Electronic Health Data Exchange - Issues and Work Around

Feb 29
14:29

2012

Sharad Gaikwad

Sharad Gaikwad

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The aspect of healthcare data is being closely watched as the advancements are continuous in nature within the arena of healthcare technology. Medical dictations, patient health records, diagnosis and prescriptions constitute some of the critical documentary health entitlements.

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Health data exchange is the transmission of healthcare-related data in an electronic form among facilities,Electronic Health Data Exchange - Issues and Work Around Articles health information organizations and government agencies according to the U.S. National standards. It is a key component of health information technology (HIT). A Health Information Exchange takes place electronically using data standards (not discussed here) and messaging standards such as Continue of Care Record (CCR) and Continuity of Care Document (CCD). It is important particularly when the National Coordinator of HIT (ONC) and Healthcare Information Technology Standards Panel (HITSP) have expressed different views on both these different standards. 

CCR and CCD Explained:

CCR standard is an XML-based format that matches with the ASTM specifications. It is intended to structure the data using XML tags and coding systems, maximizing the possibility of easy interpretation of data elements both by man and machine. It allows short textual elements. Health information tagged reliably, using XML within a single file passed across networks can be easily understood by servers and software applications. CCR standard’s content includes data such as advance directives, lab results etc. It supports continuity of care, reduce medical errors and increase efficiency by eliminating duplication of tests and procedures. 

CCD is an electronic document exchange standard meant for sharing patient information in summarized form. Generally this summary can be shared by all computer applications viz., electronic medical records (EMR) or web browsers.  While there are experts who think that CCR and CCD standards compete with each other, Health Level-7 (HL7) considers the CCD standard an implementation of the former. CCD is intended to be the snapshot of summarized health information. Some experts are of the opinion that CCD is more complex than CCR and is yet to be tested in the market. According to Vince Kuraitis, former chair of the ASTM International E31 Technical Committee on Healthcare Informatics, “it is a particular instance of a class of HL7 standard known as the Common Document Architecture or CDA.” He is of the view that the formal designation for the CCD is the CDA CCD, and the CCD xml file is merely textual and it lacks computability. “However it can accommodate large blocks of text and can serve providers who do not have data structuring capabilities but want XML package for portability of documents. Many health care providers approach computability in stages using the CDA CCD,” he adds. 

Experts like Vince Kuraitis think that CCR standard is more user-friendly and it is widely used. All its sections viz. problems and conditions, medications list, family history etc. are optional. For that reason, validity of the XML file remains intact even with partial filling i.e. header or footer. The CCR standard also allows adding of new sections when needed. 

A Pragmatic Approach:

Standards are meant for making our lives simple and enterprises attempting to control it would only harm the cause. Both the CCR standard and the CDA CCD have their uses, merits and demerits. What is needed is to continue encouraging innovation in interoperability and computability and allow the market forces to determine the worth of each individually and as a part of the solutions basket. 

Talking about different solutions, new Transcription software has recently hit the market called Orra Health. It comprises of a digital audio recorder, secure data storage and management options alongside a highly user friendly web interface. It’s an app for the iPhone and can be downloaded for free here. You can visit www.orratech.com to know more about the application. It seems like another solution that’s focused towards absolute security of health data exchange.