Interoperability standards provide a common language and set of expectations to enable hospitals, practitioners, and patients to share data regardless of applications and devices they are using. There are over 40 different standard development organizations
accredited by the American National Standard Institute. Some of these entities create standards, while others connect existing standards and describe how they can work together to support information exchange.
Here are four of the more popular healthcare IT standards
Health Level 7 (HL7
) is a set of international healthcare standards that guide data sharing between distinct healthcare providers. HL7 was developed by Health Level 7 International, and it is used in over 50 countries. HL7 v2 was released in 1989. It is a messaging standard for exchanging clinical information among different systems. It can support a central patient care system and a distributed environment. It can be viewed as a database query language that providers can use to access health data. HL7 v3 includes some additional capabilities, for example, it supports government reporting.
HL7 standards rely on ASCII text-based messages to communicate between different systems, such as EHR and laboratory information systems. HL7 v2 employs Consolidated Clinical Document format, which is similar to pdf files, making it hard to extract information.
Fast Healthcare Interoperability Resource (FHIR
) was released in 2014 by HL7 as an alternative to HL7 v2. It relies on RESTful web services and open web technologies for communication, which can enhance interactions among legacy healthcare systems. Additionally, RESTful API provides a one-to-many interface, accelerating new data partners onboarding. FHIR’s interoperability merits are not limited to EHR and similar systems but extend to mobile devices and wearables.
Digital Imaging and Communications in Medicine (DICOM
) is a standard for communicating and managing medical images and related data. The National Electrical Manufacturer’s Association developed this standard. DICOM can integrate medical imaging devices produced by different manufacturers by providing a standardized image format. It allows healthcare practitioners to access and share DICOM-compliant images even if they are using different devices for image capturing.
At ITRex, we had a large project involving the DICOM standard and medical imaging interoperability
. A medical imaging solutions company teamed with ITRex to enable all associated clinics and authorized individual providers to view DICOM-compliant medical images from their own station through a web browser. Medical images, such as CT scans, are challenging to handle due to their large size. Therefore, physicians had to go to the internal server room every time they needed to access an image. The client wanted to build a system that would integrate different DICOM images and make them available through the web in doctor’s office.
Our team built a cloud-based DICOM-compliant solution that enables clinicians to upload, access, and manipulate medical images. Doctors could, for example, increase an image’s resolution or accurately measure different aspects of the image. The solution includes one database for all participants and allows various clinics to share images. It also performs automatic backups and software updates.
Several entities took part in developing Consolidated Clinical Document Architecture ( C-CDA
), including the aforementioned HL7 and Integrating the Healthcare Environment (IHE) initiative. C-CDA allows creating clinical documents that are readable for humans and machines, as they contain Extensible Markup Language (XML) tags. This healthcare interoperability standard provides CDA templates for several structured document types and one unstructured type. It specifies the syntax and semantics of clinical documents. Practitioners can use C-CDA to compose and exchange diagnostic imaging reports, procedure notes, and continuity of care documents, among others.