Electronic Health Record
(www.nist.gov/ehealth)
Lynne Rosenthal (lynne.rosenthal@nist.gov)
Overview:
When visiting a new doctor, have you ever failed to recall your
medical history accurately? Have you been asked to have lab work repeated, even
though you just recently had that blood test? Given the
duress of an illness or injury, such patient experiences are common,
yet, they could be avoided through modern heath information
technology. Having access to complete patient health information
is critical to improving clinical care, reducing medical errors and
decreasing costs. The Electronic Health Record (EHR) is a
longitudinal collection of patient-centric healthcare information
available across providers, care settings, and time. It is a
central component of an integrated health information system.
However, full benefits of EHRs can not yet be realized, for barriers
exist to their acquisition and use. There is a lack of
interoperability and standards. Organizations such as ANSI/HITSP, HL7,
ASTM, and HIMSS/IHE, in partnership with vendors, users and
government organizations, are addressing these challenges. Evolving
examples include HITPS Interoperability Specifications, HL7’s functional model for EHR systems,
and ASTM’s continuity of care record (CCR) for patient referrals. NIST,
through the development of conformance test tools and measurements,
is working with these organizations to accelerate development,
adoption and use of standard-based EHR systems.
Industry
Need: Today, a person’s
medical information is scattered among various providers who most
often store it in thick paper files. Although pieces of this overall
record may be in digital format, they are probably located on
different, incompatible health information systems. There is no
coordinated, standard-based system that integrates a person’s medical
information within and across care settings. EHRs and EHR systems
can provide this capability. But first, patient information must be
captured digitally for a common set of EHR functions. To be
successful, digital patient information must be accurate, sharable,
and improve workflow. EHR systems must be integrated, secure, and
interoperable, yet not be prohibitive to implement.
NIST Approach: NIST’s
contribution emphasizes a pivotal aspect, the interoperability of
EHR systems. We work with HHS's Offic of the National Coordinator to define testing strategies that support
EHR implementation and integration efforts via the development of conformance criteria, tests, and
tools. Collaborating with HL7 and IHE, we are designing distributed models and architectures
for healthcare information systems (e.g., IHE profiles, EHR
Functional Model). Our efforts have resulted in providing the basis for the Certification Commission
for Healthcare Information Technology (CCHIT) certification program.
Impact:
Testing and quality assurance activities, when integrated into standards, software
and certification processes, raise the quality of the outcomes, lower costs to implement, and
foster adoption. The EHR has a capacity to speed care,
reduce costs, and improve patient safety. An EHR improves clinical
decision making at the point of care, provides better long term
health outcomes and yields important data for public health
monitoring and research. However, this can only happen within a
setting of standardized, interoperable EHR functions and elements.
The HL7 EHR-S will provide a common functionality model upon which
developers, vendors, and users can plan and evaluate EHR systems.
A full patient EHR, while in the future, will definitely materialize
as part of the systematic automation and modernization of health
care.
|
|
