• Standards
  • WHO Forum on eHealth Standardization and Interoperability expands its access

    When resources are scarce, collaboration is invaluable. Charles Darwin, the 19th century naturalist and author of On the Origins of the Species, once said “In the long history of humankind (and animal kind, too) those who learned to collaborate and improvise most effectively have prevailed.”  This is especially important when facing new and complex challenges. eHealth standards and interoperability fit this well, since the WHO AFRO RC resolution on eHealth and the WHA 66.24 Resolution on eHealth Standardization and Interoperability were passed last month. The work of the WHO Forum on eHealth Standardization and Interoperability offers a good way to respond.

    WHO has supported and driven eHealth initiatives globally for many years and the Inter-Ministerial Policy Dialogue and 2nd WHO Forum on eHealth Standardization and Interoperability Forum has substantial support. The first event in December 2012 attracted over 200 people from 54 countries. Numerous other participants followed the event through live webcasting. The 2nd event takes place next year from 10 – 11 February at the WHO Headquarters in Geneva.

    The Forum’s primary objectives are to: facilitate a dialogue on the need for Policy and Governance mechanisms for adopting health data standards in countries; and to draft a policy and governance framework for full adoption of standards at national and sub-national levels. The Forum has six panels. Three panels meet on the first day to review key policy issues in eHealth standardization and interoperability, overcoming eHealth regulatory and administrative barriers in standards adoption, and the essentials of a good policy framework needed to adopt standards for interoperability. On the second day, the other three panels review the components of evidence-informed policy, statutory requirements, governance and stewardship.

    Like Darwin’s famous work, WHO’s Forum is a massive undertaking. The findings of these proceedings are an invaluable resource for African countries. Similar initiatives are needed to cover other challenging eHealth topics. Without these, eHealth evolution is more tortuous.

    For more information on the event email WHO at whofhdsi@who.int

  • HL7 restates its link with GS1

    Improving healthcare supply chains seems an unending task. Opportunities to use eHealth and mHealth ingenuity seem endless. Health Level Seven International® (HL7®) has restated its support of GS1, a global not-for profit organization, by formally endorsing GS1 System of Standards for Healthcare with more than 50 healthcare stakeholders. They see GS1’s solution as the global standard best suited for the healthcare supply chain

    GS1 is a member organisation in over 100 countries. Its services include designing and implementing global standards and solutions that improve supply and demand chains. The GS1 system of standards for supply chains is the most widely used in the world. Its products include the familiar bar codes.

    The GS1 management board includes people from many well-known companies, and with the HL7 link, indicates the potential for African countries to consider the opportunities to improve their healthcare supply chains.

  • The course of true ICD-10 never runs smoothly

    The great mind of Sophocles produced the aphorism that “Things gained through unjust fraud are never secure.” Leaving aside the concept of a just fraud, it leads to the altruistic approach to cyber-security of preventing fraud for the benefit of the potential perpetrators. However, the motivation in the USA to secure its switch to ICD-10 has more to do with enlightened self-interest.

    A Government Health IT report by Julie Malida of SAS Institute, a developer of analytics software in the USA, says that there are significant problems that need fixing. ICD-10’s impact is extensive, across billing documentation, claims, provider contracting, payment integrity analysis, ICT, analysis and analytics.

    Moving to ICD-10 has two big changes; some codes are more specific, and some are restructured. These lead to a set of eight security questions:

    How reliable is the data that for re-mapping? How will trend and peer group analysis match over time? Are there mapping errors or misrepresentation of the facts by creative billers? Will billers use ICD-9 and ICD-10 codes for their advantageous reimbursement? Will providers and plans use the ICD-10 opportunity to re-negotiate contract provisions that add administrative and medical costs? Will fraud alerts be false positives because of data integrity issues? Is there a facility to correct data during mapping? Who carries the cost of errors?

    A valuable insight for African countries with significantly less eHealth capacity than the USA is while that switching information design can bring extra benefits, it also brings unexpected costs, risks and extended timescales. Careful, rigorous planning and testing before pressing go buttons is essential before promising big gains. eHealth is a marathon, not a sprint, something that Sophocles would know much about as he wrote his Greek tragedies.

  • LOINC and SNOMED-CT link up

    A new, long-term link is in place between the International Health Terminology Standards Development Organisation (IHTSDO) and the Regenstrief Institute. They have signed a ten-year agreement to integrate the clinical semantic codes of their two global healthcare terminologies, Logical Observation Identifiers Names and Codes (LOINC) and Systematized Nomenclature of Medicine – Clinical Terms (SNOMED-CT). Three domain areas at the core the collaboration are:

    Laboratory, including orders and observations and panel names for orders, but not panel structures, as the main focus Anthropomorphic measurements and evaluations Vital signs and physiological measurements.

    These changes aim to help clinical systems worldwide understand and share this type of information that they receive from numerous sources.