While Meaningful Use is on everyone’s mind, semantic interoperability may be an unfamiliar concept. Semantic interoperability, medical vocabulary, Meaningful Use, LOINC ®, and HL7 might seem even more of an alphabet soup. How do all these pieces fit together and how does it help my organization?
Healthcare is complex. The ability to exchange diverse clinical information generated during delivery of healthcare is essential to ensuring continuity of care and patient safety. Electronic exchange of information can occur
- between providers
- between providers and patients
- between organizations
- between care settings
At the heart of electronic information exchange are medical vocabularies and transmission standards. By requiring controlled vocabularies, Meaningful Use is laying the foundation for the healthcare environment to exchange information consistently and ubiquitously. A medical vocabulary allows for the consistent representation of medical concepts; however this representation is only part of the picture. It is not simply the exchange of data but transmitting data with shared meaning where value is realized.
LOINC ®, a universal code system for identifying laboratory and clinical observations, is a vocabulary standard named in Meaningful Use requirements in lab information exchanges and in Cancer Registry exchanges for ambulatory providers. (See the previous blog post on February 12, 2013, “LOINC and Meaningful Use,” for further background.)
HL7 is a transmission protocol named prominently in Meaningful Use. HL7 has been quoted as being the most widely used healthcare interoperability standard in the world in use in over 90% of hospitals in the US and widely supported by healthcare IT suppliers worldwide. * HL7 is a standardized format and syntax of passing and formatting data in a message between computer systems.
Although HL7 began initially in admission, discharge and transfer (ADT) systems, its use has expanded throughout the healthcare enterprise. A field in a HL7 message or document may use LOINC ® universal code names and identifiers. HL7 acts as a semantic data model, a description of how vocabulary items can be combined to make a valid representation of medical information. In HL7, vocabulary elements are linked to the message structure using identifiers and coded element data types. It is the combination of the semantic data model, HL7, and structured medical vocabulary that completes representation of a medical concept.
Meaningful Use requirements may seem arbitrary or capricious at times, however when taking the pieces and parts of the requirements together, it is easier to see the value that Meaningful Use can bring to the healthcare environment.
Development of the Logical Observation Identifier Names and Codes (LOINC ®) vocabulary
*Principles of health interoperability HL7 and SNOMED by Tim Benson