Hi -
A few associates and myself are starting an EMR project (Electronic Medical Records). I have heard talk in the past - and more so lately - about a standard record format - to facilitate the transferring of records when appropriate (HIPAA) from one facility to another. Has anyone seen any information on this?
Much appreciated, Jim
You can look to HL7 for interoperability between systems (http://www.hl7.org/). Patient demographic information and textual notes can be passed. I've been out of the EMR space too long to know if any standards groups have done anything interesting of late. A standard format that maintains semantic meaning is a really, really difficult problem. See SnoMed (http://www.nlm.nih.gov/research/umls/Snomed/snomed_main.html) for one long-running ontology effort -- barely the start of a rich interchange format.
A word of warning from someone who spent several years with an upstart EMR vendor...This is a very hard business to be in. Sales cycles for large health systems literally can take years, and the amount of hand-holding required for smaller medical practices can quickly erode margins. Integration with existing practice management systems is non-standard, even if those vendors claim otherwise. More and more issues abound. I'm not sure that it's a wise space for an unfunded start-up to enter.
Have a look at the Continuity of Care Record--IIRC, that's what Google Health uses for input. It's not an HL7-family standard (there's a competing HL7-family standard--don't recall what it's called off-top).
I think it's an error to consider HL7 to be a standard in the sense you seem to mean. It is heavily customized and can be quite different from one customer to the next. It's one of those standards with too much flexibility.
I recommend you read the standard (which should take you a while), then try to find a community of developers working with the standard. Ask them for horror stories, and be prepared for what you'll hear.
This is a very hard problem because data collection starts with an MD and the only coding they know (ICD and CPT) is all about billing, not anything likely to be of use between providers (esp. in a form where the MD can be held legally liable). And they hate even that much paperwork.
Add to that the fact that HIPAA dictates that the patient not the provider owns the data. Not that they could understand it or do anything useful with it if they had it.
Good luck. Whatever happens will result from coercion by the govt and be a long long time coming IMHO.
Interestingly the one source of solid medical info turns out to be the VA (because they don't have the adversarial issues of payment and legal liability.) Go figure. That might be a good place to start for a standard with any existing data and some momentum, though. Here's another question with some info.
A month late, but...
The standard to shoot for is definitely HL7. It is used in many fields, so is highly customizable but there is a well defined standard for healthcare. Each message (ACK, DSR MCF), segment (PID, PV1, OBR, MSH, etc), sequence and event type (A08, A12, A36) has a specific meaning regardless of your system of choice.
We haven't had a problem interfacing MiSYS, Statlan, Oacis, Epic, MUSE, GE Centricity/Lastword and others sending DICOM, ADT, PACS information between the systems we have in use. Most of these systems will be set up with an interface engine to tweak messages where needed, so adding a way to filter HL7 messages as they come through to your system, and as they go out to the downstreams, would be a must.
Even if there would be a new "presidential standard" for interoperability, and I would hazard a guess that it will be HL7 anyway, I would build the system with HL7 messaging as this is currently the industry accepted standard.
its correct answer but i think some add about meaningful use of emr..... Officials Announce ‘Meaningful Use,’ EHR Certification Criteria Last week, CMS released proposed regulations defining the “meaningful use” of electronic health records, Reuters reports (Wutkowski/Heavey, Reuters, 12/31/09).
In addition, the Office of the National Coordinator for Health IT released an interim final rule describing the required certification standards for EHR technology (Simmons, HealthLeaders Media, 12/31/09).
Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHRs will qualify for incentive payments through Medicaid and Medicare.
Officials will offer a 60-day public comment period after both regulations are published in the Federal Register on Jan. 13. The interim final rule on EHR certification is scheduled to take effect 30 days after publication (Goedert, Health Data Management, 12/30/09). http://www.myemrstimulus.com/