| An Introduction to Healthcare Standard |
With the widespread use of computers in medicine, it is now possible to have “filmless” radiology department and “Paperless” hospitals. To make this happen, radiology modalities using computers should be connected seamlessly and computers in a hospital need to be integrated into a network. |
Over the years, certain standards have been formulated for radiology departments, endowed with modalities using digital technology (Ultrasonography, CT, MR etc) and peripheral devices like laser printers. Digital Imaging and Communications in Medicine (DICOM), is one such standard, which deals with imaging equipment, printers, picture archival and communication systems (PACS), etc. It also offers assorted functions such as film printing or CD burning, which are distinctly determined by service classes. A broad knowledge of service classes is important while installing and handling radiology equipments. On the other hand, in a hospital-based scenario, for managing non imaging data, Health Level Seven (HL7) as a standard is useful. It provides protocols for exchange, management and integration of clinical and administrative electronic health data. Its area of focus is on clinical interoperability of health records and it interfaces the requirements of the entire healthcare organization. To a modern day radiologist, three important health care standards and initiatives need to be understood. They include DICOM, HL7 and IHE (Integrating the Healthcare Enterprise). |
Different Standards in Healthcare |
HL7 |
| Health Level Seven - provides standards for exchanging clinical data. |
| The HL7 2.3 standard has a broad functional coverage: |
| Clinical |
| Laboratory, pharmacy, radiology, most other diagnostic services, dietary, patient care, public health. |
| Clinical-Administrative |
| Patient registration, admission, patient accounts, medical document life cycle. |
| DICOM |
Digital Imaging and Communications in Medicine - provides for handling, storing, printing, and transmitting information in medical imaging. The DICOM standard has been adopted by virtually all suppliers of imaging products: modalities, PACS (Picture Archive and Communication Systems), diagno-
stic workstations, archives. |
| HL7 CDA |
Clinical Document Architecture – provides an exchange model (XML-based) for clinical documents (such as discharge summaries and progress notes); recently known as the Patient Record Architecture (PRA). |
| CCR |
Continuity of Care Record – responds to the need to organize and make transportable a set of basic information about a patient’s health care that is accessible to clinicians and patients. |
| CCOW |
Clinical Context Management Specification - allows clinical applications to share information at the point of care. |
| LOINC |
Logical Observation Identifiers Names and Codes – applies universal code names and identifiers to medical terminology related to the Electronic Health Record and assists in the electronic exchange and gathering of clinical results (such as laboratory tests, clinical observations, outcomes management and research). |
| ELINCS |
| EHR-Lab Interoperability and Connectivity Standards – an emerging standard for reporting lab test results. |
| X12 |
Provides for electronic exchange of business transactions-electronic data interchange (EDI). The American National Standards Institute (ANSI) chartered the Accredited Standards Committee (ASC) X12 to develop uniform standards. |
| SNOMED |
Systematized Nomenclature of Medicine Clinical Terms – provides comprehensive computerized clinical terminology covering clinical data for diseases, clinical findings, and procedures |
| NCPDP |
| National Council for Prescription Drug Programs – governs prescription transactions. |
| IHE |
Integrating the Healthcare Enterprise – promotes the coordinated use of established healthcare integration standards, such as DICOM and HL7, to address specific clinical needs in support of optimal patient care. |
| CCHIT |
Certification Commission for Healthcare Information Technology – serves as the recognized US certification authority for electronic health records (EHR) and their networks. In September 2005, CCHIT was awarded a 3-year contract by the U.S. Department of Health and Human Services to develop and evaluate the certification criteria and inspection process for EHRs and the networks through which they interoperate. |
| HITSP |
Healthcare Information Technology Standards Panel – assists in achieving widely accepted and readily-implemented consensus-based standards that will enable and support widespread interoperability among healthcare information technology, especially as they would interact in a Nationwide Health Information Network (NHIN) for the United States. |
