tag:blogger.com,1999:blog-4384692836709903146.post1824260993198799091..comments2024-03-27T09:55:23.143-07:00Comments on Dispatch from the Digital Health Frontier: The Safety of HIT-Assisted CareJohn Halamkahttp://www.blogger.com/profile/04550236129132159307noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-4384692836709903146.post-25879581492103416492011-02-13T17:03:39.232-08:002011-02-13T17:03:39.232-08:00Hi John,
Your points about data consistency when ...Hi John,<br /><br />Your points about data consistency when sharing between different systems is probably the key to interoperability. Exchange, by comparison, is relatively simple. Safety risks are huge if there is inconsistency in data, and also if the data structure is not ratified as 'fit for use' by clinicians.<br /><br />Your example of adverse reactions/allergies is critical for patient safety. A common and agreed structure for representing an adverse reaction in disparate systems, plus appropriate terminology binding will prevent some of the issues you raise. You can find an example of an evolving model that is undergoing review by the Australian clinical and stakeholder community here - http://bit.ly/dTaTij - under the auspice of NEHTA.<br /><br />The potential disparities of data being sent and received are very real and can be solved with collaboration, but I'd also like to point out that data structure and definitions need to be considered carefully and by clinicians and informaticians who understand how clinical data can be used in EHRs, for exchange in messages, for aggregation and to support knowledge-based activities such as decision support. For exmaple, recent advice coming from UK NHS includes avoiding sharing information about 'mild' allergies or 'moderate' adverse reactions - as these statements usually relate only to the severity of reaction that was experienced during one exposure event. However these qualifiers are often captured in receiving systems and then displayed in such a way that the the severity qualifier is represented (incorrectly) as the future propensity for the reaction. It is not safe for a mild reaction on first exposure to be persisted in an EHR or exchanged with other providers as a mild propensity for future reactions.<br /><br />Regards<br /><br />HeatherHeather Lesliehttp://omowizard.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-71610536120260296722011-02-08T06:26:05.290-08:002011-02-08T06:26:05.290-08:00Hi Dr. Halamka,
Does BIDMC save each CCD/CCR that ...Hi Dr. Halamka,<br />Does BIDMC save each CCD/CCR that is generated as a discrete document in the medical record for reference at a later date? Or are these not saved as a stand-alone document. Thank you.Unknownhttps://www.blogger.com/profile/07286649124675247854noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-43391184729697147382011-02-02T21:48:28.585-08:002011-02-02T21:48:28.585-08:00Hi John,
Does the public health surveillance mess...Hi John,<br /><br />Does the public health surveillance message must contain OBX segment? Is there any message definition available for this?<br /><br />Thanks for your time and helpUnknownhttps://www.blogger.com/profile/18009298077073028898noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-92210126531636087392011-02-02T06:50:19.435-08:002011-02-02T06:50:19.435-08:00Manual inspection is all that is done because at t...Manual inspection is all that is done because at this point, no tools are available. Hopefully this will change soon as an implementation is issued.John Halamkahttps://www.blogger.com/profile/04550236129132159307noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-65651327665664664032011-02-02T01:28:54.501-08:002011-02-02T01:28:54.501-08:00Hi John,
Thanks for the public surveillance messa...Hi John,<br /><br />Thanks for the public surveillance message. Since there is no validators to test the conformance of the message, how can I verify the message? Against which one I'l verify that? NIST asked to do manual verification of the message based on message type (if HL7 2.5.1 is version, then what is the message type which is used to test the conformance of the message generated). Could you please shed some light on this?Unknownhttps://www.blogger.com/profile/18009298077073028898noreply@blogger.com