Health Information Exchange

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).


laptop and stethoscope

  • 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


  • “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

Image Credit: Posted by jfcherry on Flickr using a Creative Commons license.
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