Healthcare Information Services
Some general information about Healthcare information principles:
1. Infrastructure: application integration interfaces, scripts, transaction variants, routing protocols, HL7 (v2.x) templates, HL7 v3 XML, etc. If you are using an integration engine that cannot exchange basic components that enable more replicable, scalable interface development, you are using the wrong solution.
2. Transactions: numerous transactions are now conducted via technology like web services for use in service-oriented architecture (SOA, via WSDLs, for example) including transactions like e-lab, e-prescribing, e-referrals, patient medication history, payer-provider connectivity (e.g. claims, remittance advices, eligibility verification), charity care advisement, etc.
3. Certified HIE Processes: as electronic medical records (EMRs), personal health records (PHRs), hospital information systems (HISs), lab information systems (LISs), physician practice management systems (PPMSs), etc. become certified for interoperability with various associations and/or government agencies, a logical next step will be the development and deployment of certified information services for HIE. Regional health information organizations (RHIOs) and other health information exchanges can now publish their services for use across scalable platforms.
4. Solutions: EMRs, PHRs, PPMSs, e-Rx, etc are moving towards software-as-a-service (SaaS) technology models where the entire application is hosted and distributable as a discreet information service. HIE with a SaaS-distributed solution is theoretically easier if the solution can leverage web service-based information exchange, for example.
5. Generic Information Services: As healthcare adopts web services / SOA or moves towards more scalable web-based applications, it’s ability to consume generic information services that are available currently in other industries will become easier and more prevalent. These include: financial services like credit checks, payment plans and mortgage inquiries; treasury management services like payables, receivables, and deductions management; and, supply chain management and integrated e-commerce applications.
6. “Mash-ups”: Another reason to move towards updated HIE technology is because of the long list of information services that rely on combining multiple information services into a “mash-up.” For example, aggregation of longitudinal patient data from multiple data sources (e.g. a patient’s valid claim data, prescriptions, lab results, and continuity of care record) would require data coordination that is currently extremely cumbersome (not at all scalable). Master person indexing (MPI), various transactional information services, application integration, data quality management, de-identification, governance, authorization, etc are all specific information services that would constitute components of a viable healthcare information services “mash-up.” Other example would include bio-surveillance (e.g. the aggregation of hospital diagnosis codes to determine the beginning of flu season, or a bio-terrorism incident), alerts and notifications (e.g. flagging a patient to read a web-based patient education pamphlet when a lab result, prescription, or diagnosis code is identified), etc. EMRs, PHRs, HISs, RHIOs, etc will someday be dependent on this level of information service if we are to truly improve healthcare.
7. Value-Added Information Services: While many healthcare information services “mash-ups” might be considered value-added services (almost by definition), consider another definition: once we begin to truly commoditize HIE (by commoditizing HCIT infrastructure and interoperability, connectivity, transaction processing, and governance), we can then start to analyze information and improve processes or lower costs or increase ROI (for example). Decision support tools, management dashboards, business intelligence, adjudication systems, etc now start to address profound clinical, financial and administrative processes and we begin to realize “better-faster-cheaper” results from HCIT and HIE.