Why Have Standards in eHealth?

What is standardization in eHealth and why is it so critical? According to eHealth Ontario, standardization in eHealth plays a critical role by ensuring there is consistency in the collection and exchange of patient information across healthcare.1  eHealth standards form the foundation for exchange of health information.2  Standards enhance quality of data and decrease medical errors to ensure clinical data is interoperable across healthcare. eHealth standards include terminology providing specific codes for clinically relevant content such as diseases, allergies, medications, problem lists and  diagnoses.

COACH has contributed to the development of standards for the protection of health information in Canada since 1989 through its privacy and security guidelines. COACH also actively contributes to the development and implementation of international standards for health information as the key to electronic health record (EHR) and interoperability initiatives in Canada and worldwide. (Visit www.coachorg.com for  details.)

In this this column, our writers focus on the significance of standards in  eHealth.

This article is part of the COACH: Canada’s Health Informatics Association eHIP Forum series about career paths, industry trends and hot topics for professionals in the first five years of their HI career. Visit www.coachorg.com to learn more about the eHIP Forum, open to all COACH members.

Key to Consistency & System Interoperability

Bogdan Pascalau

Bogdan is currently working as a Business Analyst in the IT Education & Clinical Informatics Department at the Centre for Addiction and Mental Health (CAMH).

Standards play a fundamental part in information integration, by providing consistency in patient health information collection and exchange. Standards must be considered throughout the eHealth realm, such as when building and implementing electronic health records (EHRs), collecting data from EHRs and in quality management for medical devices. This is done in order to facilitate system interoperability, ensure adherence to current privacy and security legislation and provide the ability to successfully leverage various devices and applications.

Emerging Professionals (EPs) completing eHealth-related degrees such as health informatics (HI) and health information management, must be keenly aware of the importance of standards, and attain at least a high-level understanding of when and where standards must be applied. With the emergence of new technologies in eHealth (i.e., enterprise and best-of- breed EHRs, remote patient monitoring technologies, point of care devices, etc.), consistency in information collection and exchange is vital to ensuring system interoperability. EPs working in this field will inevitably be involved with standards at some point in their career, either by creating them or adhering to those put in place by their colleagues.

Facilitating a Progressive, Responsive eHealth Ecosystem

Crystal Chin

Crystal is a recent graduate from the Master of Health Informatics (MHI) program at the University of Toronto. She is currently working with iamsick.ca.

There is no question that eHealth standards are incredibly important. As a recent graduate from the U of T MHI program, I learned that standards are critical in ensuring that health IT systems can work together. Not only are they important with regards to traditional HIT systems, standards also play a role in the success of newer, non-traditional HIT innovations.

On one hand, standards can be seen as hindering creative, innovative disruption. The nature of standards is to impose a definitive – though not necessarily exhaustive – list of rules and guidelines. Contrary to that is the nature of innovation, where pushing boundaries and breaking rules is encouraged. There is an inherent tension that may prevent new solutions from becoming implementable products.

On the other hand, standards can help new ideas connect to the existing eHealth space. It is naive to assume that a new eHealth product can exist on its own, without any influence from established practices. Standards can be the common language that facilitates the creation of a progressive and responsive eHealth ecosystem.

The Accountability & Attainability Connection

Arjun D Segal

Arjun is currently completing his Master of Science in eHealth degree at McMaster University. He is an eHealth Analyst at ClinicalConnect at Hamilton Health Sciences.

Health is an industry of constant growth, advancement and endless possibilities, but with complications along with the way. I’ve come to understand, within this digital realm of informatics, that standards are the human aspects that determine the industry’s success – as standards are pushing the matters of contention through the philosophy to embrace and promote innovations in the industry.

EPs need to be “eHealth Champions”  and target the leaders of organizations, who can endorse these standards to assure there is awareness, progress and continuity in the industry – be it within the health links, clinical, research, private or public organizations. The willingness to adopt and embrace ongoing advancement within the industry is exemplified through implementation, development and novelties. As a balance between the avenues of personable deliverable healthcare, standards bring forth accountability to assure that measures are attainable and that the quality of care within eHealth is being met for all individuals.

Vital to Continuity of Care

James Castillo

James is a Master of Health Informatics student at the University of Toronto.

While I was in nursing school I worked  as a community personal support worker. When visiting my recently discharged clients in the community, I would have to ask them about the care they received in the hospital so I would be able to provide consistent care across different care settings. Unfortunately, there was hardly any kind of formal information exchange between care sectors. Too often continuity of care was jeopardized because of the lack of information sharing between sectors. Technology could be leveraged to facilitate this information sharing, but how would this be possible? Standards.

Standards in eHealth are important because they enable information exchange across diverse healthcare IT systems, which can improve a patient’s continuity of care as she/he travels throughout Canada’s health system. Standards, in eHealth today, are critical for how the whole industry will evolve over time. As standards change and are updated, professionals in the eHealth space will adapt to various requirements, guidelines and characteristics that are specified.

When thinking about standards, I like to think in terms of specifics: “How will this standard impact the work that I would like to be doing in the future?”

Supporting Integrated EMRs

Samantha Schultz

Samantha, a Health Sciences student at University of Waterloo, is completing her internship at the Centre for Addiction and Mental Health (CAMH).

To me, standards in eHealth mean implementing the same guidelines around electronic medical records (EMRs) in every hospital, clinic and office across Ontario. It is critical that medical records can be integrated from every hospital, pharmacy, specialist, etc. so that every patient has a comprehensive EHR, allowing healthcare professionals to provide the best, safest individualized care. This would require a great deal of change and plenty of recruiting and persuading to be done by those working in the eHealth industry. I think EPs in eHealth need to understand it is a slow process and many people are resistant to change. However, it is a worthy cause and improving the eHealth system across the province could greatly benefit Ontarians.

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