1. Your Healthcare Standards Conformance Partner
Accelerating Adoption of Health
Information Exchange Standards
AbdulMalik Shakir
President and Chief Informatics Scientist

2. Electronic Health Information
The use of Electronic Health
Records and the demand for
electronic exchange of health
information from one health
care professional to another is
growing along with national
efforts to improve the quality,
safety and efficiency of health
care delivery.
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3. National Health Programs

Meaningful use requirements,
new payment approaches,
and federal financial
incentives are all driving the
interest and demand for
health information exchange.

Similar initiatives are
underway in other nations
throughout the world.
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4. Healthcare Informatics Standards

Healthcare organizations have
found it advantageous to
collaborate in the pursuit of
solutions to healthcare
information management issues.

Healthcare provider, payer, vendor,
consulting, and regulatory
organizations have formed
industry groups to study
information management issues
and develop standard solutions to
their common problems.
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5. Electronic Health Information Exchange
Claims/Prescriptions
Referral Process
Eligibility
Claim Status
Referral Process
Eligibility
Claim/Status
Payors
Pharmacies
Physicians
Public Health
Medical Society
Medical Records
Patient Data
Family Planning
Lab results
Mental Health
Hospitals
County/Community
Entities
Enrollment
Orders
Insurance Updates
Health Information
Results
Images
Testing Organizations
Lab/Images
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Employers
Government
Medicare/Medicaid
Patients/Consumers
Accelerating Adoption of Health
Information Exchange Standards
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6. Healthcare Data Interchange Standards
HL7
X12N
X12N / HL7 (Non-US only)
NCPDP
Healthcare
Information
System
HL7
HL7
HL7, X12N
DICOM
IEEE MIB,
ASTM
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HL7
Accelerating Adoption of Health
Information Exchange Standards
HL7, X12N
October 14, 2013

7. Leading U.S. Healthcare Data Interchange SDOs
IEEE
Institute of Electrical and Electronic
Engineers
NCPDP
National Council for Prescription Drug
Programs
X12N
Insurance Subcommittee of X12
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ASTM
American Society for Testing and
Materials
DICOM
Digital Imaging and Communications in
Medicine
HL7
Health Level Seven
Accelerating Adoption of Health Information Exchange Standards
October 14, 2013

8. Leading U.S. Healthcare Data Interchange SDOs
IEEE
Instrumentation communication standards
and generalized information interchange
standards
ASTM
Lab reporting standards and standard guide
for content and structure of computerbased patient records
NCPDP
DICOM
Standards for communication of
prescription, billing, and other pharmacy
material
Standards for exchanging digital radiology
images
X12N
HL7
Standards for exchange of healthcare
insurance and billing information
Inter-application interoperability standards
for healthcare
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9. HL7 and X12N


HL7
Insurance / Billing
X12N
Clinical / Administrative


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HL7 and X12N are standards
development organizations
accredited by the American
National Standards Institute
(ANSI).
Each organization adheres to a
strict and well-defined set of
operating procedures that ensures
consensus, openness and balance
of interest.
HL7 develops standards that
enable disparate healthcare
applications to exchange key sets
of clinical and administrative data.
X12N develops specification that
enable the electronic interchange
of healthcare insurance and claims
processing data.
Accelerating Adoption of Health Information Exchange Standards
October 14, 2013

10. An X12N Data Interchange Scenario
Patient Billing
Application
System
Dataset
Program
Module
Outbound
Transformation
Inbound
Transformation
A to B
Transformation
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Dataset
Patient Billing
Application
System
B to A
Transformation
Inbound
Transformation
Claims Processing
Application
System
User Interface
Outbound
Transformation
Program
Module
User Interface
Accelerating Adoption of Health Information Exchange Standards
Claims Processing
Application
System
October 14, 2013

11. An HL7 Data Interchange Scenario
Order Entry
Application
System
Dataset
Program
Module
Outbound
Transformation
Inbound
Transformation
A to B
Transformation
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Dataset
Order Entry
Application
System
B to A
Transformation
Inbound
Transformation
Laboratory
Application
System
User Interface
Outbound
Transformation
Program
Module
User Interface
Accelerating Adoption of Health Information Exchange Standards
Laboratory
Application
System
October 14, 2013

12. Reaching the Limits of Application
Interfaces
Decision
Support
Electronic
Health Record
Lab
Radiology
Pharmacy
?
External
Systems
?
Order Entry
ADT
?
Administrative
Systems
Enterprise
Systems
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13. HIE Standards: Why
• The number of interfaces between N systems is given by the formula (N2-N)/2.
• Linking 2 systems only needs 1 interface, (22 – 2) / 2 = 1;
• Linking 6 systems needs as many as 15 interfaces, (62 – 6) / 2 = 15
• The benefits of using standard increase rapidly with the number of systems involved.
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14. HIE Standards: Why
Interfaces Requirements
120
100
Interfaces
80
60
40
20
0
2
3
4
5
6
7
8
9
10
11
12
13
14
15
W/O HL7
1
3
6
10
15
21
28
36
45
55
66
78
91
105
With HL7
2
3
4
5
6
7
8
9
10
11
12
13
14
15
System s
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Tolerable
Painful
Accelerating Adoption of Health Information Exchange Standards
Intolerable
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15. Health Information Exchange
Effective, meaningful health information exchange
requires that all parties involved in information
exchange adhere to predetermined transaction formats,
usage constraints, and encoding rules.
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16. Healthcare Information Integration Infrastructure
Your healthcare standards conformance partner

Product Domains


Health Information Integration


Health Information Standards Compliance
Healthcare Quality and Performance Measurement
Service Offerings

Consulting and Contracted Resources

Education and Training
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17. Health Information Standards Compliance

Hi3 Solutions’ STANDARDS CONFORMANCE VALIDATOR™ (SCV) is a
comprehensive suite of application services that validates compliance with
healthcare information exchange standard specifications and conformance
with related implementation guides and profiles.
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18. STANDARDS CONFORMANCE VALIDATOR

Standard HIE Transaction Specifications

Standard Clinical Terminology Code Systems

Data Item Specific Value Sets

Use Case Driven Specification Profiles

Data Exchange Instance Validation
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19. Short List of HIE Standards
Standards

Exchange Structures









HL7 v2.x
HL7 v3 Messages
HL7 v3 CDA Documents
ASC X12 v5010
Code Systems

Profiles / Guides
SNOMED CT
LOINC
CPT
ICD
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HL7





Case Notification
Laboratory Reporting
Immunization
Consolidated CDA
X12



834 Benefit Enrollment
837 Health Care Claim
835 Health Care Claim Payment
Accelerating Adoption of Health Information Exchange Standards
October 14, 2013

20. Health Information Integration
Hi3 Solutions’ HEALTH INFORMATION INTEGRATOR™ (HII) is a
comprehensive suite of application and database services that facilitate the
transformation of data structures, translation of clinical terminologies, and
integration of health information.

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21. HEALTH INFORMATION INTEGRATOR


Standard structure to local
structure transform

Standard structure to
standard structure transform

Coded value to coded value
translation

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Local structure to standard
structure transform
Integrated health information
data repository
Accelerating Adoption of Health Information Exchange Standards
October 14, 2013

22. Healthcare Quality and Performance Measurement
Hi3 Solutions’ HEALTHCARE QUALITY MONITOR™ (HQM) is a
comprehensive suite of data warehousing and business intelligence
solutions geared specifically toward monitoring quality and performance in
healthcare in accordance with established measurement standards.

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23. HEALTHCARE QUALITY MONITOR



RIM-based Integrated
Data Repository
RIM-based Star-Schema
Business Intelligence
database
Predefine performance
measures and metrics
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


Drill-down and drillthrough capabilities
Information publication
and data export
capabilities
Data visualization and
reporting capabilities
Accelerating Adoption of Health Information Exchange Standards
October 14, 2013

24. Quality and Performance Measures

CMS: Clinical Quality Measures

NCQA: Healthcare Effectiveness Data and Information Set

JCAHO: National Quality Core Measures

CMS: Physician Quality Reporting System

BC/BS: Pay For Performance
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26. Hi3 Solutions Products

STANDARDS CONFORMANCE VALIDATOR™ a comprehensive suite of
application services that validates compliance with healthcare information
exchange standard specifications and conformance with related
implementation guides and profiles.

HEALTH INFORMATION INTEGRATOR™ a comprehensive suite of
application and database services that facilitate the transformation of data
structures, translation of clinical terminologies, and integration of health
information.

HEALTHCARE QUALITY MONITOR™ a comprehensive suite of data
warehousing and business intelligence solutions geared specifically toward
monitoring quality and performance in healthcare in accordance with
established measurement standards.
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27. http://54.200.52.82/

28. Hi3 Solutions Services

Consulting and Contracted Resources [Hi3 Consulting Group]


Consulting personnel provide advisory services and expert strategic guidance, while contracted
resources provide staffing for projects to augment internal personnel and fulfill gaps in skills or available
bandwidth.


Hi3 Solutions’ CONSULTING AND CONTRACTED SERVICES are provided by a diverse set of HIT
professionals with talent and experience in all areas of healthcare informatics, health information
exchange, and health information management in general.
Contracted services are also available to design and develop of custom turnkey solutions to meet client
specific information management needs.
Education and Training [Hi3 University]

Hi3 Solutions’ EDUCATION AND TRAINING SERVICES provide the knowledge transfer, skills
development, and skills certification required to establish an effective HIT workforce.

Education is provided in the form of instructor lead classroom tutorials, custom on-site training and
certification, and online live and pre-recorded webinars.

Hi3 educational offerings include topics in the area of health informatics standards, information
modeling and vocabulary management, and healthcare information management tools and technologies.
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29. Hi3 University
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30. www.hi3solutions.com
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31. Hi3 Solutions,
3500 W. Olive Ave,
Suite 300,
Burbank, CA 91505
ww.hi3solutions.com
+1 800 918-6520
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