This document discusses healthcare interoperability standards. It covers the need for standardization in areas like minimum data sets, code directories, unique identifiers, registries, and data privacy. The document provides examples of challenges around adopting standards, including ensuring identifiers and registries are properly synced across systems to avoid misidentification. It also discusses the importance of clearly defining minimum data sets and code directories to facilitate data integration, analytics and exchange.

1. 08 AUG 2013
CONFIDENTIAL AND PROPRIETARY TO THE PARTIES IN DISCUSSION.
Contact: Dr Pankaj Gupta
Partner, Taurus Glocal Consulting
Board Member HIMSS Asia-Pacific-India Chapter
HIR @ The International Centre for Health Innovation, Richard
Ivey School of Business, Canada
Website: www.taurusglocal.com
Blog: http://www.healthcareitstrategy.blogspot.com/
LinkedIn: http://www.linkedin.com/in/drpankajgupta
Open Data for Innovation in
Governance

2. ORIGIN OF STANDARDS
R A I L W A Y G A U G E
S T A N D A R D
Meter Gauge
Scotch 4 ft 6 in (1,372 mm)
Cape 3 ft 6 in (1,067 mm)
Standard Gauge
4 ft 8 1⁄2 in (1,435 mm)
(Stephenson gauge)
Broad Gauge
Indian 5 ft 6 in (1,676 mm)
O R I G I N O F T H E
S T A N D A R D ?

3. PARADIGM SHIFTS QUESTION STANDARDS
P A R A D I G M S H I F T I N
I N D U S T R Y
S T A N D A R D S D E B A T E :
T I M E I S C Y C L I C A L O R
L I N E A R ?
25 December 1969:
While Swiss watch makers were
playing one-upmanship with
their mechanical watches
Seiko Japanese company unveiled
the world's first quartz
wristwatch - the 35SQ Astron
Watch
2013:
Sony has launched mobile phone
watch. Now will time become
multi-dimensional?!

4. ADOPTION OF STANDARDS DEPENDS ON PERCEPTION
BIRD OR A RABBIT?

5. HEALTHCARE STANDARDS
Interoperability Standards
 Minimum Data Sets and Data Standards
 Standard Code Directories
 Standard Meta Data for Semantics
 Standard Ref Architecture
 Standard Interfaces
HIPAA Title II: Preventing Health Care Fraud
and Abuse; Administrative Simplification;
Medical Liability Reform
 Data Privacy
 Transactions and Code Sets
 Data Security
 Unique Identifiers

6. INTEROPERABILITY STANDARDS:
E.G. CANADA HEALTH INFOWAY BLUEPRINT

7. UNIQUE IDENTIFIERS AND REGISTRIES
Health information exchange between systems
 Facility Registry
 Physician Registry
 Patient Registry
 Disease Registry
 Document Registry
Integration between systems
 All IDs to be Unique
 Registries to be in Sync
 Avoid: Dr Om Prakash Singh in ENT vs Dr OP
Singh in Otolaryngology?

8. DEFINE MINIMUM DATA SETS
H I S T O R I C A L
P E R S P E C T I V E
Hb < 7
Hb > 7
IFA Tablets Given :
Report in blocks
of 100
100 Tablets Given? or
Tablets given to 100
Women?
C L E A N S L A T E
P E R S P E C T I V E
Define Min Data sets
that can be used
by all applications
Lab Test Type = Hb
Lab Test Value =
5, 7, 9, 11, 13
Define meta data for
clear semantics of
Data Elements
and Indicators

9. CODE DIRECTORIES
Master Data integration challenge – codify
diagnosis, procedures and order sets
Data Analytics challenge - standard terminology
for clinical notes
 Diabetes with MI discharged with B-blocker
 Diabetes with Coronary Atherosclerosis
discharged with B-blocker
 Type-II Diabetes with CHF discharged with
Metoprolol

10. DATA PRIVACY
Protected Health Information (PHI)
 Right to keep personal information from outside world
 Hospital staff, in-house and outsourced IT staff may be
authorized to see data and may disclose it inappropriately
Protect sensitive information – PNDT and MTP Act
Positive results for sensitive Lab tests - HIV etc.
Public health research - Anonymised data
Don’t want data of one landing up on another’s desk - People
master, Dept master to be in sync in integrated systems
Dr Parminder Singh = Dr P Singh !
Dr Paramjit Singh = Dr P Singh ?

11. THANKS!