X12 and HL7 Interoperability
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X12 and HL7 Interoperability







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X12 and HL7 Interoperability. Presented March 19, 2004 Kathleen Connor, Fox Systems Inc. National Standards Interoperability. HIPAA and a number of federal health initiatives, including NHII, CHI and EHR are accelerating the adoption of health care data standards, including X12 and HL7
X12 and HL7 Interoperability

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Slide 1

X12 and HL7 Interoperability

Presented March 19, 2004Kathleen Connor, Fox Systems Inc

Slide 2

National Standards Interoperability

  • HIPAA and a number of federal health initiatives, including NHII, CHI and EHR are accelerating the adoption of health care data standards, including X12 and HL7

  • However, interoperability issues arise when health care systems send, receive, store and process data that come from multiple data standards

Kathleen Connor Fox Systems Inc

Slide 3

Key Issues

  • If these standards are not interoperable, if semantics do not align, then systems will map these standards differently

  • As a result, data will not be comparable and our national health goals will be compromised

  •   Yet achieving interoperability among data standards is not a trivial endeavor

Kathleen Connor Fox Systems Inc

Slide 4

Topics to Consider

We need to understand

  • The roles of X12 & HL7 in achieving National Health Care goals

  • Note: although not the in the scope of this presentation, everything said applies to NCPDP as well!

  • The Interoperability “Problem Space” as made evident by real-life examples, and

  • Why Interoperability Matters

Kathleen Connor Fox Systems Inc

Slide 5

ASC X12N

X12 HIPAA transactions are used to transmit financial and administrative information by many of the same health care entities that use HL7:

  • Health care providers, hospitals, and insurers

  • Intermediaries who process electronic health care transactions, such as financial institutions, billing services and clearinghouses; and

  • Health care purchasers, such as Medicare and Medicaid

Kathleen Connor Fox Systems Inc

Slide 6

HL7

HL7 message and information structures (HL7 specifications) are used by many of the same health care entities that use X12 HIPAA transactions, including

  • Providers, hospitals, insurers, and research institutions

  • Producers of health care products

  • Public health and regulatory agencies

Kathleen Connor Fox Systems Inc

Slide 7

Mixing X12 and HL7

  • Many health care entities use both X12 and HL7 to communicate health information

  • An episode of health care may involve several HL7 messages and X12 transactions running sequentially or concurrently, all communicating about the the same health care “objects” or events

Kathleen Connor Fox Systems Inc

Slide 8

ProblemSpace

Kathleen Connor Fox Systems Inc

Slide 9

Data Degradation Issues

  • Health care trading partners most likely do not populate or derive data from X12 transactions and HL7 specifications in the same ways

  • X12 and HL7 data will likely be mapped differently to the proprietary formats within trading partners’ systems

  • X12 or HL7 data may not represent a health care “object” in the same way, but we don’t know how they differ

Kathleen Connor Fox Systems Inc

Slide 10

Ambulance Transport Information

Kathleen Connor Fox Systems Inc

Slide 11

The HL7 specifications have been developed without considering that the information transmitted in HL7 message and information structures is (1) used to populate or (2) may be derived from X12N health care transactions

The X12N health care transactions have been developed without considering that the information transmitted in X12 transactions is (1) used to populate or (2) may be derived from HL7 messages andinformation structures

These Standards have to “Start Talking”

Kathleen Connor Fox Systems Inc

Slide 12

Problem Status

  • To date, there has been no assessment of the congruence of the concepts underlying the information that must flow between these two standards

  • We can assume that there are “maps” between them because hospitals that use HL7 for internal messaging, populate X12N healthcare transactions using information derived from those messages

Kathleen Connor Fox Systems Inc

Slide 13

Why Data Interoperability?

  • Prior to federal efforts to bring standards to clinical electronic health records, code sets and messages, any incompatibility between these two standards was a “non-issue”

  • Health entities used X12 only for inter-enterprise, administrative communications

  • They used HL7 only for intra-enterprise, research and public health communication

Kathleen Connor Fox Systems Inc

Slide 14

NHII / EHR Increase the Need

Federal eHealth initiatives absolutely depend on X12 and HL7 interoperability

  • If the EHR standard set requirements for the clinical and demographic data in clinical systems, more HIPAA data will be derived from HL7 specifications

  • At the same time, providers’ EHR systems will likely be designed to use data that is derived from inbound HIPAA transactions

Kathleen Connor Fox Systems Inc

Slide 15

End2End Data Interoperability

  • Ultimately, we need a dynamic workflow model of the interdependent functionalities among and within interchange partners in the health community that can trace the migration of X12 and HL7 data throughout

  • This can only happen with collaboration between these two SDOs

Kathleen Connor Fox Systems Inc


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