Healthcare institutions are urged to adopt common industry standards to ensure interoperability of healthcare information infrastructures, both legacy and emerging.
By adopting common standards such as the HL7CDA, healthcare providers can reduce errors, lower their costs through standardized interfaces, and make it easier for clinicians to locate and retrieve information.
HL7CDA is the Clinical Document Architecture standard from Health Level Seven or (HL7). Certified by the American National Standards Institute, the standard provides an exchange model for clinical documents such as patient discharge summaries and progress notes.
Jill Kaufman, IBM's program director for life sciences standards, said in a recent interview: "Standards is an opportunity [for information systems] to become scalable and to achieve interoperability."
More importantly, Kaufman added, the benefits of standards go "beyond the four walls" of a healthcare provider.
"Looking at the way healthcare is going, it is not local anymore," she said. "And, there are public health concerns and disease knows no borders. Healthcare needs to scale and standards enable this."
One patient, one record
Standards like HL7CDA ensure information can be seamlessly exchanged between healthcare providers, and will help countries like Singapore achieve their vision of a universal patient record and grab medical tourism growth opportunities.
Although Singapore's healthcare sector has made progress, where several hospitals have embraced electronic medical records (EMR) systems to improve operational efficiency, there is still the challenge of exchanging information between different healthcare institutions.
Emphasizing the interoperability challenge arising from different hospitals having different naming conventions for patient data, Kaufman said: "Many hospitals have started their journey, and many have chosen different standards or vocabularies. But there will be a need to exchange information, so how do you resolve the two different sets of names? Standards are required not just in the syntax but in the common vocabulary."
Industry experts say the road to establishing a single record for every citizen is a long one, but if there is one country that can successfully transform its nationwide healthcare information infrastructure, it is Singapore.
Kaufman, who is also the co-chair of HL7's Clinical Genomics Special Interest Group, said: "I'd like to compliment Singapore on its common patient identifier. Most countries that I've visited don't have that, which puts Singapore ahead. You have higher patient safety, as you know that that is [indeed] the patient when you work with a particular patient record.
"In the United States, we have to spend a lot of time checking that [the person] is really the patient and the patient's record [is the one] that we're working with. So Singapore is really ahead," she added.
Quek Hui Nar, executive committee president of the Association of Medical and Bio-Informatics Singapore (AMBIS), said that although Singapore's healthcare sector has its challenges of legacy systems, they are not insurmountable.
"Our public hospitals are quite advanced in their adoption of IT. They've built upon systems over the years, either with primitive or little or no standards," Quek said. "There will be work, but I don't think it'll be a total rework. It'll be just another implementation, [whilst] keeping the legacy system for operational needs."
Last month, AMBIS and IBM jointly organized a half-day workshop on how established standards such as the HL7, can support the evolution of electronic health records.