You will reflect on the need for EHR structural standardization and the potential impact of this standardization on their utility. You will also take a close look at a variety of EHR data sets and have an opportunity to differentiate between their structural, functional, and developmental specifics. Finally, you will review some commonly used structural standards for patient health records and consider different types of EHR interoperability.
• How can you determine the specific structural components and the potential benefits of the Continuity of Care Record (CCR)?
• What is the relationship between the CCR and the Continuity of Care Document (CCD)?
• How can you differentiate the structural, functional, and developmental specifics of data sets used to capture patient information?
• Article: Ferranti, J. M., Musser, R. C., Kawamoto, K., & Hammond, W. E. (2006). The clinical document architecture and the continuity of care record: A critical analysis. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1513652/
This article compares two data standards: Health Level 7’s Clinical Document Architecture (CDA) and The American Society for Testing and Material’s Continuity of Care Record (CCR). The details of the standards are examined, and the advantages and disadvantages of each are discussed.
• Article: Niess, D. (2006). Creating the Continuity of Care Record (CCR)-The time is right! Leading Edge, 3(2), 1.
Retrieved from http://ezp.waldenulibrary.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=21979068&site=ehost-live&scope=site
This article advocates the widespread adoption and use of the CCR, outlining its benefits and differentiating it from other types of patient records.
• Article: Ryan, A., & Eklund, P. (2008). A framework for semantic interoperability in healthcare: A service oriented architecture based on health informatics standards. Studies in Health Technology and Informatics, 136, 759-764.
This article explores a solution for semantic interoperability in health care based on a software architecture that is used in enterprise solutions and that has been translated into health care using messaging and modeling standards.
• Article: Van Vleck, T. T., Wilcox, A., Stetson, P. D., Johnson, S. B., & Elhadad, N. (2008). Content and structure of clinical problem lists: A corpus analysis. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2655994/pdf/amia-0753-s2008.pdf
This article details the findings of a Columbia University study analyzing the structure and content of the Past Medical History (PMH) sections of clinical notes, as a proxy for patient problem lists.
• Article: Kibbe, D. C., & Waldren, S. E. (2005). The ASTM continuity of care record: CCR, a tool for health data exchange. Retrieved from http://www.aafp.org/online/etc/medialib/chit/documents/proj-ctr/astmccr.html
This online PowerPoint presentation from the Center for Health Information Technology provides a general overview of the CCR and explores how it can (and has been) implemented.
• Article: EHR-Centric Interoperability Specification (IS) Tiger Team. (2009). EHITSP EHR-Centric Interoperability Specification (HITSP/IS 107). Retrieved from http://ushik.ahrq.gov/recordExport.pdf?system=si&itemKey=85322000&format=pdf&enableAsynchronousLoading=true
This online document outlines the Healthcare Information Technology Standards Panel (HITSP)’s interoperability and capability specifications for the electronic health record.