Notes from module 9 of the Interprofessional Health Informatics course I’m working on (plus side reading that I did to fill in some blanks/learn more about some things mentioned in the course).
Interoperability
- Interoperability: “the ability of two or more systems or components to exchange information and to use the information that has been exchanged” (IEEE Standard Computer Dictionary)
- exchange – information transported
- interoperability – semantic tools needed to make sure that you can use the information once you get it!
- interprofessional opportunity – disparate services can be integrated – data standards are critical
- we need common terminologies to enable meaningful information exchange across professions
Standardization
- “continuously learning health system” vision – we will learn from the system and apply those learnings to the system
- USA Federal health IT strategic plan: better technology –> better information –> transform healthcare
- essential data sets (nursing as an example, but other professions have these as well)
- purpose: meet information needs of multiple users (e.g., clinicians, patients, administrators, payers)
- minimum, core, essential data to capture the care experience
- enable the collection, management, manipulation and communication of data for multiple purposes
- Nursing Minimum Data Set (NMDS)
- 16 essential elements in 3 broad categories
- nursing care elements – nursing dx, nursing intervention, nursing outcomes, intensity of nursing care
- patient or demographics – personal ID, DOB, sex, race/ethnicity, residence
- service elements – facility, unique patient number, unique number of principal RN provider, episode admission or encounter data, discharge/termination data, disposition of pat, expected payer for the bill
- Nursing Management Minimum Data Set (NMMDS)
- essential data for support administration and management of nursing care delivery across multiple settings
- 18 elements in three broad categories
- environment: unit/service, type of unit/service, patient population, volume of delivery, accreditation, decisional participating, unit/service complexity, patient accessibly, method of care delivery, complexity of clinical decision making
- nursing care: manager demographic profile, nursing staff & client care support personnel, nursing care staff demographic profile, nursing care staff satisfaction
- financial resource: payer type, reimbursement, unit/service budget, expenses
- International Nursing Minimum Data Set (I-NMDS)
- NMDS and NMMDS were created in the US
- wanted to know if they’d be applicable globally
- International Council for Nurses and International Medical Informatics Association working together
- Established NMDSs (Australia, Canada, Belgium, Iceland, Switzerland, Thailand & Netherlands)
- Emergent NMDS: Nordic countries, Brazil, UK, etc.
- core variables: patient problem/phenomenon, interventions, and outcomes, plus nursing resource, are in the international set
- focused on core data that, if every country collected it, we’d be able to work together
- want to work towards best use of nursing resource, best care and patient/family experience
- Logical Observation Identifiers Names and Codes (LOINC(R))
- originally for lab, but NMMDS is being coded to be included in LOINC
- to be able to collect the minimum data set data, you need classifications/vocabularies/terminologies (recall from module 3)
- we want data from multiple agencies and vendors to be integrated
- we want to be able to link interventions and outcomes
Resource: An IT Primer for Health Information Exchange
