Are Meaningful Use Stage 2 certified EHRs ready for interoperability? Findings from the SMART C-CDA Collaborative.
Bottom Line: Based upon our analysis and vendor discussions, we identified 11 specific areas that represent relevant barriers to the interoperability of C-CDA documents.We identified errors and permissible heterogeneity in C-CDA documents that will limit semantic interoperability.Our findings also point to several practical opportunities to improve C-CDA document quality and exchange in the coming years.
Affiliation: Lantana Consulting Group, LLC, East Thetford, Vermont, USA Diameter Health, Inc., Newton, Massachusetts, USA.Show MeSH
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Mentions: Based upon our analysis and discussions with Collaborative participants, we identified 11 specific areas (ie, ‘trouble spots’) in examined C-CDA documents. Although not comprehensive, each trouble spot represents a relevant, common issue in C-CDA documents. Since not all vendors elected to publicize their participation in the Collaborative, de-identified results were presented in the last group call (figure 3). The severity and clinical relevance of these trouble spots vary according to the context of C-CDA document use. Data heterogeneity or omission may impose a minimal burden in cases where humans or computers can normalize or supplement information from other sources. In other cases, a missing or erroneous code (eg, terminology misuse; table 4) could disrupt vital care activities, such as automated surveillance for drug–allergy interactions. Because the severity of trouble spots depends upon specific clinical workflows, we confine our discussion to the knowable barriers they create to semantic interoperability.
Affiliation: Lantana Consulting Group, LLC, East Thetford, Vermont, USA Diameter Health, Inc., Newton, Massachusetts, USA.