Pradeep K. Sinha, Gaur Sunder, Prashant Bendale, Manisha Mantri, Atreya Dande
Electronic Health Record (eBook, PDF)
Standards, Coding Systems, Frameworks, and Infrastructures
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Pradeep K. Sinha, Gaur Sunder, Prashant Bendale, Manisha Mantri, Atreya Dande
Electronic Health Record (eBook, PDF)
Standards, Coding Systems, Frameworks, and Infrastructures
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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…mehr
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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
Produktdetails
- Produktdetails
- Verlag: John Wiley & Sons
- Seitenzahl: 376
- Erscheinungstermin: 4. Dezember 2012
- Englisch
- ISBN-13: 9781118479643
- Artikelnr.: 37340086
- Verlag: John Wiley & Sons
- Seitenzahl: 376
- Erscheinungstermin: 4. Dezember 2012
- Englisch
- ISBN-13: 9781118479643
- Artikelnr.: 37340086
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.
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 2.3 Discussion
18 2.4 Conclusion
20 3 Standard for Healthcare Concepts 23 3.1 Introduction
23 3.2 CEN/TC EN 13940-1
24 3.3 CEN/TC prEN 13940-2
28 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 4.3 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 5.3 Discussion
51 5.4 Conclusion
53 6 Messaging Standard for Healthcare Data 57 6.1 Introduction
57 6.2 HL7 v2.x
58 6.3 Discussion
64 6.4 Conclusion
67 7 Model-Based Messaging Standard for Healthcare Data 69 7.1 Introduction
69 7.2 HL7 v3
69 7.3 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 8.3 Continuity of Care Document (CCD)
85 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 9.3 Improvements in DICOM Standard
96 9.4 Discussion
96 9.5 Conclusion
100 10 Standard for Patient Health Summary 103 10.1 Introduction
103 10.2 Continuity of Care Record (CCR)
103 10.3 Discussion
107 10.4 Conclusion
108 PART THREE Coding Systems 11 Coding System for Classification of Diseases and Related Health Problems 113 11.1 Introduction
113 11.2 ICD
114 11.3 Improvements in ICD-10
114 11.4 Discussion
116 11.5 Conclusion
116 12 Coding System for Laboratory Tests and Observations 119 12.1 Introduction
119 12.2 LOINC
120 12.3 Discussion
122 12.4 Conclusion
123 13 Coding System for Patient Care Procedures 125 13.1 Introduction
125 13.2 CPT
126 13.3 Discussion
129 13.4 Conclusion
130 14 Extended Coding System for Patient Care Procedures 131 14.1 Introduction
131 14.2 HCPCS
132 14.3 Discussion
134 14.4 Conclusion
134 15 Comprehensive Coding System for Clinical Terms 137 15.1 Introduction
137 15.2 SNOMED CT
138 15.3 SNOMED CT Database Browsers
141 15.4 Discussion
141 15.5 Conclusion
142 16 Unified Medical Language System 145 16.1 Introduction
145 16.2 UMLS-Supported Coding Systems
146 16.3 UMLS Architecture
146 16.4 UMLS Licensing
150 16.5 Discussion
150 16.6 Conclusion
151 17 Other Coding Systems 153 17.1 Introduction
153 17.2 AHFS Drug Information (AHFS DI)
154 17.3 Current Dental Terminology (CDT)
154 17.4 International Classification of Diseases for Oncology (ICD-O)
155 17.5 International Classification of Functioning
Disability and Health (ICF)
155 17.6 Coding Systems for Nursing Practices
156 17.7 Radiology Lexicon (RADLEX)
157 17.8 RxNorm
157 17.9 Discussion
157 17.10 Conclusion
158 PART FOUR Standard Frameworks 18 openEHR 163 18.1 Introduction
163 18.2 openEHR Process Model
164 18.3 openEHR Architecture
166 18.4 Discussion
170 18.5 Conclusion
172 19 Integrating the Healthcare Enterprise (IHE) 175 19.1 Introduction
175 19.2 IHE Domains
176 19.3 IHE Initiatives on Electronic Health Record
180 19.4 Exchange
180 19.5 Security
181 19.6 Discussion
182 19.7 Conclusion
183 PART FIVE Case Studies: National EHR Efforts 20 Australia's HealthConnect 189 20.1 Introduction
189 20.2 Overview
190 20.3 Architecture
190 20.4 Discussion
195 20.5 Conclusion
196 21 Austria's ELGA 199 21.1 Introduction
199 21.2 Overview
200 21.3 Architecture
200 21.4 Functional Implementation
203 21.5 Exchange
205 21.6 Discussion
205 21.7 Conclusion
207 22 Canada's EHRS Blueprint 211 22.1 Introduction
211 22.2 Overview
211 22.3 Architecture
212 22.4 Discussion
217 22.5 Conclusion
219 Bibliography
219 23 Denmark's MedCom 221 23.1 Introduction
221 23.2 Overview
221 23.3 Architecture
222 23.4 Discussion
225 23.5 Conclusion
226 24 Hong Kong's eHR Sharing System 229 24.1 Introduction
229 24.2 Overview
229 24.3 Architecture
230 24.4 Discussion
234 24.5 Conclusion
235 25 India's Health IT Initiatives 239 25.1 Introduction
239 25.2 Overview
240 25.3 ITIH Framework
240 25.4 Recommendations on Guidelines
Standards
and Practices for Telemedicine in India
242 25.5 iHIND
244 25.6 Other Initiatives
247 25.7 Discussion
249 25.8 Conclusion
251 26 Netherlands' AORTA 253 26.1 Introduction
253 26.2 Overview
253 26.3 Architecture
254 26.4 Discussion
256 26.5 Conclusion
257 27 Singapore's NEHR 259 27.1 Introduction
259 27.2 Overview
259 27.3 Architecture
260 27.4 Discussion
263 27.5 Conclusion
264 28 Sweden's NPO 267 28.1 Introduction
267 28.2 Overview
268 28.3 Architecture
269 28.4 Discussion
273 28.5 Conclusion
274 29 Taiwan's Health Information Network 277 29.1 Introduction
277 29.2 Overview
278 29.3 Architecture
278 29.4 Exchange
280 29.5 Discussion
282 29.6 Conclusion
284 30 United Kingdom's Spine 287 30.1 Introduction
287 30.2 Overview
287 30.3 Architecture
288 30.4 Discussion
292 30.5 Conclusion
294 31 USA's EHR Meaningful Use 295 31.1 Introduction
295 31.2 Overview
296 31.3 EHR Meaningful Use
296 31.4 National Health Information Network (NHIN)
301 31.5 Discussion
304 31.6 Conclusion
307 PART SIX Findings and Conclusion 32 Findings and Conclusion 313 32.1 EHR Standards
313 32.2 Coding Systems
317 32.3 Standard Frameworks
318 32.4 Case Studies: National EHR Efforts
319 32.5 Recommended Phases for Implementing A National EHR System
325 Glossary 327 Index 339
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 2.3 Discussion
18 2.4 Conclusion
20 3 Standard for Healthcare Concepts 23 3.1 Introduction
23 3.2 CEN/TC EN 13940-1
24 3.3 CEN/TC prEN 13940-2
28 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 4.3 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 5.3 Discussion
51 5.4 Conclusion
53 6 Messaging Standard for Healthcare Data 57 6.1 Introduction
57 6.2 HL7 v2.x
58 6.3 Discussion
64 6.4 Conclusion
67 7 Model-Based Messaging Standard for Healthcare Data 69 7.1 Introduction
69 7.2 HL7 v3
69 7.3 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 8.3 Continuity of Care Document (CCD)
85 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 9.3 Improvements in DICOM Standard
96 9.4 Discussion
96 9.5 Conclusion
100 10 Standard for Patient Health Summary 103 10.1 Introduction
103 10.2 Continuity of Care Record (CCR)
103 10.3 Discussion
107 10.4 Conclusion
108 PART THREE Coding Systems 11 Coding System for Classification of Diseases and Related Health Problems 113 11.1 Introduction
113 11.2 ICD
114 11.3 Improvements in ICD-10
114 11.4 Discussion
116 11.5 Conclusion
116 12 Coding System for Laboratory Tests and Observations 119 12.1 Introduction
119 12.2 LOINC
120 12.3 Discussion
122 12.4 Conclusion
123 13 Coding System for Patient Care Procedures 125 13.1 Introduction
125 13.2 CPT
126 13.3 Discussion
129 13.4 Conclusion
130 14 Extended Coding System for Patient Care Procedures 131 14.1 Introduction
131 14.2 HCPCS
132 14.3 Discussion
134 14.4 Conclusion
134 15 Comprehensive Coding System for Clinical Terms 137 15.1 Introduction
137 15.2 SNOMED CT
138 15.3 SNOMED CT Database Browsers
141 15.4 Discussion
141 15.5 Conclusion
142 16 Unified Medical Language System 145 16.1 Introduction
145 16.2 UMLS-Supported Coding Systems
146 16.3 UMLS Architecture
146 16.4 UMLS Licensing
150 16.5 Discussion
150 16.6 Conclusion
151 17 Other Coding Systems 153 17.1 Introduction
153 17.2 AHFS Drug Information (AHFS DI)
154 17.3 Current Dental Terminology (CDT)
154 17.4 International Classification of Diseases for Oncology (ICD-O)
155 17.5 International Classification of Functioning
Disability and Health (ICF)
155 17.6 Coding Systems for Nursing Practices
156 17.7 Radiology Lexicon (RADLEX)
157 17.8 RxNorm
157 17.9 Discussion
157 17.10 Conclusion
158 PART FOUR Standard Frameworks 18 openEHR 163 18.1 Introduction
163 18.2 openEHR Process Model
164 18.3 openEHR Architecture
166 18.4 Discussion
170 18.5 Conclusion
172 19 Integrating the Healthcare Enterprise (IHE) 175 19.1 Introduction
175 19.2 IHE Domains
176 19.3 IHE Initiatives on Electronic Health Record
180 19.4 Exchange
180 19.5 Security
181 19.6 Discussion
182 19.7 Conclusion
183 PART FIVE Case Studies: National EHR Efforts 20 Australia's HealthConnect 189 20.1 Introduction
189 20.2 Overview
190 20.3 Architecture
190 20.4 Discussion
195 20.5 Conclusion
196 21 Austria's ELGA 199 21.1 Introduction
199 21.2 Overview
200 21.3 Architecture
200 21.4 Functional Implementation
203 21.5 Exchange
205 21.6 Discussion
205 21.7 Conclusion
207 22 Canada's EHRS Blueprint 211 22.1 Introduction
211 22.2 Overview
211 22.3 Architecture
212 22.4 Discussion
217 22.5 Conclusion
219 Bibliography
219 23 Denmark's MedCom 221 23.1 Introduction
221 23.2 Overview
221 23.3 Architecture
222 23.4 Discussion
225 23.5 Conclusion
226 24 Hong Kong's eHR Sharing System 229 24.1 Introduction
229 24.2 Overview
229 24.3 Architecture
230 24.4 Discussion
234 24.5 Conclusion
235 25 India's Health IT Initiatives 239 25.1 Introduction
239 25.2 Overview
240 25.3 ITIH Framework
240 25.4 Recommendations on Guidelines
Standards
and Practices for Telemedicine in India
242 25.5 iHIND
244 25.6 Other Initiatives
247 25.7 Discussion
249 25.8 Conclusion
251 26 Netherlands' AORTA 253 26.1 Introduction
253 26.2 Overview
253 26.3 Architecture
254 26.4 Discussion
256 26.5 Conclusion
257 27 Singapore's NEHR 259 27.1 Introduction
259 27.2 Overview
259 27.3 Architecture
260 27.4 Discussion
263 27.5 Conclusion
264 28 Sweden's NPO 267 28.1 Introduction
267 28.2 Overview
268 28.3 Architecture
269 28.4 Discussion
273 28.5 Conclusion
274 29 Taiwan's Health Information Network 277 29.1 Introduction
277 29.2 Overview
278 29.3 Architecture
278 29.4 Exchange
280 29.5 Discussion
282 29.6 Conclusion
284 30 United Kingdom's Spine 287 30.1 Introduction
287 30.2 Overview
287 30.3 Architecture
288 30.4 Discussion
292 30.5 Conclusion
294 31 USA's EHR Meaningful Use 295 31.1 Introduction
295 31.2 Overview
296 31.3 EHR Meaningful Use
296 31.4 National Health Information Network (NHIN)
301 31.5 Discussion
304 31.6 Conclusion
307 PART SIX Findings and Conclusion 32 Findings and Conclusion 313 32.1 EHR Standards
313 32.2 Coding Systems
317 32.3 Standard Frameworks
318 32.4 Case Studies: National EHR Efforts
319 32.5 Recommended Phases for Implementing A National EHR System
325 Glossary 327 Index 339
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 2.3 Discussion
18 2.4 Conclusion
20 3 Standard for Healthcare Concepts 23 3.1 Introduction
23 3.2 CEN/TC EN 13940-1
24 3.3 CEN/TC prEN 13940-2
28 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 4.3 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 5.3 Discussion
51 5.4 Conclusion
53 6 Messaging Standard for Healthcare Data 57 6.1 Introduction
57 6.2 HL7 v2.x
58 6.3 Discussion
64 6.4 Conclusion
67 7 Model-Based Messaging Standard for Healthcare Data 69 7.1 Introduction
69 7.2 HL7 v3
69 7.3 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 8.3 Continuity of Care Document (CCD)
85 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 9.3 Improvements in DICOM Standard
96 9.4 Discussion
96 9.5 Conclusion
100 10 Standard for Patient Health Summary 103 10.1 Introduction
103 10.2 Continuity of Care Record (CCR)
103 10.3 Discussion
107 10.4 Conclusion
108 PART THREE Coding Systems 11 Coding System for Classification of Diseases and Related Health Problems 113 11.1 Introduction
113 11.2 ICD
114 11.3 Improvements in ICD-10
114 11.4 Discussion
116 11.5 Conclusion
116 12 Coding System for Laboratory Tests and Observations 119 12.1 Introduction
119 12.2 LOINC
120 12.3 Discussion
122 12.4 Conclusion
123 13 Coding System for Patient Care Procedures 125 13.1 Introduction
125 13.2 CPT
126 13.3 Discussion
129 13.4 Conclusion
130 14 Extended Coding System for Patient Care Procedures 131 14.1 Introduction
131 14.2 HCPCS
132 14.3 Discussion
134 14.4 Conclusion
134 15 Comprehensive Coding System for Clinical Terms 137 15.1 Introduction
137 15.2 SNOMED CT
138 15.3 SNOMED CT Database Browsers
141 15.4 Discussion
141 15.5 Conclusion
142 16 Unified Medical Language System 145 16.1 Introduction
145 16.2 UMLS-Supported Coding Systems
146 16.3 UMLS Architecture
146 16.4 UMLS Licensing
150 16.5 Discussion
150 16.6 Conclusion
151 17 Other Coding Systems 153 17.1 Introduction
153 17.2 AHFS Drug Information (AHFS DI)
154 17.3 Current Dental Terminology (CDT)
154 17.4 International Classification of Diseases for Oncology (ICD-O)
155 17.5 International Classification of Functioning
Disability and Health (ICF)
155 17.6 Coding Systems for Nursing Practices
156 17.7 Radiology Lexicon (RADLEX)
157 17.8 RxNorm
157 17.9 Discussion
157 17.10 Conclusion
158 PART FOUR Standard Frameworks 18 openEHR 163 18.1 Introduction
163 18.2 openEHR Process Model
164 18.3 openEHR Architecture
166 18.4 Discussion
170 18.5 Conclusion
172 19 Integrating the Healthcare Enterprise (IHE) 175 19.1 Introduction
175 19.2 IHE Domains
176 19.3 IHE Initiatives on Electronic Health Record
180 19.4 Exchange
180 19.5 Security
181 19.6 Discussion
182 19.7 Conclusion
183 PART FIVE Case Studies: National EHR Efforts 20 Australia's HealthConnect 189 20.1 Introduction
189 20.2 Overview
190 20.3 Architecture
190 20.4 Discussion
195 20.5 Conclusion
196 21 Austria's ELGA 199 21.1 Introduction
199 21.2 Overview
200 21.3 Architecture
200 21.4 Functional Implementation
203 21.5 Exchange
205 21.6 Discussion
205 21.7 Conclusion
207 22 Canada's EHRS Blueprint 211 22.1 Introduction
211 22.2 Overview
211 22.3 Architecture
212 22.4 Discussion
217 22.5 Conclusion
219 Bibliography
219 23 Denmark's MedCom 221 23.1 Introduction
221 23.2 Overview
221 23.3 Architecture
222 23.4 Discussion
225 23.5 Conclusion
226 24 Hong Kong's eHR Sharing System 229 24.1 Introduction
229 24.2 Overview
229 24.3 Architecture
230 24.4 Discussion
234 24.5 Conclusion
235 25 India's Health IT Initiatives 239 25.1 Introduction
239 25.2 Overview
240 25.3 ITIH Framework
240 25.4 Recommendations on Guidelines
Standards
and Practices for Telemedicine in India
242 25.5 iHIND
244 25.6 Other Initiatives
247 25.7 Discussion
249 25.8 Conclusion
251 26 Netherlands' AORTA 253 26.1 Introduction
253 26.2 Overview
253 26.3 Architecture
254 26.4 Discussion
256 26.5 Conclusion
257 27 Singapore's NEHR 259 27.1 Introduction
259 27.2 Overview
259 27.3 Architecture
260 27.4 Discussion
263 27.5 Conclusion
264 28 Sweden's NPO 267 28.1 Introduction
267 28.2 Overview
268 28.3 Architecture
269 28.4 Discussion
273 28.5 Conclusion
274 29 Taiwan's Health Information Network 277 29.1 Introduction
277 29.2 Overview
278 29.3 Architecture
278 29.4 Exchange
280 29.5 Discussion
282 29.6 Conclusion
284 30 United Kingdom's Spine 287 30.1 Introduction
287 30.2 Overview
287 30.3 Architecture
288 30.4 Discussion
292 30.5 Conclusion
294 31 USA's EHR Meaningful Use 295 31.1 Introduction
295 31.2 Overview
296 31.3 EHR Meaningful Use
296 31.4 National Health Information Network (NHIN)
301 31.5 Discussion
304 31.6 Conclusion
307 PART SIX Findings and Conclusion 32 Findings and Conclusion 313 32.1 EHR Standards
313 32.2 Coding Systems
317 32.3 Standard Frameworks
318 32.4 Case Studies: National EHR Efforts
319 32.5 Recommended Phases for Implementing A National EHR System
325 Glossary 327 Index 339
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 2.3 Discussion
18 2.4 Conclusion
20 3 Standard for Healthcare Concepts 23 3.1 Introduction
23 3.2 CEN/TC EN 13940-1
24 3.3 CEN/TC prEN 13940-2
28 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 4.3 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 5.3 Discussion
51 5.4 Conclusion
53 6 Messaging Standard for Healthcare Data 57 6.1 Introduction
57 6.2 HL7 v2.x
58 6.3 Discussion
64 6.4 Conclusion
67 7 Model-Based Messaging Standard for Healthcare Data 69 7.1 Introduction
69 7.2 HL7 v3
69 7.3 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 8.3 Continuity of Care Document (CCD)
85 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 9.3 Improvements in DICOM Standard
96 9.4 Discussion
96 9.5 Conclusion
100 10 Standard for Patient Health Summary 103 10.1 Introduction
103 10.2 Continuity of Care Record (CCR)
103 10.3 Discussion
107 10.4 Conclusion
108 PART THREE Coding Systems 11 Coding System for Classification of Diseases and Related Health Problems 113 11.1 Introduction
113 11.2 ICD
114 11.3 Improvements in ICD-10
114 11.4 Discussion
116 11.5 Conclusion
116 12 Coding System for Laboratory Tests and Observations 119 12.1 Introduction
119 12.2 LOINC
120 12.3 Discussion
122 12.4 Conclusion
123 13 Coding System for Patient Care Procedures 125 13.1 Introduction
125 13.2 CPT
126 13.3 Discussion
129 13.4 Conclusion
130 14 Extended Coding System for Patient Care Procedures 131 14.1 Introduction
131 14.2 HCPCS
132 14.3 Discussion
134 14.4 Conclusion
134 15 Comprehensive Coding System for Clinical Terms 137 15.1 Introduction
137 15.2 SNOMED CT
138 15.3 SNOMED CT Database Browsers
141 15.4 Discussion
141 15.5 Conclusion
142 16 Unified Medical Language System 145 16.1 Introduction
145 16.2 UMLS-Supported Coding Systems
146 16.3 UMLS Architecture
146 16.4 UMLS Licensing
150 16.5 Discussion
150 16.6 Conclusion
151 17 Other Coding Systems 153 17.1 Introduction
153 17.2 AHFS Drug Information (AHFS DI)
154 17.3 Current Dental Terminology (CDT)
154 17.4 International Classification of Diseases for Oncology (ICD-O)
155 17.5 International Classification of Functioning
Disability and Health (ICF)
155 17.6 Coding Systems for Nursing Practices
156 17.7 Radiology Lexicon (RADLEX)
157 17.8 RxNorm
157 17.9 Discussion
157 17.10 Conclusion
158 PART FOUR Standard Frameworks 18 openEHR 163 18.1 Introduction
163 18.2 openEHR Process Model
164 18.3 openEHR Architecture
166 18.4 Discussion
170 18.5 Conclusion
172 19 Integrating the Healthcare Enterprise (IHE) 175 19.1 Introduction
175 19.2 IHE Domains
176 19.3 IHE Initiatives on Electronic Health Record
180 19.4 Exchange
180 19.5 Security
181 19.6 Discussion
182 19.7 Conclusion
183 PART FIVE Case Studies: National EHR Efforts 20 Australia's HealthConnect 189 20.1 Introduction
189 20.2 Overview
190 20.3 Architecture
190 20.4 Discussion
195 20.5 Conclusion
196 21 Austria's ELGA 199 21.1 Introduction
199 21.2 Overview
200 21.3 Architecture
200 21.4 Functional Implementation
203 21.5 Exchange
205 21.6 Discussion
205 21.7 Conclusion
207 22 Canada's EHRS Blueprint 211 22.1 Introduction
211 22.2 Overview
211 22.3 Architecture
212 22.4 Discussion
217 22.5 Conclusion
219 Bibliography
219 23 Denmark's MedCom 221 23.1 Introduction
221 23.2 Overview
221 23.3 Architecture
222 23.4 Discussion
225 23.5 Conclusion
226 24 Hong Kong's eHR Sharing System 229 24.1 Introduction
229 24.2 Overview
229 24.3 Architecture
230 24.4 Discussion
234 24.5 Conclusion
235 25 India's Health IT Initiatives 239 25.1 Introduction
239 25.2 Overview
240 25.3 ITIH Framework
240 25.4 Recommendations on Guidelines
Standards
and Practices for Telemedicine in India
242 25.5 iHIND
244 25.6 Other Initiatives
247 25.7 Discussion
249 25.8 Conclusion
251 26 Netherlands' AORTA 253 26.1 Introduction
253 26.2 Overview
253 26.3 Architecture
254 26.4 Discussion
256 26.5 Conclusion
257 27 Singapore's NEHR 259 27.1 Introduction
259 27.2 Overview
259 27.3 Architecture
260 27.4 Discussion
263 27.5 Conclusion
264 28 Sweden's NPO 267 28.1 Introduction
267 28.2 Overview
268 28.3 Architecture
269 28.4 Discussion
273 28.5 Conclusion
274 29 Taiwan's Health Information Network 277 29.1 Introduction
277 29.2 Overview
278 29.3 Architecture
278 29.4 Exchange
280 29.5 Discussion
282 29.6 Conclusion
284 30 United Kingdom's Spine 287 30.1 Introduction
287 30.2 Overview
287 30.3 Architecture
288 30.4 Discussion
292 30.5 Conclusion
294 31 USA's EHR Meaningful Use 295 31.1 Introduction
295 31.2 Overview
296 31.3 EHR Meaningful Use
296 31.4 National Health Information Network (NHIN)
301 31.5 Discussion
304 31.6 Conclusion
307 PART SIX Findings and Conclusion 32 Findings and Conclusion 313 32.1 EHR Standards
313 32.2 Coding Systems
317 32.3 Standard Frameworks
318 32.4 Case Studies: National EHR Efforts
319 32.5 Recommended Phases for Implementing A National EHR System
325 Glossary 327 Index 339