MED INF 405-0 HIT Integration, Interoperability & Standards

ASTM E-31

January 14, 2010

By

Imran Khan

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Introduction – ASTM

• American Society for Testing and Materials (ASTM) International is a standards organization:• Founded in 1898• 32,000 members in over 100 countries • ANSI accredited and maintains 12,000+ standards ranging from

materials, products, services and systems…

• ASTM E31 is a committee on Health Informatics:• Established in 1970 • About 300 members, Global Participation in 17 countries • 40 approved standards and additional draft standards• Approved standards published annually in Volume 14.01 in Annual Book• Develops standard on:

• Architecture, content, storage• Confidentiality, security, functionality• Communication

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Scope of ASTM E-31

-Promotion of knowledge and development of standard classifications, guides, specifications, practices

-Terminology for architecture, content, storage and communication of health information, including patient-specific information and medical knowledge.

-Address policies for integrity and confidentiality that support uses of data and decision making.

-Coordinate with other relevant committees and organizations internal / external to ASTM

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ASTM E31 Organizational Structure

• 3 technical sub-committees

• Meet semi-annually in May & November

• Approx. 300 members, which include:• clinicians, • provider institutions, • administrators, • patient advocates, • vendors, and others from throughout the

healthcare industry, as well as strong support from the CCR sponsors*.

• Chairman: Dr. David Kibbe

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ASTM E31 Sub-Committees

E31.01 Controlled Health Vocabularies for Healthcare Informatics

E31.10 Pharmaco-informatics Standards

E31.13 Clinical Laboratory Information Management

E31.16 Interchange of Electrophysiological Waveforms & Signals

E31.17 Privacy, Confidentiality, and Access

E31.19 Electronic Health Record Content and Structure

E31.20 Data and System Security for Health Information

E31.22 Health Information Transcription and Documentation

E31.23 Modeling for Health Informatics

E31.24 Electronic Health Record (EHR) System Functionality

E31.25 XML Document Type Definitions (DTDs) for Health Care

E31.26 Personal (Consumer) Health Records

E31.27 Data Capture and Reporting

E31.90 Executive

E31.95 Education and Publicity

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ASTM Key Features

• ASTM AIIMASTM-BP-01-08 Portable Document Format-Healthcare (PDF) A Best Practices Guide

• E1384 Practice for Content and Structure of the Electronic Health Record (EHR)

• Standard Guides:• E1762 - Electronic Authentication of Health Care Information• E2086 - Internet and Intranet Healthcare Security• E2117 - Identification and Establishment of a Quality Assurance

Program for Medical Transcription• E2364 - Speech Recognition Technology Products in Health Care• E2369 Standard Specification for the Continuity of Care Record

(XML SCHEMA is an adjunct)

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ASTM E-31 Data Segments

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Standards in an Enterprise Information Domain

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Impact on Market

• ASTM E31 Committee notes use of CCR (Continuity of Care Record) in Google Health Beta. Pilot at Cleveland Clinic.• CCR Standard is an XML – based format for access to, transport

of and interoperable exchange of core summary health information. Allows to import health data from pharmacies, labs, personal data.

• ASTM CCR becomes part of U.S. Policy for HIT in Jan 2010

• Supports continuity of care; Reduces medical errors; Increases efficiency by reducing waste.

• Has potential to be used in more Personal Health Records such as Google Health.

• DrFirst, eClinicalWorks, Allscripts,Medirex Systems etc.

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References

• http://www.astm.org/COMMIT/E31_FactsheetHI.pdf

• http://www.astm.org/COMMIT/E31HealthInfandEHRStdsTraining.pdf

• http://www.astm.org/COMMIT/E31standardseducation.pdf

http://www.astm.org/COMMIT/E31HealthInfandEHRStdsTraining.pdf

http://www.astmnewsroom.org/default.aspx?pageid=1418

http://www.ncvhs.hhs.gov/010201h9.pdf

http://www.astm.org/COMMIT/E31_Brochure.pdf

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CCR sponsors

Collectively represent:

• 500,000 practitioners,

• 13,000 IT professionals,

• 200 IT companies–over19,000 managers of over 11,000 organizations in which 240,000 physicians practice, and

• 12,000 institutions in the long-term care community that provide care to over 1.5 million elderly and disabled.