US Health Information Interoperability: Challenges and HIPAA. Roy Rada, M.D., Ph.D. Univ. Maryland Baltimore County [email protected] Point. Interoperability is the holy grail. However, problem is not primarily technical.
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Roy Rada, M.D., Ph.D.
Univ. Maryland Baltimore County
Major components in a hospital information system are:
Patient management includes medical records, registration, and order entry
Each data element has :
Medical records department ‘owns’ record.
From technical perspective, key to interoperability is technical standards.
HL7 & ASTM
For example, the ‘Information Source Name’ might be transmitted as:
PR*2*Blue Cross Blue Shield Illinois****PI*12345~
Transactions will include a claim attachment which is a medical record.
Compliance with the intent of the Transactions Rule difficult:
National framework for health privacy protection.
Workflow management is way to get privacy and interoperability.
Opens certain path to interoperability.
Covered entities are required to:
Compliance with Privacy Rule has been at enormous cost to the health care system
But creates a public perception of trust on which interoperability could build
Two types of Implementation Specifications:
If the entity determines that an addressable implementation specification is not a reasonable approach to its security needs, then the entity must only document why.
This supports diffusion of the standard
This cost/benefit mentality is wise for system interoperability decisions too
Annual maintenance costs are high. Takes time of every employee (e.g. security checks at doors).
But again creates a foundation from which interoperability of EHR can grow.
Health care systems nationally:
have differences that are challenge to trans-national interoperability