JAMIA Article is Latest Demonstration of Company’s Proactive Efforts to Resolve Industry Challenges to CDS-EHR Integration
Wolters Kluwer Health Outlines Challenges, Offers Solutions to Mandated EHR Infobutton Implementations in Renowned Informatics Journal
Wolters Kluwer Health | Clinical Solutions
Co-authored by Dr. Strasberg, Guilherme Del Fiol, MD, PhD, with the Department of Biomedical Informatics at the University of Utah, and James Cimino, M.D., of the Laboratory for Informatics Development with the National Institutes of Health Clinical Center, the article provides insight into the terminology challenges associated with retrieval of Infobutton content. The strengths and weaknesses associated with two primary retrieval methods—text search terms and standardized codes—are outlined, and the authors point to a hybrid approach of both methods as potentially delivering the most optimal outcome.
“Infobutton implementation is not as simple as indexing some content with a few standardized codes and assuming that retrieval of direct matches will provide optimal results. Instead, a variety of subtleties must be considered, including handling inexact matches and different term types and ranking results,” said Dr. Strasberg. “A variety of approaches can be used such as retrieving exact or related code matches and, through query expansion, leveraging the ranking capabilities of search engines. As such, we recommend implementers determine the best approach on a case-by-case basis to achieve the best possible outcomes.”
A key take-away from the review is the need for careful consideration of the complexities associated with integration of CDS technology into EHRs. Identified as a key element to successfully achieving the aggressive quality goals laid out in federal initiatives, the widespread use of CDS technology such as order sets, evidence-based reference content, care plans, medication alerting systems and surveillance technology, is most hindered by EHR integration challenges, according to leading industry research groups like KLAS and The Advisory Board.
Specifically, the use of the HL7 Infobutton standard for retrieval of relevant patient education content is a requirement under Stage 2 Meaningful Use rules for certified EHRs. The rules also require EHRs to provide linked referential CDS, optionally using this same standard.
Many initiatives are underway such as the Health eDecisions Project and various activities of the HL7 CDS working group to design CDS standards that promote interoperability and easier integration. Industry thought leaders and experts believe that the adoption of these standards by health IT vendors will increase momentum with the deployment and use of CDS technology.
Wolters Kluwer Health has taken a proactive approach to CDS standards development, working alongside national initiatives and utilizing standard terminologies such as ICD-9-CM, ICD-10-CM, SNOMED CT, LOINC and RxNorm across its comprehensive line of CDS applications. Dr. Strasberg currently serves as co-chair of the HL7 CDS working group.
“There is little dispute in the healthcare industry that the uptake and use of CDS technology is critical to achieving short- and long-term quality and cost expectations,” said Arvind Subramanian, President and CEO, Wolters Kluwer Health, Clinical Solutions“Wolters Kluwer Health is actively engaged in helping the industry bridge the current integration gap that exists between EHRs and CDS to improve both patient care outcomes and the health IT landscape overall.”
Wolters Kluwer Health (Philadelphia, PA) is a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Serving more than 150 countries and territories worldwide, Wolters Kluwer Health’s customers include professionals, institutions and students in medicine, nursing, allied health and pharmacy. Major brands include , , , , , , , , , and .
is part of , a market-leading global information services company. Wolters Kluwer had 2012 annual revenues of €3.6 billion ($4.6 billion), employs approximately 19,000 people worldwide, and maintains operations in over 40 countries across Europe, North America, Asia Pacific, and Latin America.