Browsing by Subject "Interoperability"

Now showing 1 - 6 of 6
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    2024 HRS perspective on advancing workflows for CIED remote monitoring
    (Elsevier, 2024-09-27) Slotwiner, David J.; Serwer, Gerald A.; Allred, James D.; Bhakta, Deepak; Clark, Richard; Durand, Julien; Ferrara, Martha G.; Hale, Jason; Irving, Chris; Iverson, Andy; Jin, Maobing; Johansen, Jens B.; Kalscheur, Matthew; Krisjnen, Dennis; Lerman, Robert; Lippman, Neal; Mendenhall, G. Stuart; Michael, Ryan; Nichols, Steven; Parkash, Ratika; Ray, Noemi; Reister, Craig; Skipitaris, Nicholas T.; Solomon, Harry; Steiner, Paul R.; Tietz, Marko; Wan, Elaine Y.; Wadhwa, Manish; Medicine, School of Medicine
    Cardiac implantable electronic devices (CIEDs) generate substantial data, often stored in image or PDF formats. Remote monitoring, now an integral component of patient care, places considerable administrative burdens on clinicians and staff, in large part due to the challenge of integrating these data seamlessly into electronic health records. Since 2006, the Heart Rhythm Society, in collaboration with the CIED industry, has led an initiative to establish a unified standard nomenclature. This effort has harmonized terminology, aligning diverse terms with single terms approved by the Institute of Electrical and Electronics Engineers. With this foundational work complete, attention now turns to developing technical standards for interoperability, which would enable the smooth communication of CIED data between information technology systems used in clinical practice. In this article, by leveraging Health Level 7 Fast Healthcare Interoperability Resources, we present a road map for the technical committee to guide this endeavor. We identify critical data exchange points between remote transceivers, electronic health records, and third-party platforms commonly used for CIED patient data management. Our objective is to establish bidirectional communication among these resources, ensuring the accuracy, timeliness, and accessibility of clinical data for clinicians. We also anticipate substantial benefits for both clinical research and administrative efficiency through the implementation of this interoperability framework.
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    Data Integration and Interoperability for Patient-Centered Remote Monitoring of Cardiovascular Implantable Electronic Devices
    (MDPI, 2019-03-17) Daley, Carly; Toscos, Tammy; Mirro, Michael; BioHealth Informatics, School of Informatics and Computing
    The prevalence of cardiovascular implantable electronic devices with remote monitoring capabilities continues to grow, resulting in increased volume and complexity of biomedical data. These data can provide diagnostic information for timely intervention and maintenance of implanted devices, improving quality of care. Current remote monitoring procedures do not utilize device diagnostics to their potential, due to the lack of interoperability and data integration among proprietary systems and electronic medical record platforms. However, the development of a technical framework that standardizes the data and improves interoperability shows promise for improving remote monitoring. Along with encouraging the implementation of this framework, we challenge the current paradigm and propose leveraging the framework to provide patients with their remote monitoring data. Patient-centered remote monitoring may empower patients and improve collaboration and care with health care providers. In this paper, we describe the implementation of technology to deliver remote monitoring data to patients in two recent studies. Our body of work explains the potential for developing a patent-facing information display that affords the meaningful use of implantable device data and enhances interactions with providers. This paradigm shift in remote monitoring-empowering the patient with data-is critical to using the vast amount of complex and clinically relevant biomedical data captured and transmitted by implantable devices to full potential.
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    Development of a FHIR Based Application Programming Interface for Aggregate-Level Social Determinants of Health
    (AMIA Informatics summit 2019 Conference Proceedings, 2019-03-25) Kasthurirathne, Suranga N.; Cormer, Karen F.; Devadasan, Neil; Biondich, Paul G.
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    Evolving availability and standardization of patient attributes for matching
    (Oxford University Press, 2023-10-12) Deng, Yu; Gleason, Lacey P.; Culbertson, Adam; Chen, Xiaotian; Bernstam, Elmer V.; Cullen, Theresa; Gouripeddi, Ramkiran; Harle, Christopher; Hesse, David F.; Kean, Jacob; Lee, John; Magoc, Tanja; Meeker, Daniella; Ong, Toan; Pathak, Jyotishman; Rosenman, Marc; Rusie, Laura K.; Shah, Akash J.; Shi, Lizheng; Thomas, Aaron; Trick, William E.; Grannis, Shaun; Kho, Abel; Health Policy and Management, Richard M. Fairbanks School of Public Health
    Variation in availability, format, and standardization of patient attributes across health care organizations impacts patient-matching performance. We report on the changing nature of patient-matching features available from 2010-2020 across diverse care settings. We asked 38 health care provider organizations about their current patient attribute data-collection practices. All sites collected name, date of birth (DOB), address, and phone number. Name, DOB, current address, social security number (SSN), sex, and phone number were most commonly used for cross-provider patient matching. Electronic health record queries for a subset of 20 participating sites revealed that DOB, first name, last name, city, and postal codes were highly available (>90%) across health care organizations and time. SSN declined slightly in the last years of the study period. Birth sex, gender identity, language, country full name, country abbreviation, health insurance number, ethnicity, cell phone number, email address, and weight increased over 50% from 2010 to 2020. Understanding the wide variation in available patient attributes across care settings in the United States can guide selection and standardization efforts for improved patient matching in the United States.
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    Towards Interoperability for Public Health Surveillance: Experiences from Two States
    (JMIR, 2013-04-04) Dixon, Brian E.; Siegel, Jason A.; Oemig, Tanya V.; Grannis, Shaun J.; Health Policy and Management, Richard M. Fairbanks School of Public Health
    Objective: To characterize the use of standardized vocabularies in real-world electronic laboratory reporting (ELR) messages sent to public health agencies for surveillance. Introduction: The use of health information systems to electronically deliver clinical data necessary for notifiable disease surveillance is growing. For health information systems to be effective at improving population surveillance functions, semantic interoperability is necessary. Semantic interoperability is “the ability to import utterances from another computer without prior negotiation” (1). Semantic interoperability is achieved through the use of standardized vocabularies which define orthogonal concepts to represent the utterances emitted by information systems. There are standard, mature, and internationally recognized vocabularies for describing tests and results for notifiable disease reporting through ELR (2). Logical Observation Identifiers Names and Codes (LOINC) identify the specific lab test performed. Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) identify the diseases and organisms tested for in a lab test. Many commercial laboratory and hospital information systems claim to support LOINC and SNOMED CT on their company websites and in marketing materials, and systems certified for Meaningful Use are required to support LOINC and SNOMED CT. There is little empirical evidence on the use of semantic interoperability standards in practice. Methods: To characterize the use of standardized vocabularies in electronic laboratory reporting (ELR) messages sent to public health agencies for notifiable disease surveillance, we analyzed ELR messages from two states: Indiana and Wisconsin. We examined the data in the ELR messages where tests and results are reported (3). For each field, the proportion of field values that used either LOINC or SNOMED CT codes were calculated by dividing the number of fields with coded values by the total number of non-null values in fields. Results: Results are summarized in Table-1. In Indiana, less than 17% of incoming ELR messages contained a standardized code for identifying the test performed by the laboratory, and none of the test result fields contained a standardized vocabulary concept. For Wisconsin, none of the incoming ELR messages contained a standardized code for identifying the test performed, and less than 13% of the test result fields contained a SNOMED CT concept. Conclusions: Although Wisconsin and Indiana both have high adoption of advanced health information systems with many hospitals and laboratories using commercial systems which claim to support interoperability, very few ELR messages emanate from real-world systems with interoperable codes to identify tests and clinical results. To effectively use the arriving ELR messages, Indiana and Wisconsin health departments employ software and people workarounds to translate the incoming data into standardized concepts that can be utilized by the states’ surveillance systems. These workarounds present challenges for budget constrained public health departments seeking to leverage Meaningful Use Certified technologies to improve notifiable disease surveillance.
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    Trends in user-initiated health information exchange in the inpatient, outpatient, and emergency settings
    (Oxford University Press, 2021-03-01) Rahurkar, Saurabh; Vest, Joshua R.; Finnell, John T.; Dixon, Brian E.; Health Policy and Management, School of Public Health
    Prior research on health information exchange (HIE) typically measured provider usage through surveys or they summarized the availability of HIE services in a healthcare organization. Few studies utilized user log files. Using HIE access log files, we measured HIE use in real-world clinical settings over a 7-year period (2011-2017). Use of HIE increased in inpatient, outpatient, and emergency department (ED) settings. Further, while extant literature has generally viewed the ED as the most relevant setting for HIE, the greatest change in HIE use was observed in the inpatient setting, followed by the ED setting and then the outpatient setting. Our findings suggest that in addition to federal incentives, the implementation of features that address barriers to access (eg, Single Sign On), as well as value-added services (eg, interoperability with external data sources), may be related to the growth in user-initiated HIE.