HL7–The Common Denominator for Health Information Exchange and Electronic Health Records.

 

By no means am I a  computer scientist or engineer. I cannot even code.

Earlier today I had the fortuitous privilege of meeting Professor William Hammond, PhD at Duke University.

Professor Drummond began his career in electrical engineering and computer science.  He then found an intense interest in medicine and what computer science would do for clinicians. He immersed himself in working along with and behind practicing clinicians at Duke University School of Medicine. He is an original thinker in ‘translational computer science” as it relates to clinical medicine.  He is fluent in  acronyms in computer science and health care

Because of his early profound understanding what physicians want and need in information technology we now have HL-7. HL-7 (Health Level Seven)  as many know it began early in the development of electronic records, long before what we now call EMR.

             

Health Level Seven (HL7), is a non-profit organization involved in the development of international healthcare informatics interoperability standards.^[1] "HL7" also refers to some of the specific standards created by the organization (e.g., HL7 v2.x, v3.0, HL7 RIM).^[2]

HL7 and its members provide a framework (and related standards) for the exchange, integration, sharing, and retrieval of electronic health information. The 2.x versions of the standards, which support clinical practice and the management, delivery, and evaluation of health services, are the most commonly used in the world.^[3]

As a result of his pioneering work we now have many Certified EMR Vendors.and Regional Health Information Exchanges much of what is based upon the HL-7 Standards

HL-7 Newsletter

Why Health Level Seven is essential. Please feel free to listen to the presentation and attempt to answer the brief quiz.

 

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How a Physician’s Smartphone Camera might save Lives | Mobihealthnews

 

As mobile technology develops, and wireless cell phone data rates increase the use of a smartphone camera with adequate resolution can become a useful source of information which requires no additional, nor specialized services to be utilized in a medical situation.

For instance the use of an electrocardiogram  for remote monitoring would ordinarily require a specialized EKG machine and a specialized data link.

 

A team of doctors at the University of Virginia medical center has developed an app to more easily, quickly, and efficiently transmit electrocardiogram tracings from heart attack patients to doctors, enabling doctors to diagnose a particular kind of heart attack that can benefit from immediate treatment.

Most of the existing commercial systems, where the EKG hooks up to a modem to send readings to a hospital computer, are expensive and time consuming.

On the other hand, just snapping a photo with a mobile phone’s camera is not always high enough quality to be helpful, and can also take a long time.

STEMISend uses the phone camera but compresses the file size as much as possible while still maintaining a diagnostic-quality image. The development of 4G and LTE on the cell phone network may obviate compressing the images. 4G and LTE adequately carry video and imaging with HD resolution. (720p or 1080p.

   Faster than my home desktop on wifi

They tested the app more than 1,500 times via Sprint, AT&T and Verizon Wireless networks, with three or more bars of cellular service. Burt and his team have been doing preliminary field testing on the app, taking pictures at various locations near UVA’s campus where heart attacks often occur, like local grocery stores.

The system can remain HIPAA compliant even though the pictures are sent through unsecure cellular networks in the same way that radio conversations with emergency response workers comply with HIPAA: by eliminating patient identifiers. The EKG images are sent without images or names of the patients.

Burt says the goal is to make this remain a low-cost option for hospitals that can’t afford to invest in expensive commercial systems:

mHealth, Telehealth and the Digital society: Where does the ‘value’ lie?

 

Medical economics and the market dynamics, competition, new emerging technology, cost containment, improving outcomes and increased government oversight are driving transformation in the delivery of healthcare.

At the same time strides are taking place in genomics, proteomics, personalized medicine in the form of DNA analysis and scientific analysis of the coming wave of big data and analytics.

 

from Health Informatics New Zealand

 

Billions of dollars are entering (or perhaps leaving) the health system with the capitalization and investment of health information systems including electronic medical records, health information exchange, mobile health applications, remote monitoring and telehealth.

The net yield is still to be accurately determined. Most payors are not reimbursing for these additional services despite the very real commitment by some institutions, small and large. If payors expect providers to provide these HIT features without additonal financial support via the current reimbursement system further growth will be throttled back..

 

There are many uses for mobile health communications.  These range from medical education, remote monitoring.

MHealth can be integrated into normal routine daily activities, it can be there at the right times, personalized, interactive,ongoing and provide social support.  In fact there are many community advocacy and support groups available from social media sites such as Google + Facebook and other focused applications.

 

Mobile health: clinical aspects from Health Informatics New Zealand

The informatics and information technology enterprises now seem to be fully engaged in health. Most vendors have a CMIO who functions to translate clinical needs with IT know how to develop useful solutions which are intutive and efficient. Times have changed, vendors must adopt to the new paradigm or face extinction.

 

 

Telehealth and Health Informatics: How They Should Work Together from Health Informatics New Zealand

 

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Not quite a “Blue Screen” perhaps HIE needs just a Reboot

 

After five or more years of terrifyingly slow progress in developing a nationwide health information network, several large enterprise vendors have agreed to bypass the nationwide effort in favor of their own agreement. While not stating the impetus to form their own alliance the vendors have entered into an agreement, named “CommonWell Alliance”

Frustrated with the snail-like pace for development of health information exchange, several U.S. Senators have suggested a ‘REBOOT”. This is detailed in a white paper entitled, “Re-examining the Strategies Needed to Successfully Adopt Health IT. They took issue with what they said is paltry progress on system interoperability so far, raised alarms about unnecessary billing enabled by EHRs, sought better oversight of the MU program, called for more stringent patient privacy protections and wondered about the chances for long-term health IT sustainability.

And at the same time there has been a critique of the new plan from the EHRA (EHR Association) Their concerns include launching  a new Collaborative .

One of the main criteria for incentive funding for providers is meaningful use and attestation requiring interoperability and the ability to communicate with differing vendor EMRs.  What happens after the fact when many providers find their EMR, although certified as interoperable by CCHIT, Drummond, or ANSI do not function correctly, and has not been used. Will HHS demand refunds from providers who have already received their incentive payments?.

I would enjoy hearing comments and feedback about the Reboot

 

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