Principles Of Health Interoperability

This book provides an introduction to health interoperability and the main standards used. Health interoperability delivers health information where and when it is needed. Everybody stands to gain from safer more soundly based decisions and less duplication, delays, waste and errors. The third edition of Principles of Health Interoperability includes a new part on FHIR (Fast Health Interoperability Resources), the most important new health interoperability standard for a generation. FHIR combines the best features of HL7’s v2, v3 and CDA while leveraging the latest web standards and a tight focus on implementability. FHIR can be implemented at a fraction of the price of existing alternatives and is well suited for use in mobile phone apps, cloud communications and EHRs. The book is organised into four parts. The first part covers the principles of health interoperability, why it matters, why it is hard and why models are an important part of the solution. The second part covers clinical terminology and SNOMED CT. The third part covers the main HL7 standards: v2, v3, CDA and IHE XDS. The new fourth part covers FHIR and has been contributed by Grahame Grieve, the original FHIR chief.

This book provides an introduction to health interoperability and the main standards used. Health interoperability delivers health information where and when it is needed. Everybody stands to gain from safer more soundly based decisions and less duplication, delays, waste and errors. The third edition of Principles of Health Interoperability includes a new part on FHIR (Fast Health Interoperability Resources), the most important new health interoperability standard for a generation. FHIR combines the best features of HL7’s v2, v3 and CDA while leveraging the latest web standards and a tight focus on implementability. FHIR can be implemented at a fraction of the price of existing alternatives and is well suited for use in mobile phone apps, cloud communications and EHRs. The book is organised into four parts. The first part covers the principles of health interoperability, why it matters, why it is hard and why models are an important part of the solution. The second part covers clinical terminology and SNOMED CT. The third part covers the main HL7 standards: v2, v3, CDA and IHE XDS. The new fourth part covers FHIR and has been contributed by Grahame Grieve, the original FHIR chief.

Joined-up healthcare makes information available when and where it is needed to improve safety, efficiency and effectiveness. Politicians may take interoperability between healthcare computer systems for granted, but it is non-trivial. Healthcare integration projects are notoriously under-estimated and come in over-budget and over-time. Joined-up healthcare depends on standards. The two leading standards are the SNOMED CT, which is a clinical terminology (semantics) and HL7 Version 3, which is a specialised healthcare interoperability language (syntax). Both are new, complex and fit for purpose. Tim Benson believes there is an unmet need for a book on Healthcare Integration. Some health informatics textbooks include chapters on HL7 and/or SNOMED, but these are usually quite short and cannot provide even an adequate introduction. There is little of much value on the Internet, or in journals or conference proceedings.

This book focuses on the development and use of interoperability standards related to healthcare information technology (HIT) and provides in-depth discussion of the associated essential aspects. The book explains the principles of conformance, examining how to improve the content of healthcare data exchange standards (including HL7 v2.x, V3/CDA, FHIR, CTS2, DICOM, EDIFACT, and ebXML), the rigor of conformance testing, and the interoperability capabilities of healthcare applications for the benefit of healthcare professionals who use HIT, developers of HIT applications, and healthcare consumers who aspire to be recipients of safe and effective health services facilitated through meaningful use of well-designed HIT. Readers will understand the common terms interoperability, conformance, compliance and compatibility, and be prepared to design and implement their own complex interoperable healthcare information system. Chapters address the practical aspects of the subject matter to enable application of previously theoretical concepts. The book provides real-world, concrete examples to explain how to apply the information, and includes many diagrams to illustrate relationships of entities and concepts described in the text. Designed for professionals and practitioners, this book is appropriate for implementers and developers of HIT, technical staff of information technology vendors participating in the development of standards and profiling initiatives, informatics professionals who design conformance testing tools, staff of information technology departments in healthcare institutions, and experts involved in standards development. Healthcare providers and leadership of provider organizations seeking a better understanding of conformance, interoperability, and IT certification processes will benefit from this book, as will students studying healthcare information technology.

This textbook begins with an introduction to the US healthcare delivery system, its many systemic challenges and the prior efforts to develop and deploy informatics tools to help overcome those problems. It goes on to discuss health informatics from an historical perspective, its current state and its likely future state now that electronic health record systems are widely deployed, the HL7 Fast Healthcare Interoperability standard is being rapidly accepted as the means to access the data stored in those systems and analytics is increasing being used to gain new knowledge from that aggregated clinical data. It then turns to some of the important and evolving areas of informatics including population and public health, mHealth and big data and analytics. Use cases and case studies are used in all of these discussions to help readers connect the technologies to real world challenges. Effective use of informatics systems and tools by providers and their patients is key to improving the quality, safety and cost of healthcare. With health records now digital, no effective means has existed for sharing them with patients, among the multiple providers who may care for them and for important secondary uses such as public/population health and research. This problem is a topic of congressional discussion and is addressed by the 21st Century Cures Act of 2016 that mandates that electronic health record (EHR) systems offer a patient-facing API. HL7’s Fast Healthcare Interoperability Resources (FHIR) is that API and this is the first comprehensive treatment of the technology and the many ways it is already being used. FHIR is based on web technologies and is thus a far more facile, easy to implement approach that is rapidly gaining acceptance. It is also the basis for a ‘universal health app platform’ that literally has the potential to foster innovation around the data in patient records similar to the app ecosystems smartphones created around the data they store. FHIR app stores have already been opened by Epic and Cerner, the two largest enterprise EHR vendors. Provider facing apps are already being explored to improve EHR usability and support personalized medicine. Medicare and the Veteran’s Administration have announced FHIR app platforms for their patients. Apple’s new IOS 11.3 features the ability for consumers to aggregate their health records on their iPhone using FHIR. Health insurance companies are exploring applications of FHIR to improve service and communication with their providers and patients. SureScripts, the national e-Prescribing network, is using FHIR to help doctors know if their patients are complying with prescriptions. This textbook is for introductory health informatics courses for computer science and health sciences students (e.g. doctors, nurses, PhDs), the current health informatics community, IT professionals interested in learning about the field and practicing healthcare providers. Though this textbook covers an important new technology, it is accessible to non-technical readers including healthcare providers, their patients or anyone interested in the use of healthcare data for improved care, public/population health or research.

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

Roadmap to Successful Digital Health Ecosystems: A Global Perspective presents evidence-based solutions found on adopting open platforms, standard information models, technology neutral data repositories, and computable clinical data and knowledge (ontologies, terminologies, content models, process models, and guidelines), resulting in improved patient, organizational, and global health outcomes. The book helps engaging countries and stakeholders take action and commit to a digital health strategy, create a global environment and processes that will facilitate and induce collaboration, develop processes for monitoring and evaluating national digital health strategies, and enable learnings to be shared in support of WHO’s global strategy for digital health. The book explains different perspectives and local environments for digital health implementation, including data/information and technology governance, secondary data use, need for effective data interpretation, costly adverse events, models of care, HR management, workforce planning, system connectivity, data sharing and linking, small and big data, change management, and future vision. All proposed solutions are based on real-world scientific, social, and political evidence. • Provides a roadmap, based on examples already in place, to develop and implement digital health systems on a large-scale that are easily reproducible in different environments • Addresses World Health Organization (WHO)-identified research gaps associated with the feasibility and effectiveness of various digital health interventions • Helps readers improve future decision-making within a digital environment by detailing insights into the complexities of the health system • Presents evidence from real-world case studies from multiple countries to discuss new skills that suit new paradigms

The aims and scope of the second edition are unchanged from the first edition. The major market is in health informatics education. The three part format, which covers principles of health interoperability, HL7 and interchange formats, and SNOMED CT and clinical terminology, works well. In the US, The ONC (Office of the National Coordinator for Health Information Technology) has estimated that the HITECH stimulus will create more than 50,000 new jobs for health informatics professionals, who need to be educated.