Healthcare interfacing insights
What is your data integrity model?
Demand for healthcare interfaces is rising, and there is a rapid pace in which healthcare entities are working to connect various internal applications and external resources. In a hospital environment, connecting the Electronic Health Record (Electronic Health Record (EHR), as defined in Defining Key Health Information Technology Terms (The National Alliance for Health Information Technology, April 28, 2008): An electronic record of health-related information on an individual that conform... More) to the Radiology Information System (Radiology Information System (RIS) is the main application in an imaging center or radiology department. RIS is used by to store, manipulate and distribute patient radiological data and imagery. RIS are used for patient scheduling, tracking, and imag... More) to the Laboratory Information System (Laboratory Information System (LIS) is an information system that receives, processes, and stores information generated by a medical laboratory processes. LIS is often interfaced with HIS and EMR applications. Synonyms: Laboratory Information System) to the Hospital Information System (Hospital Information System (HIS) is the main system in a hospital used by most caregivers. Sends ADT broadcasts to all ancillary applications. The HIS is typically the patient administrative system and order entry system for a hospital. Synonyms: Ho... More) is one example of typical hospital workflow.
Today, healthcare interoperability initiatives are shifting more and more to external requirements. This shift is largely due to the passage of As a part of the America Recovery and Reinvestment Act (ARRA) of 2009, Health Information Technology for Economic and Clinical Health (HITECH) refers to the portion of the ARRA that is used to increase the use of Electronic Health Records (EHR) by ph... More and the implementation of Meaningful Use. More practically, many healthcare organizations were already connecting externally. An external laboratory may be delivering lab test results electronically to a hospital system or a physician’s Electronic Medical Record (Electronic Medical Record (EMR), as defined in Defining Key Health Information Technology Terms (The National Alliance for Health Information Technology, April 28, 2008): An electronic record of health-related information on an individual that can be... More) application is delivering patient information to a hospital system. In either scenario, there may be data integrity concerns as the data is no longer controlled entirely by the initiating hospital or other organization.
HL7 is a Standards Developing Organization accredited by the American National Standards Institute (ANSI) to author consensus-based standards representing a board view from healthcare system stakeholders. HL7 has compiled a collection of message form... More is the standard method to define the clinical messages sent between the applications and the institutions. Beyond clinical messages, other healthcare standards come into play including Continuity of Care Document or Record (Continuity of Care Document (CCD) The HL7 CCD is the result of a collaborative effort between the Health Level Seven and American Society for Testing Materials (ASTM) to “harmonize” the data format between ASTM’s Continuity of Care Record (CCR)... More or Continuity of Care Record (CCR) is an XML-based standard for the movement of “documents” between clinical applications. Furthermore, it responds to the need to organize and make transportable a set of basic information about a patient’s health ... More), X12 provides for electronic exchange of business transactions-electronic data interchange (EDI). The American National Standards Institute (ANSI) chartered the Accredited Standards Committee (ASC) X12 to develop uniform standards., The National Council for Prescription Drug Programs (NCPDP) creates and promotes the transfer of data related to medications, supplies, and services within the healthcare system through the development of standards and industry guidance. Visit the NC... More, and the list goes on. With the growing number of standards, interfaces, and connections to different healthcare entities, instilling solid data integrity practices throughout the process is critical.
Why is this critical? Without the right data integrity model, the confidence in the deployed interfaces will be low and the support costs will be high. Clinical data not received properly, or received in an untimely manner, will quickly erode the healthcare professionals’ outlook on future healthcare interfaces and raise concerns regarding the quality of the data being exchanged.
Clinical data integrity model
There are several aspects to ensuring a robust data integrity model, and one way to look at it is based on two dimensions—Interface Testing and Interface Monitoring. Interface Testing is the practice of ensuring that the interfaces being developed are of the highest quality prior to deployment. Interface Monitoring is the practice of ensuring that the interfaces continue to operate with a high degree of integrity after deployment. Together, these two practices ensure the highest integrity for the connected healthcare environment.
The image below explains the Clinical Data Integrity Model.
Depending on the quadrant that a healthcare institution may be in, different characteristics can be defined to the data integrity state. Ideally, the institution will want to be in the top right quadrant— High Performance—which means an equally proactive discipline to both Interface Testing and Interface Monitoring.
Why does being in the High Performance quadrant matter? The following five points summarize the importance of having implemented the right data integrity model:
- Clinical data sent to another healthcare application or entity is received as intended.
- Clinical data received from another healthcare application or entity is accepted as it is defined.
- Healthcare interfaces are fully tested and documented before being deployed.
- Interfaces are developed efficiently within requirements—the selected HL7 standard version and modifications included, as well as other healthcare standards such as CCD, CCR, Clinical Document Architecture (CDA) HL7 CDA uses XML for encoding of the documents and breaks down the document in generic, unnamed, and non-templated sections. Documents can include discharge summaries, progress notes, history and physical reports,... More, X12, NCPDP, and the list goes on.
- Messages are exchanged in a timely manner. Bottlenecks or potential problem areas are identified quickly and proactively repaired. Healthcare departments and external entities (e.g., clinics, imaging centers and laboratories) receive high performing customer service which boosts their confidence in the integrity of the data used.
There are many initiatives unfolding which are driving greater demand for healthcare integration from Meaningful Use to EMR connectivity to Health Information Exchange (Health Information Exchange (HIE) focuses on the mobilization of healthcare information electronically across organizations within a region or community. HIE provides the capability to electronically move clinical information between disparate health... More) participation. Being in the High Performance quadrant is no longer optional; it is a necessity in order to deliver on today’s demands.
About Corepoint Health
Corepoint Health solutions deliver interoperability for healthcare organizations and simplify the complexities of healthcare data through practical software applications, consulting and training. Our innovative and proven software solutions leverage clinical data flow efficiently for a diverse group of healthcare entities including hospitals, imaging centers, laboratories, clinics and healthcare vendors. This next generation approach to healthcare data and streamlined workflow is where Corepoint Health specializes in helping customers discover the power of integration.