Your Input Is Need - Call For Public Review Of Emerging Standard

[rninformatics, DNP, RN]

all - i need your professional opinions. what's more fun that just giving opinion on someone else's work product!! please take this opportunity to do so!!

one of the standards developing organizations hl7 is asking for public input from the nursing community (the community that will be most affected by the ehr - the electronic health record) to further develop standards related to the ehr.

i would like to encourage you to - please take the time to participate in this public review period. the next opportunity for you to give input to this emerging standard is in a formal hl7 ballot period which will require some level of membership fee for you to participate. this opportunity is free!

this is how you participate:

go to the www.hl7.org/ehr website.

download to your pc the three zip files that are in the pink box in the middle of the page.

the three zip files address the areas of

1. direct care functions of an ehr system

2. supportive (clinical decision support) functions of an ehr system

3. information infrastructure functions of an ehr system.

open the zip files and the bulk of the content will be found in the ehr_fm_.... file name. you will record your opinions in the excel spreadsheet which is the last 5th file in each of the three zip files. if you want additional information on the how the conformance criteria are generated or a readers guide to get the gist of the entire project, you can look at those files within each of the three zip files.

i have included a sample here to let you know what is inside the zip files.

**please do not give me feedback on just these examples on this forun posting.**

that will not help inform the hl7 process as we move this work product to become a standard. there are over 100 functions with their associated conformance criteria. you do not need to give comments on all three sections - you do not need to give comments to all of the functions. for example, i never pay much attention to the information infrastructure files - let the engineers deal with that content area.

just provide comments in the excel spreadsheet for the functions and conformance criteria that you deem need improvement. then mail the spreadsheets to the [email protected] distribution list.

one critical thing to remember is that the conformance criteria are abstracted to a very high level to be applicable to all clinical care environments and all international communities. there is a methodology of creating a profile that will allow for further refinement of these high level conformance criteria to be used within a specific care setting or regional area.

here are three examples (out of over 100) of what you will find within the zip files.

function:

direct care.1.2.2 manage and execute patient-specific care plans

conformance criteria:

1. the system shall provide tools or applications to facilitate creation and maintenance of patient-specific care plans.

2. the system shall enable the use of locally or non-locally developed templates for the creation of patient specific care plans.

3. the system shall allow previously established care plans to be used as a basis for the creation of new care plans.

4. the system should allow tracking of updates to care plans by: authors, creation date, version history, references, local sources, non-local sources.

5. the system should allow order sets and care plans to be coordinated and derived from one another

function:

direct care .1.2.3 generate and record patient-specific instructions related to pre- and postprocedural and postdischarge requirements.

conformance criteria:

1. the system shall generate instructions pertinent to the patient

2. the system shall encourage the inclusion of details on follow up, return visits and appropriate timing of further care.

3. the system shall record and document the instructions given to the patient

4. the system should allow digital signature or other secure recording of the identity of the person receiving the instructions, attesting to their having been received and understood

function:

direct care .1.3.2 manage medication administration

conformance criteria:

1. the system shall securely relate medications to be administered to the unique identity of the patient (see dc.1.1.1)

2. the system shall present the list of medications to be administered.

3. the system shall unambiguously display the timing, route of administration, and dose of all medications on the list.

4. the system may notify the clinician when specific doses are due.

5. the system shall facilitate the recording of medication administration details --including timestamp of when medication was or was not given, related clinical observations, and complications.

6. the system may check and report allergies, drug-drug interactions, and other potential adverse reactions, when new medications are given. (see dc 2..3.1.1, dc 2.3.1.2)

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for the original call and details about hl7 see below

hl7's ehr technical committee opens public comment on enhanced ehr functional model

ann arbor, mich.¾august 26, 2005-- the health level seven (hl7) electronic health record (ehr) technical committee (tc) today announced the opening of a public comment period on the enhanced draft ehr system (ehr-s) functional model. the comment period is open from august 26 to september 9 and is intended to elicit feedback from a broad range of industry stakeholders. all interested parties--both members and non-members of hl7--can submit comments via the ehr area of the hl7 website (www.hl7.org/ehr) by downloading the relevant documents posted, completing a comment spreadsheet, and emailing it to: [email protected].

in addition to minor revisions to the existing content, conformance criteria have been added to the ehr draft document and will be used by clinicians, vendors, and other industry representatives to objectively measure the presence and effectiveness of a function within an ehr system. the ehr tc is especially interested in feedback on the format, the use, and the content of the new conformance criteria. the ehr tc will review all comments at hl7's september working group meeting in san diego, california, which convenes september 11-16, 2005.

this represents the first time in almost a year that the draft standard is available for public review, and brings the document one step closer to becoming a fully-approved american national standards institute (ansi) standard. earlier this year, the ehr tc developed a roadmap for the functional model that anticipates submission to ansi for approval in 2006. during this final year of development, the committee continues to seek additional stakeholder feedback, which will become part of the final standard.

about hl7

founded in 1987, health level seven, inc. (http://www.hl7.org/) is a not-for-profit, ansi-accredited standards developing organization dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services. hl7's more than 2,000 members represent approximately 500 corporate members, including 90 percent of the largest information systems vendors serving healthcare.

hl7's endeavors are sponsored, in part, by the support of its benefactors: capgemini; centers for disease control and prevention (cdc); documentum; duke clinical research institute (dcri), eclipsys corporation; eli lilly & company; the food and drug administration; ge medical systems; guidant corporation; ibm; idx systems corporation; intersystems corporation; kaiser permanente; mckesson provider technologies; microsoft corporation; misys healthcare systems; nhs connecting for health; nictiz national ict institute for healthcare in the netherlands; oracle corporation; partners healthcare system, inc.; pfizer, inc.; philips medical systems; quest diagnostics inc.; science applications international corporation (saic); siemens medical solutions health services; the u.s. department of defense, military health system; the u.s. department of veterans affairs; and wyeth pharmaceuticals.

international affiliates have also been established in 25 countries throughout the globe including argentina, australia, brazil, canada, china, croatia, czech republic, denmark, finland, france, germany, greece, india, ireland, italy, japan, korea, mexico, the netherlands, new zealand, spain, switzerland, taiwan, turkey and the united kingdom. recently, the hl7 board approved the establishment of two new affiliates in malaysia and uruguay.