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HL7 updates DSTU to include conformance criteria

HIM Connection, December 6, 2005

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Even though the Health Level Seven (HL7) draft standard for trial use (DSTU) won't be officially accredited by the American National Standards Institute until July 2006, HL7 introduced significant changes to its original draft that can help guide both providers and vendors through the EHR selection and upgrade process.

The HL7 team, an array of industry stakeholders such as the pediatrics data-standards special interest group, has created conformance criteria-a completely new addition to the DSTU-for each function an EHR should perform. If you haven't revisited the draft since its 2004 release, you'll be surprised to find hundreds of criteria associated with the functional model.

The conformance criteria show both providers and vendors what a system needs to execute to comply with each function in the standard, says Donald Mon, PhD, vice president of practice leadership at the American Health Information Management Association and cofacilitator for the direct care section of the EHR standard for HL7. Each of the 130 functions has between three and 18 criteria. Following are a sample function and two sample criteria:

• Sample function: The system must be able to capture patient demographic data.
• Sample criterion: The system must capture a single, logical patient record.
• Sample second criterion: The record should be unique for each patient.

The group has completed work on approximately one-third of the functions. "Work gets very granular at the conformance-criteria level. The individual criterion have to spell out the various ways that function must [or should] be executed," Mon says.

What the standard will do for healthcare
HL7 is going into great detail to provide vendors with guidance, Mon says. The vendor will now know what to do to meet the standard. For example, when a vendor reads a conformance criterion that says, "A system must capture a single, logical patient record," the vendor can test its product against that statement. To fully comply, the vendor would need to satisfy the whole list of criteria for each function.

The DSTU helps purchasers as well because they now have a guide and specific criteria for which to ask. They can use this standard in a request for information or request for proposal during system selection. For example, they can ask, "Does your system uniquely identify each patient? How?"

Many providers already use this standard to hold more detailed and knowledgeable conversations with vendors, Mon says. "Even though it's not an accredited standard at this point, the material that's in there is very useful and there's no reason to wait for it to be fully accredited."

How the DSTU affects you
Do you wonder what to do if you're in the middle of rolling out your EHR? "The key message is that just because the standard isn't final, the hospital shouldn't delay the purchasing decision, implementation, or stop using the system it already has," Mon says. This standard can help the hospital compare what it has in its current system with the standard, and then request an upgrade or modification to its product for those parts that lack the proper functions.

Mon says there will be additional changes once the draft period ends. The group plans to add certain functions that HL7 will likely fine-tune. HL7 will make the DSTU more specific and break down certain functions to make them more manageable for vendors to supply and users to request.

The variety of professionals working on the project-emergency physicians, attorneys, HIM professionals, and long-term care professionals-means no stone will be left unturned, Mon says. "The beauty of this is when you take a look at the conformance criteria, when you look at the EHR standard, it will address all of the needs in healthcare."

Editor's note: This article was adapted from Electronic Health Records Briefing, published by HCPro, Inc.

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