Health Data & Interoperability Standards 1

Health Data and Interoperability Standards

Why is there a problem?

There is a problem because of the difference between syntax and semantics.

Example: National Drug Code system (FDA)

Medication is mainstay of all dieases so standardization across all of them is very important.

National Library of Medicine

–      RxNorm (RXCUI unique number) to access the drug names

–      UMLS – unified medical language system

Standards for Medical problems

Brief history: 

-                    Mid 1400 Northern Italy – Death certificates – name & age of deceased, cause of death certified by physician

-                    Black death 1629-1631: Death certificates used as source of data for analysis

-                    1661 London – Captain John Graunt interested in why children die – turned to death certificates to learn

-                    Massachusetts 1639 – death certificate made available for analysis

-                    London 1839 William Farr discovers interoperability

o   Each disease described in many ways, many terms (this is a problem!)

-                    London 1851 Great exposition, demonstrate top technology. Difficult to compare because no standards

-                    Chicago 1893, International List of Causes of Death (Bertillon Classification) He grouped disease by what we recognize today

-                    Denmark 1899, ICD (international classification of diseases) Decennial revisions, 10^th in 1994, first disease “ontonogy” US want to use it in Oct 2015, only advanced industrial country to not use it.

-                    ICD-10: Radical departure. Introduce content model to facilitate automatic coding of diseases. More specific and detailed.

Another example:

Result: vast increase in complexity. 16X more codes. Lots of complaints from providers.

Example:

 

LOINC Codes – Logical Observation Identifier Names and Codes

            - developed by Regenstrief Institude in Indiana, leading health information center in US.