. "2 Components of a National Health Information Infrastructure." Patient Safety: Achieving a New Standard for Care. Washington, DC: The National Academies Press, 2004.
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As part of the demonstration process, HL7 presented a report card delineating progress with regard to interoperability standards. Key findings in this assessment include the following:
A certain level of systems integration is routine within the enterprise, but with few exceptions, stops at the enterprise boundary.
We are only beginning to understand how to mine the information contained in narrative and to encode and make use of discrete findings.
Strengths include admission–discharge–transfer information and laboratory results reports.
Emerging strengths include a common approach to documenting metadata and to producing readable, transferable documents; findings-based reporting; and decision support.
Weaknesses include lack of a business and technical infrastructure for distributed access.
Table 2-4 provides an outline of the functions executed for the scenario and the standards utilized. The scenario demonstrated that even with the current state of relatively disparate data standards and interaction of multiple vendors, use of available data standards1 allowed for a level of interoperability to support cross-organizational data flows and care coordination.
The committee found participation in the demonstration to be a useful experience. This project revealed some of the potential of interoperability standards. It also highlighted current gaps in standards supporting the communication of patient information between systems and revealed areas in which additional standards—e.g., for documenting ADEs—are needed. Based on these capabilities, and with effort in linking vendors through exist-
1
Standards used in the demonstration include: HL7 context management for the user interface, HL7 data interchange formats and clinical document architecture, clinical terminology SNOMED CT (Systemized Nomenclature of Human and Veterinary Medicine, Clinical Terms), clinical drug notations of RxNORM, and laboratory terminology of LOINC (Logical Observation Identifiers, Names, and Codes) for the patient’s data.
