In January, the International Health Terminology Standards Development Organization (IHTSDO) and the International Council of Nursing (ICN) announced the release of an equivalency table between the International Classification for Nursing Practice (ICNP) concepts and SNOMED CT concepts. What does this mean for nursing? In order to answer this I will describe the collaboration agreement between the ICN and IHTSDO, give an overview of ICNP, and discuss how this agreement impacts standardized nursing terminologies.
The IHTSDO has a formal Harmonization Agreement with ICN to “advance terminology harmonization and foster interoperability in health information systems.” ICN is a federation of more than 130 national nurse associations representing millions of nurses worldwide. Operated by nurses and leading nursing internationally, ICN works to ensure quality nursing care for all and sound health policies globally. Continue reading
I’ve started reading a book by William Baumol called The Cost Disease, which raises an interesting question. Why in 2014 can I buy a laptop computer that is smaller, more powerful, and most of all, much cheaper than one I could have bought just ten years ago, but healthcare costs have risen from ten years ago? Why are some industries able to become more efficient, and produce more of their goods or services, faster and cheaper, while other industries are stuck in a spiral or are continually raising costs with stagnant efficiency?
I won’t give a full, in-depth review of the book, but in short, the analysis lays out the premise that in some industries, such as with computers or automobiles, manufacturers are able to continually improve on both their manufacturing processes and the quality of the goods they are manufacturing. This enables these manufacturers to produce better goods at lower costs. These lower costs then enable them to pass some of these savings on to their customers, as well as to pay their employees more money. Continue reading
As more and more hospitals and healthcare organizations convert more and more of their paper medical records to electronic health records (EHRs), an interesting dynamic has begun to emerge, as well as an interesting challenge.
The dynamic is that while the conversion from paper to electronic records was promised to provide time and cost savings for healthcare, the adoption of EHR systems by physicians has led to a number of perhaps unforeseen consequences. One of the chief consequences, which could also be considered a chief complaint, is that physicians who document on their patients electronically make less eye contact with their patients and have lower patient satisfaction ratings, vs. physicians who document on paper. Continue reading
If you need a coronary artery bypass graft, India might not be the first place you’d think of to have the surgery done, but you might want to think again. A coronary bypass graft in the U. S is likely to cost $88,000 dollars. The same treatment in a JCAHO accredited hospital in India only costs $9,500. Both the U.S. and India meet world-class quality standards, so why does the surgery cost so much less in India? It’s simple: Innovation in the healthcare delivery process.
A recent Harvard Business Review article studied seven hospitals in India that are delivering world-class care at a fraction of the cost in the U.S. These hospitals are able to deliver affordable, high quality care largely because they have adopted a hub-and-spoke model for delivery. They concentrate the most expensive equipment (PET scanners, cyberknives, and cyclotrons) and specialized physicians in the Hub. In the spokes, they keep general practitioners and lower cost equipment. Patients are diagnosed and care plans are created in the hub, and the treatment is delivered in the regionalized spokes. Continue reading
Guest blog by Senthil Nachimuthu
The normative release of the HL7 Common Terminology Services version 2 (CTS2) functional specification is about to be completed, and that made my latest expedition to the Alamo city especially enjoyable. This month, the HL7 Working Group Meeting (WGM) was in San Antonio, Texas. The HL7 CTS2 Service Functional Model (SFM) outlines the ‘functional capabilities’ of the next version of HL7 CTS v1.2. If you are new to CTS2, it’s a joint project between HL7, OMG and others under the umbrella of Healthcare Services Specification Project (HSSP), where HL7 publishes the functional specification and OMG publishes the technical specification. I’m a co-author of the HL7 CTS2 SFM and am pleased to see that the standard is about to be published. It’s nice to see the editors and co-authors of the standard in person at the HL7 meetings after talking to them on conference calls week after week. Continue reading
This past week, I gave a tour of our Innovation Center to one of our newest employees, a recent college graduate. During the experience, she remarked, “I like the feeling of being in the Innovation Center. It makes me feel like I work for a company that is doing really cool things.” I had to smile, because we designed the 3M Innovation Center to do just that: create conversations between 3M experts, industry experts, and customers to identify unmet needs, so we could create “cool things.”
We opened the first Innovation Center in Salt Lake City in 2010. The economy was struggling and the Healthcare Reform bill had just passed, which accelerated the transformation of health IT, similar to the shift from analog to digital. The healthcare landscape was changing and changing quickly, so we invited our customers to join us in the Innovation Center for joint strategy sessions. Continue reading
Healthcare data should be structured within a standardized information model so it can be easily and safely shared among patients, consumers, and providers. This structure would advance the vision of a transformed health system while enabling improved outcomes, quality of care, and lower costs. Standardized nursing assessment charting can enhance continuity of care yet research has demonstrated a lack of standardization in codified point-of care nursing assessment data. There is an international initiative in progress to develop guidelines for the creation detailed clinical models (DCMs) that can be used for standardized care. The goal of DCMs is to provide sharing of data, information, decision support, reports and knowledge to support evidence based practice and ultimately translates into a higher level of quality care. Continue reading
Guest blog by Pam Banning, Healthcare Data Analyst with 3M Health Information Systems
A recent American Association of Clinical Chemistry webinar, “Essential Tools to Implement Meaningful Use (MU) in the Laboratory” discussed what laboratories needed to know about standard terminologies and how to start on the enlightened path towards meeting MU (for more information on MU visit the CMS Electronic Health Record website). The audience expressed challenges in meeting MU requirements within their organization. Specifically, they voiced concerns such as:
- Variation between platforms at their facility
- Confusion on standard terminology requirements
- Adoption and implementation of these standard terminologies
The questions articulated were parallel to difficulties communicated from audiences since the MU legislation was put into place in 2011. MU provides basic requirements in the storage of terminology codes and human readable representations for these codes. However, many organizations don’t know which internal systems should adopt standard terminologies and what the implementation strategy should look like.
The open ended template styles within the electronic health record (EHR) succeed in accepting a lot of data from multiple sources, but many fail in providing the detailed information required to identify appropriate standard terminology codes for laboratory tests and results. Continue reading
When our esteemed Medical Director is about to make a pronouncement about something outside his vast area of expertise, he usually starts by saying, “I’m just a country doctor, but …”
Well, I’m just a country computer programmer, but I think we should discuss the difference between a nomenclature and a classification. “Nomenclature” is the “N” in SNOMED. “Classification” is the “C” in ICD-9 or -10.
Why am I wandering into such dangerous waters, swarming with medical informaticists and other academic denizens capable of biting my head off, or at least splitting all my hairs? Because many people, in their desire to have an easy ICD-9 to ICD-10 transition, are setting their expectations of the GEMs too high. This manifests itself as requests for otherworldly extensions to software that I helped write. And though I’d do almost anything to keep my customers satisfied, I’m not a magician. Continue reading
Interoperability is one of the leading goals in the healthcare industry, but how can we get there? In spite of decades of experience with electronic health records, the lack of semantic interoperability in healthcare has prevented sharing of healthcare data. Often, health data is not comparable, cannot be aggregated, and cannot be used to accurately automate or augment clinical decision making. The Health Information Technology Standards Committee has recommended Logical Observations, Identifiers, Names and Codes (LOINC) as the standard for structured coded assessment instruments and Systemized Nomenclature of Medicine Clinical Terms (SNOMED CT) for appropriate responses (“answers”). This implies that point-of-care measures should be codified using LOINC and SNOMED CT. Continue reading