Shared Data Model and Notation

As part of these transformations, there is an increased need for technology innovation and increased reliance on evidence-based medicine. Healthcare automation needs have become so critical and pervasive that to address these concerns head-on, a community of practice, Health Level Seven® (HL7®) International BPM Community of Practice, previously BPM+ Health Community, has been created. It was established based on the use of open, standards-based modeling notations and other open IT standards which allows for all types of health organizations, professional societies, and vendors to ensure smooth data exchange between electronic health records (EHRs), medical devices, and healthcare providers, and to standardize data formats for interoperability between hospitals, clinics, insurance companies, and regulatory bodies. Examples include HL7 standards and FHIR® (Fast Healthcare Interoperability Resources®).

Why SDMN is Essential in Healthcare:

• Interoperability Between Systems: Healthcare systems like Electronic Health Records (EHRs), laboratory information systems, imaging systems, and insurance platforms often use disparate data formats. SDMN can ensure compatibility and seamless transformations.Example: Data exchange between hospitals and pharmacies for medication reconciliation.
• Patient-Centered Care: Shared data models provide a unified view of a patient’s medical history, enabling personalized and coordinated care across providers. Example: A primary care physician and a specialist accessing the same data for collaborative treatment.
• Regulatory Compliance: SDMN helps healthcare organizations comply with standards like HIPAA (Health Insurance Portability and Accountability Act) and GDPR (General Data Protection Regulation). Example: Ensuring protected health information (PHI) is consistently structured for secure sharing.
• Data Sharing for Research: Research institutions rely on standardized data for clinical trials, public health studies, and advancements in medical science. Example: Aggregating de-identified patient data for studying disease trends.
• Efficiency in Administrative Processes: Shared data models streamline billing, claims processing, and eligibility verification, reducing costs and administrative burdens. Example: Standardized insurance claims submissions using X12 or HL7 formats.

Key Applications of SDMN in Healthcare:

• Electronic Health Records (EHRs): SDMN can ensure that EHRs from different vendors can share patient data seamlessly across healthcare organizations. Example: FHIR (Fast Healthcare Interoperability Resources) is widely adopted for EHR data exchange.
• Health Information Exchange (HIE): SDMN can enable the secure sharing of health data between providers, patients, and payers. Example: An HIE platform integrates patient lab results from multiple hospitals using HL7 standards.
• Medical Imaging: Standardized data models like DICOM (Digital Imaging and Communications in Medicine) allow interoperability for imaging devices and storage systems. Example: A radiology lab shares a patient’s X-ray image with a referring physician using DICOM.
• Claims Processing and Revenue Cycle Management: SDMN can ensure standardized data formats for billing and insurance claims submissions, reducing errors and rejections. Example: Insurance claims submitted using X12 formats for faster reimbursement.
• Telehealth and Remote Monitoring: Telehealth platforms use shared data models to integrate patient data with EHRs and monitoring devices. Example: A wearable device sends standardized blood pressure readings to a telehealth provider for analysis.
• Population Health Management: SDMN can improve aggregation and analysis of data to identify health trends and improve outcomes for specific populations. Example: Public health agencies use standardized data for tracking vaccination rates and disease outbreaks.

Key Standards and Frameworks in Healthcare That Can Use SDMN

• FHIR (Fast Healthcare Interoperability Resources): A standard developed by HL7 for exchanging healthcare information electronically. Example: Used to integrate EHRs with third-party apps for patient data sharing.
• HL7 (Health Level Seven): A set of international standards for the exchange, integration, and sharing of healthcare information. Example: Used for sharing lab results between hospitals and outpatient clinics.
• DICOM (Digital Imaging and Communications in Medicine): A standard for storing and transmitting medical imaging data. Example: Sharing CT scan results between imaging centers and hospitals.
• X12: A standard for electronic data interchange (EDI) used in claims processing, eligibility, and payments. Example: Insurance claims submitted using the X12 837 format.
• LOINC (Logical Observation Identifiers Names and Codes): A universal standard for identifying medical laboratory observations. Example: Used for sharing lab test results across institutions.
• SNOMED CT (Systematized Nomenclature of Medicine Clinical Terms): A comprehensive clinical terminology used to encode diseases, conditions, and treatments. Example: Standardizing diagnostic terms across EHRs.
• ICD (International Classification of Diseases): A standard for coding diseases and health conditions. Example: Used in billing and reporting to insurance providers.