X12 and HL7 Interoperability - Public Health Data Standards

Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Kathleen Connor Fox Systems Inc,*,X12 and HL7 Interoperability,Presented March 19,2004Kathleen Connor,Fox Systems Inc,1,National Standards Interoperability,HIPAA and a number of federal health initiatives,including NHII,CHI and EHR are accelerating the adoption of health care data standards,including X12 and HL7,However,interoperability issues arise when health care systems send,receive,store and process data that come from multiple data standards,2,Key Issues,If these standards are not interoperable,if semantics do not align,then systems will map these standards differently,As a result,data will not be comparable and our national health goals will be compromised,Yet achieving interoperability among data standards is not a trivial endeavor,3,Topics to Consider,We need to understand,The roles of X12&HL7 in achieving National Health Care goals,Note:although not the in the scope of this presentation,everything said applies to NCPDP as well!,The Interoperability“Problem Space as made evident by real-life examples,and,Why Interoperability Matters,4,ASC X12N,X12 HIPAA transactions are used to transmit financial and administrative information by many of the same health care entities that use HL7:,Health care providers,hospitals,and insurers,Intermediaries who process electronic health care transactions,such as financial institutions,billing services and clearinghouses;and,Health care purchasers,such as Medicare and Medicaid,5,HL7,HL7 message and information structures(HL7 specifications)are used by many of the same health care entities that use X12 HIPAA transactions,including,Providers,hospitals,insurers,and research institutions,Producers of health care products,Public health and regulatory agencies,6,Mixing X12 and HL7,Many health care entities use both X12 and HL7 to communicate health information,An episode of health care may involve several HL7 messages and X12 transactions running sequentially or concurrently,all communicating about the the same health care“objects or events,7,Problem,Space,8,Data Degradation Issues,Health care trading partners most likely do not populate or derive data from X12 transactions and HL7 specifications in the same ways,X12 and HL7 data will likely be mapped differently to the proprietary formats within trading partners systems,X12 or HL7 data may not represent a health care“object in the same way,but we dont know how they differ,9,Ambulance Transport Information,Data Element,Non-Custom Segment,Custom Segment,Patient Weight,OBX field 3=CR102Patient Transport Weight9981,ZHI field 29,OBX field 5=weight,OBX field 6=lb,Transport Code,OBX field 3=CR103Type of Transport991316,ZHI field 6,OBX field 5=I,R,T,X,10,These Standards have to “Start Talking,The HL7 specifications have been developed without considering that the information transmitted in HL7 message and information structures is(1)used to populate or(2)may be derived from X12N health care transactions,The X12N health care transactions have been developed without considering that the information transmitted in X12 transactions is(1)used to populate or(2)may be derived from HL7 messages and,information structures,11,Problem Status,To date,there has been no assessment of the congruence of the concepts underlying the information that must flow between these two standards,We can assume that there are“maps between them because hospitals that use HL7 for internal messaging,populate X12N healthcare transactions using information derived from those messages,12,Why Data Interoperability?,Prior to federal efforts to bring standards to clinical electronic health records,code sets and messages,any incompatibility between these two standards was a“non-issue,Health entities used X12 only for inter-enterprise,administrative communications,They used HL7 only for intra-enterprise,research and public health communication,13,NHII/EHR Increase the Need,Federal eHealth initiatives,absolutely,depend on X12 and HL7 interoperability,If the EHR standard set requirements for the clinical and demographic data in clinical systems,more HIPAA data will be derived from HL7,specifications,At the same time,providers EHR systems will likely be designed to use data that is derived from inbound HIPAA transactions,14,End2End Data Interoperability,Ultimately,we need a dynamic workflow model of the interdependent functionalities among and within interchange partners in the health community that can trace the migration of X12 and HL7 data throughout,This can only happen with collaboration between these two SDOs,15,