A standard was defined by the NSPAC (National Standards Policy Advisory Committee) as 'a prescribed set of rules, conditions, or requirements concerning definitions of terms; classification of components; specification of materials, performance, or operations; delineation of procedures; or measurement of quantity and quality in describing materials, products, systems, services, or practices.'
Quite a mouthful! But that complicated definition can be drilled down to basics to answer the question, 'How do standards apply to healthcare?'
Standards are used in all phases of an inpatient or outpatient visit. Messaging standards are used when the patient is admitted using the electronic health record (EHR) to order medications, diet, tests, and procedures. Content standards are used as the nurse documents the lung sounds according to unified terminology. Standards of measurement are in oxygen tubing and pharmacy dosing. Communication standards are in the digital phone lines as well as in the interoperability of competing companies products. Performance and quality standards are in evidence-based best medical and surgical practices.
When a physician sees a patient in the office or emergency room and inputs the orders on the computer system, messaging standards allow the systems with interoperability to talk to each other, reducing the possibility for errors and decreasing the time required for order clarification.
Another scenario: A patient is admitted to the hospital and a paper chart is initiated with basic information including allergies. The hospital has a policy that allergies must be noted in red ink on every sheet of the chart, but the hospital is short-staffed and someone forgets to note the allergies on the front of the chart and medication record, placing the patient at risk. A standard EHR would eliminate this patient safety issue, as the entry for allergies would be regulated.
When the nursing assessment is completed on a newly admitted patient, the nurse may use one of a variety of charting methods. In our hypothetical hospital, all units do not chart uniformly; data collection forms, SOAP (subjective, objective, activity and plan) charting, as well as free style are all used. A nursing model content standard with unified terminology would normalize nursing notes to have greater significance.
ANSI (American National Standards Institute) has delegated the role of ISO/TC 215 secretariat to HIMSS. This initiative connects HIMSS to healthcare informatics experts worldwide, affording us the opportunity to contribute to the development of international standards. (See the April 2003 issue of HIMSS News for more about HIMSS' secretariat appointment.)
Information technology in healthcare is on the high-speed express. Standards improve the ability of multiple organizations to work together for the good of improving patient care.
HIMSS members and non-members alike are invited to join the US/TAG (technical advisory group) and ISO/TC 215 as this important work goes forward.
For additional Standards work visit the Standards Insight archive.
For further information, please contact Audrey Dickerson, incoming secretary for ISO/TC 215 at adickerson@himss.org
Susan Matney
Bibliography
Judy Ozbolt, Vanderbilt University
AMIA 2002 Development Evaluation
Bibliography on Terminology Standards
Nursing Terminologies for NHII
HHS Proposes Adoption of ICD-10 Code Sets and Updated Electronic Transaction Standards
Proposed Changes Would Improve Disease Tracking and Speed Transition
to an Electronic Health Care Environment
SNOMED Forms New Division To Promote International Adoption
SNOMED's international division changes name to reflect its recent changes. The new division marks a step forward in the international adoptioon of SNOMED. Read the full press release at http://www.himss.org/content/files/CAPSTS_news_091107.pdf.
HIMSS Approves Position on HITSP Interoperability Recommendations
The HIMSS Board of Directors approved, at its June 2007 board meeting, the following position statement in support of the Health Information Technology Standards Panel.
