Standards Groups and Technology Standards

American Health Information Community
AHIC is the public-private entity that will develop standards and work to develop a national approach to interoperability. The committee will include HHS officials and representatives of key agencies including DOD and VA.

American Society for Testing and Materials
A component of the American National Standards Institute (ANSI) that has a subcommittee

(E31)
for general healthcare informatics. This E31 Subcommittee on Healthcare Informatics develops standards related to the architecture, content, storage, security, confidentiality, functionality, and communication of information used within healthcare and healthcare decision making, including patient-specific information and knowledge.

Certification Commission for Health Care Information Technology
The purpose of The Commission is to create an efficient, credible, sustainable mechanism for the certification of healthcare information technology products. The Commission will focus its initial efforts on HIT market sectors expected to enjoy the greatest potential acceleration of adoption from Product Certification. The consensus has emerged, supported by Dr Brailer's report, that EHRs and related clinical HIT products marketed to the physician office practice represent the most appropriate place to start. The Commission will have the goal of having its initial certification requirements and processes in place for testing in spring or summer 2005.

The Clinical Informatics Wiki -- Clinfowiki
Wiki technology applied to the growing content of informatics terminology.

Clinical Data Interchange Standards Consortium
The Clinical Data Interchange Standards Consortium (CDISC) is committed to the development of standards to support the electronic acquisition, exchange, submission and archiving of clinical trials data and metadata for medical and biopharmaceutical product development. Microsoft serves on the organization's Industry Advisory Board.

Commission on Systemic Interoperability
Commission on Systemic Interoperability is to submit a report (on October 25, 2005) on a comprehensive strategy for the adoption and implementation of health care IT standards that includes a timeline and prioritization for adoption and implementation.

Connecting for Health
Connecting for Health is a public-private collaborative designed to address the barriers to development of an interconnected health information infrastructure. Connecting for Health organized several working groups focusing on understanding the business and organizational issues of community-based information exchange, sharing electronic information with patients, and several aspects of technical interoperability.

Consolidated Health Informatics
CHI is a collaborative effort to adopt health information interoperability standards, particularly health vocabulary and messaging standards, for implementation in federal government systems.

Consumer-Purchaser Disclosure Project (C/PDP)
The Consumer-Purchaser Disclosure Project is a group of leading employer, consumer, and labor organizations working toward a common goal to ensure that all Americans have access to publicly reported health care performance information by January 1, 2007. Our shared vision is that Americans will be able to select hospitals, physicians, and treatments based on nationally standardized measures for clinical quality, consumer experience, equity, and efficiency.

eHealth Initiative
eHI's Parallel Pathways for Quality Healthcare
is a framework and a set of principles for aligning emerging incentive programs with both quality goals and the health information technology infrastructure required to achieve those goals -- both within the physician practice and across regions and communities through health information exchange.

EHR Collaborative
The EHR Collaborative is a group of organizations representing key stakeholders in healthcare, including practicing clinicians, payers, purchasers, researchers, healthcare providers, IT suppliers, information and technology managers, accrediting groups, public health organizations, manufacturers, and public sector partners. The goal of the EHR Collaborative is to facilitate rapid input from the healthcare community in this and other development initiatives that advance the adoption of information standards for healthcare.

Electronic Healthcare Network Accreditation Commission
EHNAC' works to set standards for electronic health care industry participants to facilitate the electronic transmission of bills and payments in a manner consistent with all federal laws and regulations.

Federal Health Architecture
The FHA will create a consistent federal framework to facilitate communication and collaboration among all health care entities to improve citizen access to health-related information and high-quality services. It will link health business processes to their enabling technology solutions and standards to demonstrate how these solutions achieve improved health performance outcomes.

Health Information Standards Board (HISB)
HISB provides an open, public forum for the voluntary coordination of healthcare informatics standards among all United States' standard developing organizations. Every major developer of healthcare informatics standards in the United States participates in ANSI HISB. The ANSI HISB has 27 voting members and more than 100 participants, including ANSI-accredited and other standards developing organizations, professional societies, trade associations, private companies, federal agencies, and others.

HHS Data Council
The HHS Data Council coordinates all health and human services data collection and analysis activities of the Department of Health and Human Services, including an integrated data collection strategy, coordination of health data standards and health information and privacy policy activities.

HL7
Health Level Seven is an accredited ANSI standard organization that produces the HL7 messaging standard. It is the accepted messaging standard for communicating clinical data. It is supported by every major medical informatics system vendor in the US. The HL7 mission is to provide a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services. Specifically, to create flexible, cost effective standards, guidelines, and methodologies to enable healthcare information system interoperability and sharing of electronic health records. The HL7 Reference Information Model (RIM) is an object model with a large pictorial representation of the clinical data (domains) and identifies the life cycle of events that a message or groups of related messages will carry.

HL7 Electronic Health Record Technical Committee's Home Page
This site is a gateway for information related to the ongoing HL7's Electronic Health Record Systems standards development work. You will find information describing the Technical Committee's work, how to get involved in a project, how to contribute to the current EHR-S Draft Standard for Trial use and future ballots, and information about other organizations that continue to support this critical initiative.

Institute of Electrical and Electronics Engineers's Standards Association
The Institute of Electrical and Electronics Engineers Standards Association (IEEE-SA) is the leading developer of global industry standards in a broad-range of industries, including biomedical and healthcare, information technology and information assurance.

IOM Committee on Patient Safety Data Standards
This group within the Institute of Medicine has the charge of producing a detailed plan to facilitate the development of data standards applicable to the collection, coding, and classification of patient safety information.

IOM Health Care Quality Initiative
The series of IOM quality reports have included a number of metrics that illustrate how wide the quality chasm is and how important it is to close the gulf between good quality care and the current norm.

MedBiquitous
MedBiquitous is the ANSI-accredited developer of information technology standards for healthcare education and competence assessment. Our XML and Web Services Standards enable communications among diverse entities in professional medicine and provide opportunities to seamlessly support the clinician learner. MedBiquitous has developed standards for healthcare learning objects (HLOs), discrete units of online instruction that may be used at the time of need, as well as standards for communicating clinician profile information, education and certification activities, journal information, and educational metrics. These standards will facilitate collaboration across organizations and make it easier to track licensure, certification, and educational changes or activities.

National Committee on Vital and Health Statistics
The National Committee on Vital and Health Statistics was established by Congress to serve as an advisory body to the Department of Health and Human Services on health data, statistics and national health information policy. It fulfills important review and advisory functions relative to health data and statistical problems of national and international interest, stimulates or conducts studies of such problems and makes proposals for improvement of the Nation's health statistics and information systems. In 1996, the Committee was restructured to meet expanded responsibilities under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

National Council for Prescription Drug Programs
NCPDP focuses on prescription drug messages and works to create and promote data interchange and processing standards for the pharmacy services sector of the health care industry including standards for billing pharmacy claims and services, rebates, pharmacy ID cards, and a standard for business functions between prescribers and pharmacies (e-prescribing).

National Institute of Standards and Technology
NIST has been actively involved with various standards' development organizations, government agencies, and private industry in developing and testing health IT standards , including ANSI HITSP, HL7, IEEE-1073, ATA, HHS/ONC, CHI, AHRQ, and others. It has ongoing programs supporting standards development, harmonization, interoperability, testing, and information dissemination.

National Quality Forum
The National Quality Forum is a private, not-for-profit membership organization created to develop and implement a national strategy for healthcare quality measurement and reporting.

Public Health Data Standards Consortium (PHDSC)
The Public Health Data Standards Consortium is an important vehicle for promoting standardization of information on health and healthcare. Members of the Consortium serve as health data collectors and data users who actively support the overall goals of developing, promoting, and implementing data standards for population health practice and research.

Actual Standards

Alliance Standards Directory
The National Alliance for Health Information Technology donated the contents of its Standards Directory to the National Institute of Standards and Technology (NIST). The Alliance’s Directory is the premier collection of health IT standards, and currently contains more than 2,100 listings for health IT standards and links and information for the 430 organizations that created them. This vast body of knowledge will be used to expand NIST’s HealthCare Standards Landscape web-application and database.

Continuity of Care Record (CCR)
Continuity of Care Record (CCR) is being developed in response to the need to organize and make transportable a set of basic information about a patient's health care that is accessible to clinicians and patients.

Current Procedural Terminology (CPT)
CPT Current Procedural Terminology was developed by the American Medical Association in 1966. These codes are used for the billing of medical procedures. Each year, an annual publication is prepared, that makes changes corresponding with significant updates in medical technology and practice. The most recent version of CPT, CPT 2003, contains 8,107 codes and descriptors.

Digital Imaging and Communications in Medicine (DICOM)
The Digital Imaging and Communications in Medicine (DICOM) Standard was developed for the transmission of images and is used internationally for Picture Archiving and Communication Systems (PACS). This standard was developed by the joint committee of the ACR (the American College of Radiology) and NEMA (the National Electrical Manufacturers Association) to meet the needs of manufacturers and users of medical imaging equipment for interconnection of devices on standard networks.

EHR-Lab Interoperability and Connectivity Standards
ELINCS will develop a national standard for the delivery of real-time laboratory results from a lab's information system to an electronic health record. Typically this process can be a fractured one in which lab results are sent to the ordering doctor's office via fax or mail. The results must be filed in the patient's paper chart or manually entered into the physician's EHR.

E-Prescribing Standards (Second Set of Recommendations)
The National Committee on Vital and Health Statistics (NCVHS) has been called upon by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) to develop recommendations for uniform standards to enable electronic prescribing (eprescribing) in ambulatory care. This letter is the second set of recommendations on eprescribing and sets forth recommendations relating to electronic signatures and other important issues. (National Committee on Vital and Health Statistics, March 4, 2005)

E-Prescribing Standards ( First Set of Recommendations)
The first set of recommendations, sent September 2, 2004, addressed message format standards that provide communication protocols and data content requirements, terminologies to ensure data comparability and interoperability, identifiers for all relevant entities within the e-prescribing process and important related issues for e-prescribing. (National Committee on Vital and Health Statistics, Sept. 2, 2004)

HealthCare Standards Landscape
The HCSL is a public web-based repository containing information about healthcare standards, the organizations that develop, promote, or use these standards, related healthcare standards' information, and links to external resources. It lets users to search for or publish information on healthcare standards and related information, thus providing a central resource of useful information for the health informatics community.

HL7 Reference Information Model
The HL7 Version 3 RIM is designed to provide a unified framework for, and to serve as a comprehensive source of, all information used by an HL7 Specification. The RIM specifically and unambiguously articulates both the explicit definitions of healthcare concepts - the "things of interest" to the world of healthcare information systems - and the relationships (aka "associations") between these concepts-of-interest.

HL7 Clinical Document Architecture
Provides an exchange model for clinical documents (such as discharge summaries and progress notes), and brings the healthcare industry closer to the realization of an electronic medical record.

Infoway Reference Implementation Suite
IRIS (Infoway Reference Implementation Suite) is a demonstration of Electronic Health Record (EHR) interoperability messaging created by Canada Health Infoway. The project demonstrates and proves Patient Registry interoperability messaging using HL7 v3.

International Classification of Diseases (ICD-9CM)
The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) was developed in the United States to provide a way to classify morbidity data for indexing of medical records, medical case reviews, and ambulatory and other medical care programs, as well as for basic health statistics. It is based on the World Health Organization (WHO) international ICD-9. A version based on ICD-10 (ICD-10-CM) is in preparation.

International Classification of Diseases (ICD-10)
The ICD has become the international standard diagnostic classification for all general epidemiological and many health management purposes. These include the analysis of the general health situation of population groups and monitoring of the incidence and prevalence of diseases and other health problems in relation to other variables such as the characteristics and circumstances of the individuals affected.

Logical Observations: Identifiers, Names, Codes (LOINC)
Coding system for the electronic exchange of laboratory test results and other observations. LOINC development involved a public-private partnership comprised of several federal agencies, academia, and the vendor community. This model can be applied to other standards setting domains.

National Drug File Reference Terminology (NDF-RT) and RxNorm
The NDF-RT and the RxNorm projects are focused on improving interoperability of drug terminology. The area of clinical drugs is seen as important in the growing issues of patient safety. The National Drug File, Reference Terminology is being developed for the Veterans Administration as a reference standard for medications to support a variety of clinical, administrative and analytical purposes. The RxNorm Project is a developing project of the NLM where new concepts are being added to the UMLS for clinical drug representations.

National Provider Identifier (NPI)
HIPAA covered entities must use NPIs to identify health care providers in standard transactions. These transactions include claims, eligibility inquiries and responses, claim status inquiries and responses, referrals, and remittance advices.

Recommendations on Medical Equipment
Because much medical equipment in use today either stores protected health information (PHI), or connects to a network with other systems that store PHI, such medical equipment needs to comply with the Security Rule. In addition, Computer errors, resulting either from a computer virus or a provider inappropriately performing a software update, may cause medical equipment or devices to malfunction, potentially resulting in patient harm Therefore, NCVHS held hearings to gather information about the effect of the Security Rule on medical devices. (National Committee on Vital and Health Statistics, March 4, 2005)

Systematized Nomenclature of Medicine
SNOMED-CT (Clinical Terminology) has been created from the combination of SNOMED-RT (Reference Terminology) and Read codes. NLM and others are working to bring coding systems such as this SNOMED-CT (clinical terms) into the public domain.

X12N
X12N is the standard for electronic data interchange (EDI) used in administrative and financial health care transactions (excluding retail pharmacy transactions) in compliance with the Health Insurance Portability and Accountability Act of 1996. Used for external financial transactions, financial coverage verification and insurance transactions and claims.