Why are there so many different system standards for EHR?

iCareManager January 24, 2020
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Standards are the basis on which effective policies are built in any organization or system. Globally, health systems are built by workable and acceptable standards. The quality of services received by the public is grossly driven by the standards established in sensitive topics such as medication management, leadership structure, governance, prevention and control of infection, quality and use of devices, and more. A high quality, reliable, and accessible healthcare system is directly proportional to the standards provided by policymakers.

Additionally, health care organizations can cut down the cost of implementation by tuning up integration projects. By so doing, the sector will be positioned to take advantage of common ideals that will ensure workable standards. When it comes to electronic health record systems, there seems to be a deviation from the above scenario owing to the challenge of integrating the various standards being operated. In the healthcare sector, there are several standalone standards such as:

  1. Direct project – which is a standard for sending health information securely over the internet. This project develops specifications for a secure, accessible, standards-based way to establish universal health addressing and transport for participants, such as providers, laboratories, hospitals, pharmacies, and patients, to send encrypted health information directly to recipients over the Internet.
  2. Fast Healthcare Interoperability Resource – a standard that relates data formats and elements and an application programming interface for exchanging electronic health records. It is a specification for exchanging clinical and administrative health care data. This standard was created by the Health Level Seven International health-care standards organization.
  3. Quality Reporting Document Architecture – a standard being developed for communicating health care quality measurement information. This project started in 2007 with a private collaboration supported by the Alliance for Pediatric Quality, Child Health Corporation of America, The American Board of Pediatrics, and the National Association of Children’s Hospitals and Related Institutions.
  4. Integrating the Healthcare Enterprise – IHE project is organized into profiles that define how systems should cooperate. This is an initiative by healthcare professionals and industry aimed at improving the way computer systems in healthcare share information. This concept promotes the coordinated use of established standards such as DICOM and HL7 to address specific clinical needs in support of optimal patient care. Systems developed by this project communicate with one another better; they are easier to implement and enable care providers to use information more efficiently.
  5. Consolidated-Clinical Document Architecture – this is a framework for creating clinical documents that contain both human-readable text and machine-readable XML.
  6. Health Level 7 (HL7 Standards) – this covers the complete life cycle of the specification of a standard which includes the development, adoption, market recognition, utilization, and adherence. The HL7 Governance and Operations Manual was updated as of May 2016, to redirect the naming of these Standards for Trial Use.
  7. OpenID Connect – this is a simple identity layer designed to work with Oauth 2.0.
  8. Health Quality Measure Format – defines the information needed to compute a quality measure and result value. Developed by Health Level Seven International, this is a standards-based representation of quality measures as electronic documents.
  9. OAuth 2.0 – this is a simple authorization framework that enables a third-party application to obtain access to an HTTP service.
  10. Prescription Drug Monitoring Program – PDMP is a prescription drug monitoring program. It is an electronic database that tracks controlled substance prescriptions in a state. This project can provide health authorities with timely information about prescribing and patient behaviors that contribute to the epidemic and facilitate a nimble and targeted response.
  11. HEART (Health Relationship Trust) — this project comprises a set of profiles that enables patients to be in control of how, when, and with whom their clinical data is shared.

The huge EHR market has at its center an interoperability challenge. There have been complications over the interplay between divergent systems. Software producers may not have enough motivation economically to create products with competing aids. Also, rival organizations that may eventually want to interchange records might as well be faced with the challenges of disparities already found in the vendor products. Organizations shy away from sending internal data to outside bodies as such transferring data to outside systems may not come easy to many organizations.

We have nursing homes, retail clinics, hospitals, individual practices and other numerous healthcare bodies out there, all of which require electronic record keeping of some sort. The specifications as per their individual needs also differ. For example, the average hospital may need a specific device that permits different departments to exchange effective communication while a private practice requirement might barely focus on the patient’s medical history, present health status, and treatment prescriptions. In the same manner, other forms of medical organizations mentioned above might have each of their own specific needs.

In the field of healthcare, there are organizational needs for specifications and set features based on established structures. However, there has been some form of government intervention following reactions from the public. So all hope is not lost. Healthcare systems are compelled to implement multiple EHR systems throughout the different aspects of their activities. Companies are encouraged to change directions and initiate new modules and systems of care. There could also be the need for merger acquisitions that will be expected to provide better solutions to the interoperability challenge. Major EHR merchants have bought into the idea of standardized frameworks. There is an increased willingness to cooperate. Indeed, there seems to be a guarantee for creating interoperability in future productions.

So far, many leading vendors have been signing into the framework for better interoperability. Though this may cut down the EHR market place, it is a very welcome development. This shows particular potential for organizations plagued with decision challenges. Nevertheless, by the time these health products are interconnected and interrelated, the risks of making a bad purchase would have been reduced. Mergers to system switches would have become easier also. The only permanent thing in life is change and when the change is for the better, society becomes the ultimate beneficiary.