3 ms·

Maybe so, but I would argue a lot of the key information isn't that different for each type of medical event. (I'm leaving aside scheduling and insurance claims

by entee 9y ago

Maybe so, but I would argue a lot of the key information isn't that different for each type of medical event. (I'm leaving aside scheduling and insurance claims for now because I'm less familiar with things there but there are still probably some commonalities). Each medical event should have: - Patient it relates to - Date it happened (possibly date it started and date it ended instead) - Who did/prescribed/ordered it - List of medical codes+coding system tuples that happened on that event There's tons of other information of course, but these very basic things are universal and should always be in the same place (I refer to FHIR in this case, but format is somewhat irrelevant if the API is good). I understand they're not for historic reasons, and that some might complain because it doesn't exactly fit how they think about things, but a consistent API provides more value and I think will lead to better process down the line. HL7 is moving along with FHIR, and I think it's a good start, I look forward to where it ends up.

commandar 9y ago
>Maybe so, but I would argue a lot of the key information isn't that different for each type of medical event. Well, I mean, that's pretty much the entire basis of the HL7 segment paradigm. >- Patient it relates to This is a much, much, much harder problem than you'd think. Patients are going to have multiple identifiers attached to them and resolving them cleanly is literally an industry of its own within healthcare. And that's precisely why it's a common problem during integrations - which identifier gets used how is generally a workflow and design decision made for a specific site-level implementation. >- Date it happened (possibly date it started and date it ended instead) >- Who did/prescribed/ordered it These usually aren't sticking points for integration because they're the easy ones to get people to agree on. >- List of medical codes+coding system tuples that happened on that event These aren't really standardized at the industry level beyond ICD-10 diagnosis codes. Things like insurance provider codes, procedure codes, order codes, etc are individual to sites; even things like ethnicity and gender codes are variable by location. I don't want it to sound like I'm down on FHIR or that I think HL7v2 is the greatest thing since sliced bread because I don't think either is the case. The point I'm getting at is that there are huge problems with healthcare data interchange that just plain aren't going to be solved by a better interchange format.

by entee 9y ago

commandar 9y ago

>Maybe so, but I would argue a lot of the key information isn't that different for each type of medical event. Well, I mean, that's pretty much the entire basis of the HL7 segment paradigm. >- Patient it relates to This is a much, much, much harder problem than you'd think. Patients are going to have multiple identifiers attached to them and resolving them cleanly is literally an industry of its own within healthcare. And that's precisely why it's a common problem during integrations - which identifier gets used how is generally a workflow and design decision made for a specific site-level implementation. >- Date it happened (possibly date it started and date it ended instead) >- Who did/prescribed/ordered it These usually aren't sticking points for integration because they're the easy ones to get people to agree on. >- List of medical codes+coding system tuples that happened on that event These aren't really standardized at the industry level beyond ICD-10 diagnosis codes. Things like insurance provider codes, procedure codes, order codes, etc are individual to sites; even things like ethnicity and gender codes are variable by location. I don't want it to sound like I'm down on FHIR or that I think HL7v2 is the greatest thing since sliced bread because I don't think either is the case. The point I'm getting at is that there are huge problems with healthcare data interchange that just plain aren't going to be solved by a better interchange format.