Raymond D. Aller, MD
Michael Weilert, MD
Directory of health care information technology standards available
AACC meeting dishes up a dollop of systems and software
HL7 CCOWspecification receives ANSI approval
Directory of health care information technology standards
The National Alliance for Health Information Technology has released a public directory of information technology standards for the health care industry.
The directory, released in June, is a comprehensive compilation of standards
developed by various organizations. It is intended to help reduce the risks
and costs of ITimplementation for health care providers by improving the interoperability
of such systems. The free guide is available online to users who set up an account
on the directory Web site, www.hitsdir.org.
The directory will help health care providers and vendors to do business "because now they’re talking the same language," says Rod Piechowski, alliance program manager.
As of August, the directory included 994 standards developed by more than 250 organizations, and 1,100 users had signed up to view it, according to NAHIT project manager Laura Wooster. The directory also includes vocabularies for standardized medical technology, such as SNOMED.
The project was initiated by NAHIT members, who began by including the obvious
IT standards, Piechowski explains. But project investigators determined that
the standards could overlap into multiple categories and were linked to other
standards coming from various organizations. So, the strategy became inclusive
rather than exclusive, Piechowski says. "We decided to be inclusive and err
on that side, rather than to try and restrict it to something that fit a much
more definitive category," he adds.
The online directory doesn’t include the full standards but offers links to sites where users can find more information. Those who access the directory Web site can offer feedback on it, such as whether information is incorrect or needs updating. "We’ll pass [the suggestion] on to researchers, and they’ll follow up and put it in" if it’s appropriate, Wooster says. The directory is updated regularly, and suggested revisions are generally acted on within 24 hours, Pie chow ski adds.
The alliance’s efforts represent a step in the direction of the federal government’s
national goal of reducing variability in IT systems, notes Dale Prestipino,
chief technology officer for CSG Global Health Solutions, an IT and management
consulting firm. "The alliance has realized the value of this and is leading
the change," he says.
However, Prestipino continues, while the health care industry may be supportive of the standards-based movement, IT vendors may not be so quick to embrace it. "There’s a natural tendency by vendors to be proprietary," he says, adding that the standards movement means that vendors are going to be held more accountable for, and therefore must be more open with, their design standards. "Either they will comply or eventually the federal government will mandate standards," he adds. "I don’t think anybody wants to see that happen."
Once vendors begin applying these standards, Prestipino says, the industry should begin to see tangible results in about two years.
NAHIT member Johnson & Johnson Health Care Systems is partially underwriting the costs of maintenance and expansion for the directory until 2006.
AACC meeting dishes up a dollop of systems and software
CAPTODAY contributing editor Hal Weiner attended this year’s American Association for Clinical Chemistry conference in July, where he saw a plethora of product demonstrations. Following is a peek at some of the more noteworthy products.
The most unusual new product at the AACC meeting was the PVTWorkstations front-end
and back-end automation solution from PVTLabsystems (www.pvtlabsystems.com).
The system consists of a series of modules, including automated centrifuges,
decapping and aliquoting, and full rack management.
Using a unique combination of software and a color digital camera, the system visually inspects all primary tubes. It can detect clots in serum and differentiate icteric, lipemic, and hemolytic samples. It measures the available serum quantity, calculates what is required to perform the requested tests, and reports back the remaining volume to a laboratory information system or specimen-tracking system. Various types of primary tubes are automatically decapped in one run. The aliquoting unit manages bar-code labeling and pipetting into microtiter plates. All standard secondary tubes can be used.
The company’s automated capping system is also impressive. The system can seal different types of sample tubes in one run using an aluminum seal similar to those on yogurt containers. The capping system can handle up to 800 specimens an hour.
A handful of vendors demonstrated new standalone quality control packages at
the AACC meeting. Athlecon Corp. (www.athlecon.com),
a new Canadian company with programmers in the Ukraine, demonstrated its suite
of QC packages, including automated capture from instrumentation, traditional
QC reports, and online peer comparison. The products can capture QC data for
all automated instruments online and store it in a common database. By standardizing
all QC processes on one software system, the company claims it can ensure that
all clinical tests are evaluated using common quality requirements and appropriate
Westgard or user-defined rules. Bio-Rad demonstrated similar capabilities with
its QCNet and QCOnCall products (www.qcnet.com).
Westgard QC (www.westgard.com)
introduced two software packages: EZ Runs for advanced QC charting, and EZ Rules
to select the best control rule for a test.
The Spanish company InterQC (www.interqc.com)
debuted its complete Internet service-based QC package, which includes user-defined
multi-rules. The package allows online capture of QC data from an LIS. Users
can specify their own quality objectives and the system will track and alert
using proprietary statistical analysis, including instability and real error
rates. The company is looking for a U.S. distributor.
Physician office laboratories that are searching for a low-cost solution for
regulatory compliance might want to consider the Neptune QC package from Atlantis
Laboratory Systems (www.atlantislabs.com).
Because the product was designed for smaller labs, it is extremely easy to use
and provides peer review with a true peer class of small labs. The system includes
straightforward statistics and clear and concise graphical reports. The package
was developed in conjunction with the U.S. Department of State.
The CAP announced at the AACC meeting that it plans to introduce e-Lab Solutions.
in January 2005. The product will allow CAP Surveys participants to enter proficiency
testing data and receive results online.
Laboratories can obtain proficiency test results within days, submit results
in any form, and get on-line alert reports with Accutest’s DigitalPT product
Accutest claims that DigitalPT fulfills all PTrequirements of the CAP, CMS,
JCAHO, AOA, and COLA, as well as those of state regulatory agencies.
Dawning Technologies (www.dawning.com)
debuted its Reference Lab Connection package at the AACC meeting. The system
can map test names between the reference lab and LIS. It also allows each user
to implement the vendor’s preferred protocol without requiring redevelopment.
Dawning provides the initial setup for all tests performed by the customer.
The customer can eventually modify the configuration to add or delete tests
itself, or Dawning can do it for the customer. The product lets each side of
an interface use its own formats and protocols (HL7 or ASTM), which should hasten
development and implementation. The application can support connections to multiple
reference labs and laboratory information systems. Dawning customers have implemented
interfaces to Quest and other labs using this product. Pricing ranges from $10,000
to $13,000, which is lower than the cost of some competing solutions.
Roche is now offering a middleware solution from Data Innovations (www.datainnovations.com)
that includes a complete instrument management, QC, and specimen storage/retrieval
component. Roche claims users will significantly improve their productivity
using the system and is offering special pricing for its customers.
Roche is also marketing a complete physician office-lab link product from Care
that includes order entry, results, eligibility, scheduling, and other capabilities.
The cost ranges from $19.95 to $24.95 per physician, per month plus a one-time
set-up and interface fee.
demonstrated its low-cost, browser-based WebMREproduct, which captures manual
results from nursing stations and doctors’ offices. The product is an add-on
to the company’s point-of-care testing modules, which are being used in many
HL7 CCOW specification receives ANSI approval
Standards Developing Organization Health Level Seven recently announced that Clinical Context Management Specification (CCOW) version 1.5 has been approved by the American National Standards Institute.
"Looking forward, the CCOW Technical Committee will now turn its attention
to new enhancements to the CCOW specification, including support for applications
that employ HL7 version 3 modeling, data representation, and messaging capabilities,"
says Robert Seliger, co-chair of HL7’s CCOW Technical Committee.
CCOW allows disparate health care applications to be visually integrated, which means they work together in ways the user can see to enhance the user’s ability to incorporate information technology as part of the care delivery process. The standard provides users with the look and feel of a single system, and it supports Web-based and client-server applications.
Unipath LLC, one of the largest providers of anatomic pathology services in the Rocky Mountain region, has contracted for Atlas’ LabWorks outreach ordering and results delivery product.
LifeSource Blood Services has implemented Information Data Management’s Surround 4.0 open laboratory system.
LifeSource will use the system to manage and transmit HIV-1, hepatitis C virus, and West Nile virus nucleic acid testing and donor serology results to its clients and to its own blood bank management system.
Per-Se Technologies has announced that it has contracted to provide North Dallas Pathology Services with compliance services, as well as accounts receivable management, coding, practice reporting, physician enrollment, fee schedule optimization, and managed care consulting services.
North Dallas Pathology Services is a 10-member practice that serves Presbyterian Hospital, Dallas.