I recently answered several questions about the need for data standards in health informatics. Here are my insights into the present landscape as well as the exciting future that a better-connected healthcare system can offer.
Is there a good starting point that can be standardized first?
In simple terms, data standards are agreed upon terms and definitions for how we capture information. Data standards are important in our quest to achieve nationwide interoperability. The Office of the National Coordinator for Health Information Technology has set forth a strategic roadmap entitled, “Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap” (ONC, 2015). As noted in report, we have not achieved adequate standardization to achieve flawless and secure exchange of information – interoperability. However, a roadmap to achieving interoperability is an excellent starting point.
Another great starting place on the road to achieving this dream is consistent formats, definitions, and vocabularies. Imagine for a minute you have a room full of healthcare professionals caring for the same patient, but all speak different languages. Then imagine everything they say is transformed into their native language and seamless communication was possible. Thus, the words irregular heartbeat in one language are easily transformed and means the same thing in the other language.
To put the United States, and the world, on the path to standardization, standards development organizations were formed. For example, Health Level Seven (HL7) and the American Society for Testing and Materials (ASTM), focus on clinical data standards. Other groups, such as Accredited Standards Committee (ASC) (who focus on images) and the National Council for Prescription Drug Programs (NCPDP) (who focus on pharmacy related items), have been formed to enhance standardization across specialties.
Who will benefit most from data standardization?
Our patients will benefit most from data standardization through improved quality, safety, and health outcomes. Imagine being cared for in an emergency department (ED). Your discharge instructions seamlessly flow to your primary care provider. Your prescriptions are waiting for you at your pharmacy. The entire team is able to see real time information to provide you with optimal care and seamless care transitions.
At present, we depend on patients to keep track of countless pieces of paper and to transport this information (data) between different providers and services. They should not have to. As a nurse practitioner, I should be able to pull up their complete ED visit information (data) and be able to follow through on next steps for the patient. I should know before my patient walks through the clinic doors what needs to happen to provide optimal, safe and seamless care = interoperability. If for some reason, this same patient was taken to a different emergency department or provider’s office, they should be able to do the same. As a country and a world, we will all benefit from improved outcomes and safety through efficient and safe care transitions.
How has data (organized or unorganized) impacted the development of technology? Are there any industry-changing examples?
I think the next big thing on the horizon is patient contributed health information. For example, I wear a Fitbit and use health related apps, such as My Fitness Pal. Both collect rich organized and unorganized data that could assist my healthcare provider in making informed decisions about my health and treatment plan. Thus, technology and industry must consider patient contributed data and uploads into the system. Therefore, ensuring mobile technology applications have a standardized way of communicating this type of data to a patient’s electronic health record is essential for data interchange. Other exciting examples of technology being developed to enhance real-time, actionable data includes info-gathering asthma inhalers (e.g. smart-tech inhaler), smart packaging and patches, appointment scheduling, GoogleGlass in hospitals and clinics, watches, telehealth, and precision diagnostic tools.
What type of impact could data standardization potentially have on the healthcare industry?
As previously mentioned, global interoperability and health information exchange. Imagine the improvement in the health of our communities and populations if healthcare professional and patients could partner through technology and data. Additionally, standardized data would allow clinicians to collect and examine multiple big data sets (e.g. clinical, financial, operational, and patient-derived) to improve quality and patient safety. Having a common data language or standardization would allow this dream to become reality.
How will domestic standards work internationally?
Internationally, health professionals have already begun the work of developing common data language. For example, the International Council of Nurses (ICN, 2015) has spearheaded the eHealth initiative aimed at the development of the International Classification for Nursing Practice (ICNP), the ICN Telenursing Network, and on online forum for sharing ideas and innovations global, Connecting Nurses. The ICNP includes centers from across the globe, including the United States.
Can policymakers do anything to try to reign in on vendors to enforce these standards?
The Office of the National Coordinator for Health Information Technology (2015) has set forth the Shared Nationwide Interoperability Roadmap version 1.0 and the Federal Health IT Strategic Plan: 2015-2020 (2015) to outline the vision forward. The Centers for Medicare & Medicaid Services has then outlined incentive programs, such as meaningful use, which specify key objectives and measures aimed at health information exchange. These are two instrumental policy measures focused on data standardization, exchange, and true interoperability.
Do you have any predictions on where the industry is going?
Leveraging big, SMART data to improve patient safety, quality, and health outcomes is the next big thing. Organizations will need to enhance expertise in connecting financial, clinical, operational, and patient-centered data to maintain a competitive edge and to achieve top decile performance and outcomes (e.g. patient engagement, staff engagement, quality, safety, interoperability, seamless care transitions, cost reduction, and cost containment). Predictive analytics combined with innovations such as gene therapy, robotics, 3D printing, telehealth, mind-controlled devices, biomedical vest, will foster in an era of more personalized healthcare. Exciting times!
Roberta Christopher is the highly-credentialed Program Director for Health Informatics and Assistant Professor at the School of Applied Health Sciences at Jacksonville University, in Jacksonville, Fla.
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