View
219
Download
0
Embed Size (px)
Citation preview
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 1/32
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 2/32
EHR Functional Model StandardsLearning Objectives
2
1. Understand the definition(s) of an
Electronic Health Record (Lecture a)
2. Understand architecture for an EHR(Lecture a)
3. Identify and understand key standards for
the EHR (Lecture a)4. Understand the HL7 EHR Functional
Model Standards (Lecture b)
Health IT Workforce Curriculum
Version 3.0/Spring 2012
Networking and Health Information Exchange
EHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 3/32
EHR Functional Model StandardsLearning Objectives
3Health IT Workforce Curriculum
Version 3.0/Spring 2012
Networking and Health Information Exchange
EHR Functional Model Standards
Lecture c
5. Understand functional profiles (Lecture b)
6. Understand the standards for Functional
Models for the PHR (Lecture c)
7. Understand the certification requirements
for EHR, PHR and functional profiles
(Lecture c)
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 4/32
Personal Health Record - FM
• Does not define PHR but does assume
certain characteristics
• Assumes “pull-push” or “push-pull” model
• Assumes many sources of data
• Assumes control by individual
• Definition or model of PHR more confusing
than EHR
4Health IT Workforce Curriculum
Version 3.0/Spring 2012
Networking and Health Information Exchange
EHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 5/32
Models for the PHR
5Health IT Workforce Curriculum
Version 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
• Provider-based• Health record bank
• Payer-based
• Free standing• Employer-based
Profiles are being developed for each ofthese models from the generic functional
model set.
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 6/32
Provider-Linked Model
• Portal for consumer to view clinician-
controlled, institutional EHR
• Added functionality for consumerinteraction such as e-mail, refill request,
appointment scheduling
• Maybe self-entered data• Consumer identify inaccuracies in EHR
6Health IT Workforce Curriculum
Version 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 7/32
Health Record Bank Model
• PHR maintained by Trust
• Persistent, secure health information
repository for individual
• Data aggregated across multiple sources
• Controlled by individual
7Health IT Workforce Curriculum
Version 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 8/32
Hybrid Payer/Provider LinkedModel
• Primarily data source is claims data
• Clinical and administrative data
• May or may not be linked to provider EHR
• Varying amount of aggregation of data
across multiple provider groups
8Health IT Workforce Curriculum
Version 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 9/32
Consumer-Centric Model
• Web-based
• Consumer controls, collects, views,
manages and shares copies of healthinformation
• Integrates tools to assist consumer in
managing their health care
9Health IT Workforce Curriculum
Version 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 10/32
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 11/32
PHR Functionality
• Provides ability to capture and maintain
demographic, insurance, and provider
information• Includes capture of problems, conditions,
symptoms, allergies, medications,
laboratory and other test results,immunizations, and encounters
11Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 12/32
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 13/32
Composition
• Functional outline divided into three
sections
– Personal Health
– Supportive
– Information Infrastructure
• Core set of functions
13Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 14/32
PHR-FM
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
Personal Health
PH.1 Account Holder Profile
PH.2 Manage Historical Clinical Data And Current State Data
PH.3 Wellness, Preventive Medicine, and Self Care
PH.4 Manage Health Education
PH.5 Account Holder Decision Support
PH.6 Manage Encounters with Providers
Supportive
S.1 Provider Management
S.2 Financial Management
S.3 Administrative Management
S.4 Other Resource Management
Information
Infrastructure
IN.1 Health Record Information Management
IN.2 Standards Based Interoperability
IN.3 Security
IN.4 Auditable Records
Health IT Workforce CurriculumVersion 3.0/Spring 2012
14
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 15/32
Personal Health Functions
• PH.1.0 Account holder profile
• PH.2.0 Manage historical clinical data
and current state data
• PH.3.0 Wellness, preventive medicine,
and self care
• PH.4.0 Manage health education
• PH.5.0 Account holder decision support
• PH.6.0 manage encounters with providers
15Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 16/32
Personal Health Descriptions
• Manage information related to self-care
and provider-based care over time
• Example - function insures individual’sdemographic data is complete and
maintained so that individual is
unambiguously identified• Actors – account holder (principle user)
16Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 17/32
Supportive Functions
• S.1.0 Provider management
• S.2.0 Financial management
• S.3.0 Administrative management
• S.4.0 Other resource management
17Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 18/32
Support Descriptions
• Subset of functions that assist administrative
and financial requirements
• Provide input into patient-care systems, promote
public health and improve quality of care• Example – query local immunization registries to
determine person’s immunization status
• Actor – primarily account holder but may also be
healthcare provider
18Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 19/32
Information InfrastructureFunctions
• IN.1.0 Health record information
management
• IN.2.0 Standards based interoperability
• IN.3.0 Security
• IN.4.0 Auditable records
19Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 20/32
Standard PHR Data Domains
• Patient Information
• Family History
• PhysiologicalInformation
• Encounter
• Medication• Immunization
• Provider
• Facility
• Health Risk Factors
• Advance Directives• Alerts
• Health Plan
Information• Plan of care
20Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 21/32
Certification
• To provide confidence that electronic
health information technology products
and systems are
– Secure
– Can maintain data confidentiality
– Can work with other systems to share
information – Can perform a set of well-defined functions
21Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 22/32
Certification Commission forHealthcare Information Technology
• First organization, formed in 2004, to
certify HIT products
• Formed by three HIT organizations – American Health Information Management
Association
– Healthcare Information and Management Systems
Society
– National Alliance for Health Informatics Technology
22Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 23/32
CCHIT®
• Was only certification body until ONC publishedFinal Rule in 2010
• From 2005-2010 CCHIT certified over 250
products, representing 85% of the installedmarket
• Voluntary, consensus-based criteria development
• Strong engagement of stakeholders
• 100% compliance required
• Rigorous, objective and consistent testing
23Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 24/32
ONC – Authorized and TestingCertification Bodies (ONC-ATCB)
• ATCBs
– Surescripts LLC
– ICSA Labs
– SLI Global Solutions
– InfoGard Laboratories, Inc.
– CCHIT – Drummond Group, Inc.
24Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 25/32
Certification Domains
• Ambulatory – Child Health
– Cardiovascular Medicine
– Behavioral Health
– Dermatology
– Clinical Research
• Inpatient EHR
• ePrescribing• Emergency Department
• Long Term/Post-Acute Care
25Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 26/32
Principals of Certification
• Certification criteria
– Assure providers that certified EHR technology
can support achievement of meaningful use
– Key capabilities that can be tested objectively – Minimal set
• Supports innovation
• Standards
– Incremental build capacity – Establish foundation for greater interoperability
26Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 27/32
Certified EHR Technology(Regulatory)
• Complete EHR or combination of EHR
Modules, each of which:
– Meets the requirements included in thedefinition of a qualified EHR
– Has been tested and certified in accordance
with the certification program established by
the National Coordinator as having met allapplicable certification criteria adopted by the
Secretary, HHS
27Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 28/32
Definitions
• Complete EHR
– EHR technology that has been developed to
meet all applicable certification criteria
adopted by Secretary, HHS
• EHR Module
– Any service, component, or combination
thereof that than can meet the requirementsof at least one certification criterion adopted
by the Secretary, HHS
28Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 29/32
Categories
• Content Exchange Standards
• Vocabulary Standards
• Transport Standards
• Privacy and Security Standards
29Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 30/32
EHR Functional Model StandardsSummary - Lecture c
• In this lecture, we covered a set of
functional requirements for the Personal
Health Record.• We discussed the ONC certification
process.
30Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 31/32
EHR Functional Model StandardsSummary
• This unit has introduced the concept of an
EHR and the PHR, from the perspective of
standards that relate to definition,architecture, and required functions.
• We looked at specific profiles and at
certification in the U.S.
31Health IT Workforce CurriculumVersion 3.0/Spring 2012
Networking and Health Information ExchangeEHR Functional Model Standards
Lecture c
8/10/2019 09- Networking and Health Information Exchange- Unit 6- EHR Functional Model Standards- Lecture C
http://slidepdf.com/reader/full/09-networking-and-health-information-exchange-unit-6-ehr-functional-model 32/32
EHR Functional Model StandardsReferences – Lecture c
References
• None used in this lecture
Acknowledgements
• Much of the material in this lecture is derived from the following websites:
• http://onc-chpl.force.com/ehrcert
• www.hl7.org • www.Source.CCHIT.org
Images
Slide 14: Ritter, J. (2008, May). HL7 Personal Health Record System Functional Model and Standard [PowerPoint
slides]. Retrieved from website: https://www.himss.org/content/files/OverviewEHealthEnabledHealthcare.pdf
32Health IT Workforce Curriculum Networking and Health Information ExchangeEHR F ti l M d l St d d