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EHRSystem Developing a Functional Model and Standard

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Title: EHRSystem Developing a Functional Model and Standard

1
EHRSystemDeveloping a Functional Model and
Standard

2
Outline

3
History

Health and Human Services (HHS) and CMS want to
pilot pay for performance
Provide financial incentives for better quality
care.
How to measure quality?
Focused on use of EHR System to
Accelerate rate of adoption of clinical systems
to achieve better quality at lower cost.
Support adoption of message and content standards
for secure and private transmission of medical
information.
Provide for consumer use of interconnected health
systems.

4
Charter

Call to Action HHS Secretary Tommy Thompson
Announcement _at_ NHII on 7/1/03
HHS has licensed SNOMED medical vocabulary and
made available for free to providers.
Enlisted Institute of Medicine and HL7 to develop
a functional model for a standardized electronic
health record.
http//www.hhs.gov/news/press/2003pres/20030701.ht
ml

5
HL7 and IOM Roles and Deliverables

CMS and Veterans Health Administration approached
HL7 and its EHR Special Interest Group (SIG) at
spring HL7 meeting.
Asked them to meet challenging goal of an ANSI
balloted EHR System (EHR-S) Functional Model and
Standard by January 2004.
HL7 EHR SIG directed to create EHR-S Functional
Model and Standard.
IOM directed to provide EHR-S Functional Needs
and Priority by Care Settings.

6
HL7 EHR System Functional Model and Standard

7
HL7 EHR-S Scope and Definition

Discovery uncovered definitions of EHR and EHR-S
from many standards groups including IOM, ISO,
ASTM and HIMSS.
Did not define the EHR but accepted the concept
of the EHR-S as a set of functions for primary
and secondary users.
Note that it is a System not just an EHR.
CMS wants advanced functions such as CPOE with
decision support not just access to a record in
electronic form.

8
HL7 EHR-S Framework
9
HL7 EHR-S Framework
10
HL7 EHR Functional Triplets

Function
Example drug-to-drug checking
Rationale for Use
Prevent adverse drug event through interaction.
Conformance Criteria
If a drug is ordered that interacts with
currently prescribed drug, system notifies user.

11
The HL7 EHR-S Functional Groupings

12
IOM Letter Report

13
The IOMs Definition of an EHR-S

Includes
longitudinal collection electronic health
information for and about persons, where health
information is defined as information pertaining
to the health of an individual or health care
provided to an individual
immediate electronic access to person- and
population-level information by authorized, and
only authorized, users
provision of knowledge and decision-support that
enhance the quality, safety, and efficiency of
patient care
support of efficient processes for health care
delivery.

14
Primary and Secondary Uses of an Electronic
Health Record System Adapted from Institute of
Medicine (1997)

15
IOMs Core Functionalities for an Electronic
Health Record System

16
IOM EHR Capabilities
High Level Abstraction
17
The HL7 Ballot Process

18
Status of the Draft Ballot

19
HIMSS Role

HIMSS has strongly supported a universal EHR and
applauds this effort
Submitted its Definitional Model June 2003
Funded HL7 EHR Standard effort (subject matter
experts)
Member of EHR Collaborative to promote industry
participation in EHR-S standardization process
Will draft a response to the Ballot by August 15
for comment by members

20
HIMSS Call to Action

Standards development is an inclusive process.
Standards rarely pass on first ballots, but
This is a major opportunity for the healthcare
and the HCIT industry.
We want to be part of the ongoing dialogue and
solution.
We also want to insure that whatever standard CMS
adopts has gone through a open consensus process.
Use HIMSS resources and participate!

21
Contacts