There Has Been A Number Of Mentions Of Digital Health Standards This Week! Not Clear Progress Is Happenng?

First we had this:

https://www.health.vic.gov.au/digital-health/clinical-information-system-and-electronic-medical-record-application-and

Clinical Information System and Electronic Medical Record application and interoperability standard

Application of this standard to the implementation of Clinical Information System and Electronic Medical Record (CIS/EMR) by health agencies will ensure continued interoperability of data applications across the state, now, and position health services to exchange data in line with future Victorian initiatives such as state-wide unique patient identification and sector wide shared clinical information whilst enabling connectivity to the national eHealth infrastructure.

Overview

This Standard defines the minimum set of functional requirements for any implementation of CIS and EMR by health services in the Victoria Public Health Sector. They are a base set of interface, terminology and functions that enable interoperability within and external to a health service.

The standard will enable health service CIS and EMR applications to integrate with current and emerging national digital health services such as My Health Record, the HI service, national electronic transfer of prescriptions.

Prior to this standard, the department (i.e. DHHS) has spent many years delivering standard and guides to the Victorian Public Health Sector (VPHS) which not only supports interoperability within the state in the current environment, but positions health services to better receive and implement national initiatives, like My Health Record. The standard includes both mandatory and optional requirements.

The mandatory requirements cover the categories of Terminology, Interfacing, ADHA, localisation to Australian and Victorian requirements and functional requirements, while the optional/future requirements cover the categories of terminology, ADHA and functional requirements.

Downloads

CIS and EMR application and interoperability standard

Here is the link:

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjKt8bT97P5AhVDSmwGHWAgBdoQFnoECA4QAQ&url=https%3A%2F%2Fwww.health.vic.gov.au%2Fdigital-health%2Fclinical-information-system-and-electronic-medical-record-application-and&usg=AOvVaw2xnb9xiBbWN5e3a4UzMYEP

Reviewed 31 July 2022

We also had this:

2 August 2022

Why medicine should #learntocode

By Dr Margaret Faux

The international language of SNOMED can make our data meaningful and precise without clinicians needing to change a thing.

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When we think about health data what do we actually mean? Is health data words, or codes, or both, and who is it for?

Let’s start with words.

There is a scene in The Hobbit in which Bilbo Baggins says “Good morning” to Gandalf. Gandalf replies:

“What do you mean? Do you wish me a good morning, or mean that it is a good morning whether I want it or not? Or perhaps you mean to say that you feel good on this particular morning. Or are you simply stating that this is a morning to be good on?”

This is reminiscent of the unique challenges we face when we try to make sense of the words contained in health records. For those of us who deal with health data downstream, after clinicians and patients have gone home, we know well that the same meaning is often expressed with different words. And in the current context of pressured health budgets, no one can afford to waste time and resources pouring through records manually or calling clinicians to ask them what they meant.

Enter SNOMED-CT.

In the document library of the Australian Digital Health Agency, there is a very helpful resource for SNOMED-CT beginners, which includes the below slide, demonstrating how four different clinicians can all mean the same thing, but use different words to say it.

One of my colleagues frequently bemoans the fact that an orthopaedic surgeon he works for always uses different words and phrases to describe exactly the same procedures on patients who have exactly the same health profiles. As a data analyst, he finds this very frustrating because he needs to know exactly what the surgeon meant for each patient. He often tells me that usually, he’s got a pretty good idea of what the surgeon meant, having seen hundreds of his records over a long period, but he also knows that there is no place for guesswork in health data analytics.

Think about the word “cold” written in a health record. You can feel cold because someone left a window open and it’s snowing outside, you can have a cold, you can have a cold personality, and in a respiratory setting, a clinician may have used “cold” an acronym for “chronic obstructive lung disease”. SNOMED-CT has different codes for all of these meanings of “cold”, and more. It is the international language of health that provides meaning, and therefore has very wide utility.

Standing in the shoes of the health data analyst for a moment, it is easy to appreciate his frustration, because he can never make the mistake of mixing the data of a patient who needs to put a jumper on with one who has a serious respiratory illness. Precision is key.

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Dr Margaret Faux is a health system administrator, lawyer and registered nurse with a PhD in Medicare compliance, and is the CEO of AIMAC, which offers courses and explainers on legally correct Medicare billing.

Two interesting articles:

The first is actually dated 2018 and seems to be a sort of standards catalogue that seems to suggest some Standards are needed in Victoria. Interesting it was approved also in July, 2022 unmodified apparently!

In the second we have a suggestion that use of SNOMED-CT would be a good thing  but really recognises that funding driven by MBS codes is the main driver of what will actually be used.

Is anyone actually seeing progress with the adoption of the suite of recognised international standards, It seems to have gone a bit quiet during and after COVID!

David.