HIE Health Information Exchange

HIT Acronyms

HIE – Health Information Exchange

HIE is defined as the mobilization of healthcare information electronically across organizations within a region, community or hospital system. HIE provides the capability to electronically move clinical information among disparate health care information systems while maintaining the meaning of the information being exchanged. The goal of HIE is to facilitate access to and retrieval of clinical data to provide safer, more timely, efficient, effective, equitable, patient-centered care.

Formal organizations are now emerging to provide both form and function for health information exchange efforts. These organizations (often called Regional Health Information Organizations [RHIOs]) are ordinarily geographically-defined entities which develop and manage a set of contractual conventions and terms, arrange for the means of electronic exchange of information, and develop and maintain HIE standards.

LOINC – Logical Observation Identifiers and Codes.

The LOINC system is a database and general standard for identifying medical observation. LOINC codes are used to describe any medical observation that is quantifiable. This includes laboratory terms and their associated measurement parameters or physical evaluations such as height, weight, and head circumference and their associated measurement parameters. Since its inception, the database has expanded to include not just medical and laboratory code names, but also: nursing diagnosis, nursing interventions, outcomes classification, and patient care data set. LOINC applies universal code names and identifiers to medical terminology related to the Electronic health record. The purpose is to assist in the electronic exchange and gathering of clinical results (such as laboratory tests, clinical observations, outcomes management and research). LOINC is one of the standards for use in U.S. Federal Government systems for the electronic exchange of clinical health information. In 1999, it was identified by the HL7 Standards Development Organization as a preferred code set for laboratory test names in transactions between health care facilities, laboratories, laboratory testing devices, and public health authorities.

Many standardized terms have to be placed into their context. For instance, a laboratory measurement of a specific analyte is obtained from a particular matrix or tissue (e.g., dried blood spot on a filter card, plasma, fibroblasts, etc.) in a specified form of measurement

A formal, distinct, and unique 6-part name is given to each term for test or observation identity. The database currently has over 58,000 observation terms that can be accessed and understood universally. Each database record includes six fields for the unique specification of each identified single test, observation, or measurement:

1. Component- what is measured, evaluated, or observed 2. Kind of property- characteristics of what is measured, such as length, mass, volume, time stamp and so on 3. Time aspect- interval of time over which the observation or measurement was made 4. System- context or specimen type within which the observation was made 5. Type of scale- the scale of measure. The scale may be quantitative, ordinal, nominal or narrative 6. Type of method- procedure used to make the measurement or observation

A unique code (format: nnnnn-n) is assigned to each entry upon registration. Other database fields include status and mapping information for database change management, synonyms, related terms, substance information (e.g. molar mass, CAS registry number), choices of answers for nominal scales, translations.

HL-7 - Health Level Seven (HL7)

HL-7 is an all-volunteer, not-for-profit organization involved in development of international healthcare standards. “HL7” is also used to refer to some of the specific standards created by the organization (i.e. HL7 v2.x, v3.0, HL7 RIM, etc.).

HL7 and its members provide a framework (and related standards) for the exchange, integration, sharing and retrieval of electronic health information. v2.x of the standards, which support clinical practice and the management, delivery, and evaluation of health services, are the most commonly used in the world.

HL-7 Standards

Hospitals and other healthcare provider organizations typically have many different computer systems used for everything from billing records to patient tracking. All of these systems should communicate with each other (or "interface") when they receive new information but not all do so. HL7 specifies a number of flexible standards, guidelines, and methodologies by which various healthcare systems can communicate with each other. Such guidelines or data standards are a set of rules that allow information to be shared and processed in a uniform and consistent manner. These data standards are meant to allow healthcare organizations to easily share clinical information. Theoretically, this ability to exchange information should help to minimize the tendency for medical care to be geographically isolated and highly variable.

HL7 develops Conceptual Standards (i.e. HL7 RIM), Document Standards (i.e. HL7 CDA), Application Standards (i.e. HL7 CCOW) and Messaging Standards (i.e. HL7 v2.x and v3.0). Messaging standards are particularly important because they define how information is packaged and communicated from one party to another. Such standards set the language, structure and data types required for seamless integration from one system to another

SnoMed CT - Systematized Nomenclature of Medicine -- Clinical Terms) SnoMed CT is a systematically organized computer processable collection of medical terminology covering most areas of clinical information such as diseases, findings, procedures, microorganisms, pharmaceuticals etc. It allows a consistent way to index, store, retrieve, and aggregate clinical data across specialties and sites of care. It also helps organizing the content of medical records, reducing the variability in the way data is captured, encoded and used for clinical care of patients and research.