The importance of standards and adaptation in HIT’s ever changing landscape
This is part of our data migration blog series – a range of topics intended to help organizations who are migrating from one EHR to another.
In the world of healthcare IT, standardization is integral to the governing process that sets the rules and regulations to ensure consistency and uniformity to bridge the gap between disparate systems. It’s a word that makes people say, “Yes, we definitely need that,” but achieving this goal or even carving out the roadmap can seem impossible.
At Galen, standardization is also an integral part of what we do when working with many different EHRs and striving to meet the needs of clients of all sizes and specialties. In our data migration process we utilize GalenETL, our integration engine, to produce HL7 messages and Continuity of Care Documents (CCDs) that can be imported into a target system. These methods of data delivery were developed in accordance with the models set forth by the Health Level Seven International Organization (HL7). Founded in 1987, HL7 is an ANSI-accredited standards developing organization that is dedicated to providing a comprehensive framework and standards for the exchange, sharing, and retrieval of electronic health information. HL7 is supported by more than 1,600 members from over 50 countries, including 500+ corporate members representing healthcare providers, government stakeholders, payers, pharmaceutical companies, vendors/suppliers, and consulting firms.
As you can imagine, standardization is an important part of our process but really, it is the process. When we extract data from a source EHR, it’s pulled into GalenETL in a homogeneous form. Our database architecture allows us to extract clinical items regardless of the many unique ways data can be documented (e.g. discrete, free text, comments, etc.) while maintaining data integrity. When it comes time to deliver the data, we use EHR specific plugins (add-on applications) that allow us to transform the normalized clinical data and generate HL7 messages in the standard format.
We’ve also built customization’s into our plugins, because no two migrations are the same, and we do so in a way that will not affect other clients who don’t have the same needs. One customization allowed for IAM-3.3 (Allergen Code-Name of Coding System) to be populated. The migration included mappings from several coding systems so Galen was tasked with differentiating between SNOMED, UNII, and RxNorm. Likewise, the Galen CCD also follows HL7 CDA standards and has the same flexibility to meet various demands. For example, Galen recently had to modify the XML tags that controlled the status of parsable data elements. The need arose after an update was applied to the client’s EHR. We implemented the change in a way that allowed the CCDs to work properly for any client with this EHR update while not effecting those who did not.
Customization and standardization may appear at odds, however, we can appropriately leverage these two and use them to address another rising tide that the healthcare industry and the technologies we use face daily – change. While we follow and implement the guidelines set forth by organizations like HL7, it’s important to keep in mind that things will change over time and what’s standard today may be replaced by a new standard tomorrow. The methods followed in Galen’s data migration process have allowed us to perform over 200 successful migrations. We continue to focus on standardization to consistently deliver quality but we thrive on the ingenuity from our team to keep relevant in today’s world. Make sure to catch our full data migration blog series.
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