Discover How Electronic Health Records Are Built to Drive the Next Generation of Healthcare Delivery
The increased role of IT in the healthcare sector has led to the coining of a new phrase "health informatics," which deals with the use of IT for better healthcare services. Health informatics applications often involve maintaining the health records of individuals, in digital form, which is referred to as an Electronic Health Record (EHR). Building and implementing an EHR infrastructure requires an understanding of healthcare standards, coding systems, and frameworks. This book provides an overview of different health informatics resources and artifacts that underlie the design and development of interoperable healthcare systems and applications.
Electronic Health Record: Standards, Coding Systems, Frameworks, and Infrastructures compiles, for the first time, study and analysis results that EHR professionals previously had to gather from multiple sources. It benefits readers by giving them an understanding of what roles a particular healthcare standard, code, or framework plays in EHR design and overall IT-enabled healthcare services along with the issues involved.
This book on Electronic Health Record:
* Offers the most comprehensive coverage of available EHR Standards including ISO, European Union Standards, and national initiatives by Sweden, the Netherlands, Canada, Australia, and many others
* Provides assessment of existing standards
* Includes a glossary of frequently used terms in the area of EHR
* Contains numerous diagrams and illustrations to facilitate comprehension
* Discusses security and reliability of data
Autorentext
PRADEEP K. SINHA, PhD, is the Senior Director (High
Performance Computing) at the Centre for Develop- ment of Advanced
Computing (C-DAC), India, and coordinator and mentor to several
high-technology R&D groups there.
GAUR SUNDER heads research and development at Medical
Informatics Group (MIG) at C-DAC, India, and is a member of the
eHealth Committee of the Bureau of Indian Standards and the
National EHR Standards Committee of the Union Health Ministry of
India.
PRASHANT BENDALE is involved in the research and
development of the distribution and integration model for building
EHR stores at C-DAC.
MANISHA D. MANTRI is involved in the research and
development of an evolving EHR model, compliance to eHealth
standards, and security policies for EHR systems at C-DAC.
ATREYA C. DANDE is involved in the research and
development of EHR standards, national EHR frameworks, distributed
technologies, and optimal search algorithms in healthcare at
C-DAC.
Inhalt
Preface XVII
Acronyms XXVII
PART ONE Introduction
1 Introduction to EHR 3
1.1 Introduction, 3
1.2 Definition of EHR, 4
1.3 Functions of EHR, 5
1.4 Significance of EHR, 6
1.5 Factors Affecting Implementation of EHR, 7
1.6 Role of Standards, 8
1.7 Role of Clinical Coding Systems, 9
1.8 Role of Standard Frameworks, 9
1.9 Case Studies of National EHR Implementations, 10
PART TWO EHR Standards
2 Standard for EHR Architecture Requirements 15
2.1 Introduction, 15
2.2 ISO/TS 18308 Requirement Specification, 16
2.2.1 Content Structure Model, 16
2.2.2 Inclusion of Clinical and Record Processes, 17
2.2.3 Content Exchange, 17
2.2.4 Privacy and Security, 17
2.2.5 Legal Considerations, 17
2.2.6 Ethical, Consumer/Cultural Aspects, 18
2.2.7 Future-proof Framework, 18
2.3 Discussion, 18
2.4 Conclusion, 20
3 Standard for Healthcare Concepts 23
3.1 Introduction, 23
3.2 CEN/TC EN 13940-1, 24
3.2.1 Actors in Continuity of Care, 24
3.2.2 Health Issues and Their Management, 25
3.2.3 Concepts Related to Responsibility, 25
3.2.4 Time-Related Concepts, 26
3.2.5 Concepts Related to Knowledge, Activities, and Decision Support, 27
3.2.6 Health Data Management, 28
3.3 CEN/TC prEN 13940-2, 28
3.3.1 Healthcare Process, 29
3.4 Discussion, 30
3.5 Conclusion, 32
4 Standard for EHR Functional Specifications 33
4.1 Introduction, 33
4.2 HL7 EHR-S Functional Model, 34
4.2.1 Functional Profiles, 34
4.2.2 Exchange, 36
4.2.3 Security/Privacy, 37
4.3 Comparison of HL7 EHR-S FM and ISO/TS 18308, 38
4.4 Discussion, 39
4.5 Conclusion, 40
5 Standard for EHR Communication 43
5.1 Introduction, 43
5.2 CEN/ISO EN 13606 Requirement Specification, 45
5.2.1 Part 1: Reference Model, 45
5.2.2 Part 2: Archetypes Interchange Specification, 46
5.2.3 Part 3: Reference Archetypes and Term Lists, 49
5.2.4 Part 4: Security, 49
5.2.5 Part 5: Exchange Models, 50
5.3 Discussion, 51
5.4 Conclusion, 53
6 Messaging Standard for Healthcare Data 57
6.1 Introduction, 57
6.2 HL7 v2.x, 58
6.2.1 Message Structure, 60
6.2.2 Auxiliary Messaging Protocols, 61
6.2.3 Usage Scenario, 62
6.2.4 Example of HL7 v2.x Message, 62
6.3 Discussion, 64
6.4 Conclusion, 67
7 Model-Based Messaging Standard for Healthcare Data 69
7.1 Introduction, 69
7.2 HL7 v3, 69
7.2.1 Message Structure, 70
7.2.2 Interaction Model, 74
7.2.3 Role-Based Access Control, 74
7.2.4 HL7 v3 and SNOMED CT, 75
7.2.5 HL7 v3 and Service-Oriented Architecture (SOA), 75
7.3 HL7 v2.x and v3 Comparison, 75
7.4 Discussion, 75
7.5 Conclusion, 77
8 Clinical Document Standards 81
8.1 Introduction, 81
8.2 Clinical Document Architecture (CDA), 82
8.2.1 Document Structures, 82
8.2.2 Example of CDA Component, 83
8.3 Continuity of Care Document (CCD), 85
8.3.1 Example of CCD Component, 86
8.4 Clinical Document Exchange, 87
8.5 Discussion, 87
8.6 Conclusion, 89
9 Standard for Medical Imaging and Communication 93
9.1 Introduction, 93
9.2 DICOM, 94
9.2.1 Information Model, 94
9.2.2 Message Exchange Model, 96
9.3 Improvements in DICOM Standard, 96
9.4 Discussion, 96
9.5 Conc...