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Please review the website of the HL7 organization, www.HL7.org , and the attached article by Kevin Heubusch (January, 2006): Interoperability:

What It Means, Why It Matters

Setting:

The Doomore Hospital, Primicare Clinic, and MaxLab all operate in a small town. Doomore hospital has had an EHR for 7 years. It has put a great deal of work into designing and customizing its system. Primicare Clinic has also implemented a clinic-based EHR. Both entities need to send lab orders to MaxLab, and obtain results back quickly and accurately. Primicare would like to send primary care and maternity patient data on drug allergies and patient care summaries to DooMore Hospital, also as needed.

These entities have differences in the way their EHRs are set up. The patient ID for Doomore is not the same as Primicare ID. Each entity’s drug allergy tables/ fields are represented in the tables below. Review the tables considering what you have learned about data dictionaries so far. Note: Do not be concerned with any demographic data you consider “missing” in the tables. Those attributes would be included in a separate Demographics Table, from what is displayed here. A relational database will easily pull up patient demographics, by simply using the PatientID linked to EHR patient demographic tables.

After one of its own patients is discharged from Doomore hospital’s ED and inpatient facility, Primicare wants to receive the hospital records promptly. Primicare wants at least the patient’s full discharge medication list, all nursing and physician care summaries, and Discharge Orders. This will allow primary care practitioners to better follow up on their patients’ care and compliance.

Usually to determine patient drug allergies at a visit, Primicare has used patient’s first and last name, or the patient ID to look up the correct record, and proceeded to ask the patient and enter data for the correct patient.

For the following questions, please provide short answers of at least 2-3 sentences each. 5 points each item. As you answer each item, consider the relevance that each item has to the challenges of achieving interoperability between systems.

1. Describe at least two problems or issues you observe with Doomore hospital trying to get drug allergy data transferred directly into their own system, from Primicare. In order to use the clinic’s data, what might the hospital need to do?
2. Do you think either the Hospital or the Doctor’s office, could improve upon their drug allergy system tables and use of them? Explain specifically what you would do. Would you add any fields, change fields, or make other changes?
3. If both Primicare and Doomore used HL7, do you think this will resolve all issues with their compatibility for the drug allergy systems? Why or why not? Please explain your reasoning.
4. When MaxLab needs to report results easily from the lab to both the hospital and the clinic-what method or software should it use? Consider a messaging strategy.
5. What computer hardware you would need for Primicare to print out a patient care summary received on its patient, from the hospital? Remember that computer hardware consists the pieces of a computer system you can “put your hands on.”
6. Describe briefly the priorities and goals of the HL7 group, as described in their website