Significant improvements must be made before legacy electronic health record systems can be used to automatically generate forms for data that can be shared in a standardized way, according to a paper published this week in BMC Medical Informatics and Decision Making.
The research, from the Medical University of Vienna in Austria, focuses on integrating archetypes--computable definitions for a single clinical concept, such as body mass index--into legacy EHR systems to generate forms for data exchange. The researchers found the idea of plug-and-play integration far from reality.
Using an ArchiMed EHR system, the researchers were able to successfully integrate 15 archetypes from a test set of 27; the other 12 failed due to the complex structure required that was not supported in ArchiMed's data model.
EHR data models tend to be less expressive than those of archetypes, the authors said, creating gaps that could be closed through workarounds at the application level in some cases, but other archetypes would have to be reworked manually outside the system and could not be integrated.
"Our results further show that the usability of the generated forms must be improved before they can be applied in clinical practice," the authors said.
Former FierceHealthIT Editor Ken Terry has called standardization the Holy Grail of data exchange. While the government has created the open source Direct Project, which has won fans including Tennessee's statewide health information exchange, the President's Council of Advisors on Science and Technology has called for a "universal exchange language" for healthcare data.
Part of the problem, as Terry pointed out, is the myriad terms and codes used to describe the same thing, with more than 70 different medical terminologies in use.
In a request for information published Dec. 28 in the Federal Record, the Centers for Medicare & Medicaid Services called for ways to make quality reporting more efficient and less burdensome for hospitals by automating the reporting of certain patient-level data to the Hospital Inpatient Quality Reporting program. Groups, including HL7, are working on quality reporting standards to make that happen.
Ultimately, CMS wants to adopt data standards to help hospitals consistently capture, transmit and format data, and a single set of electronic specifications for clinical quality measures under various quality reporting programs, according to the RFI.
To learn more:
- read the research