoperability is 'Nonelectronic data'. There is no use of IT to share information (examples: mail, telephone). This is the equivalence of paper based charts.
Level 2 Interoperable EMR systems typically capture data through image capture, e.g. fax and scanner. Users are limited to search only by a file name or manually catalogued data. Users are unable to search for the data within the image file. An image based system is the least practical solution.
Level 3 Interoperable EMR systems typically capture clinical data through voice dictation, handwriting recognition or word based templates. Data is captured as text. Without the addition of codification there is no way to aggregate or filter the data that results from multiple encounters over time. Adding codification to this type of EHR permits users and stakeholders to manage data within a community however it inhibits integration of that data nationally because of higher start up and operation costs. Examples of this type of system include free text, emails, or PC based exchange of incompatible data formats.
Level 4 Interoperable EMR systems are the future of interoperability for a national healthcare system. Clinical data is available for calculations and aggregation; for example, automatic calculation of E&M codes. Codified systems have the capability to dramatically increase revenues by ascertaining complexity of medical decision making based on the documentation thus ensuring proper coding. Disease management is enhanced through the aggregation and reporting of quality of care indicators over time. Codified EHRs provide for additional revenue opportunities in respect of clinical trials, and allow for advanced access to patient charts and the ability for patient chart exchange, data sharing and clinical data repositories.
What does this mean to the healthcare system?
If you look at major industries - such as banking, automotive, retail - they all adopted appropriate codification systems to achieve maximum efficiency in supply management and information exchange. However, the healthcare industry's adoption of a codification system was very slow and fragmented. We had several reference terminologies that emerged - but served mostly a single isolated process. Examples of that are the CPT codes that are used for billing, the ICD-9 codes for diagnosis, the SNOMED codes for research, and the NDC codes for the exchange of drug information. However, none of these terminologies helped in streamlining the direct process of healthcare delivery and clinical management of patients and conditions. Eventually, point-of-care vocabularies were available. A point-of-care terminology is designed for the purpose of capturing clinical information at the point of care. It typically consists of data elements that have a relevant clinical meaning in relation to one or many medical conditions. For example, chest pain, as opposed to chest alone or pain alone, forms a data element in a point of care terminology because chest alone does not have a clinical meaning and pain alone does not have a clinical meaning. But, both of them combined have a clinical meaning.
Record captures numerically codified data using MEDCIN, a numerically codified Point of Care Terminology. This has opened the door for Interoperability. MEDCIN is dramatically different than reference terminologies like ICD, CPT, LOINC, and SNOMED that must capture information in discrete data elements. MEDCIN captures clinical concepts. It presents extremely fine granularity of clinical data in a numerically codified fashion, allowing the creation of homogeneous health records. It imparts the relevant clinical information based on a patient's condition and is being mapped to all the reference terminologies. Fully structured and numerically codified patient charts enable the aggregation, analysis and extensive mining of all clinical and practice management data related to a patient, a disease, or a population.
Record facilitates clinical decision support, disease management, data mining, data warehousing and Level 4 Interoperability between different healthcare providers. In addition, it is capable of automatically populating unmanned Clinical Data Repositories with specific clinical data or the entire chart to meet requirements for health maintenance, disease surveillance and quality of care improvement.
Systems like Record that offer Level 4 Interoperability are the key to achieving the benefits of a national healthcare information system and preventing higher costs or further fragmentation. The data standard used by the Department of Defense is MEDCIN, the nomenclature on which Record is built. National Health Information Technology Coordinator Dr. David Brailer's office also is monitoring the DOD system to see how it can be used in the private sector, American Medical News reports. "Brailer is especially interested in the data standards that enable military facilities with different equipment to access shared patient information." Source: www.ihealthbeat.org.
MedcomSoft Record is the first EMR application in the world that produces complete longitudinal patient health records; whereby all the information, including doctor notes, laboratory results, and drug prescription data, are all automatically codified with a single terminology, therefore providing an excellent foundation for the exchange of detailed clinical information between different systems. Providers and sponsors can best protect and secure their IT investment today, by adopting a system like Record that is built around a point of care terminology, offering TRUE Interoperability.
|
