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The current fragmented system of healthcare delivery in the UnitedStates is often blamed on lack of standardization, which stems fromthe complexity involved in normalizing data. Looking ahead,it"s clear that achieving true meaningful use requires us tomove beyond simply integrating systems to the more complex task ofintegrating information. By embracing localization—terms and phrases that are uniqueto an organization or geography—while still standardizingdata, we can accomplish meaningful use in a way that supports theultimate goal of universal health information exchange. All U.S. healthcare organizations bill health insurers using ICD-9and CPT codes, but not all physicians, nurses and lab companiesdocument diseases and procedures in the same way. This creates achallenge for coders, but also for organizations that want toexchange and understand information from unaffiliatedorganizations, which is a requirement for Stage 2 of meaningful useof electronic health records (EHRs). Integrating EHR systems can certainly help organizationscommunicate more efficiently, but the end result often is just theconsolidation of data in one area. If the data can"t beunderstood, then it can"t be used to enhance continuity ofcare or achieve meaningful use. Assuming an organization is able toelectronically receive information from an unaffiliated practice ordelivery system, the data then must be combined with internalinformation and translated into accurate ICD-9, SNOMED CT, LOINCand other standards. Technology is key to translating unique terms from multiple systemsinto standardized language. A Web-based language engine thatincorporates common provider-friendly terms, for example, can helpproviders and coders quickly identify the correct ICD or SNOMEDcode by allowing them to search using familiar colloquial terms andphrases. As standards expand—as they will with the conversionto ICD-10, for instance—a Web-based tool can be updated inreal-time to help organizations manage the influx of new codes andterminologies. This kind of utility not only helps providers improve thespecificity of their documentation within workflow, but it can beused to generate reports that help pinpoint precise documentationtraining needs. Smoothing the road to meaningful use To achieve Stage 2 meaningful use, organizations will need to dothings such as convert disparate terminologies for medications,problem lists and medication allergy reconciliation; record patientfamily histories, demographics and smoking status as structureddata; and provide structured electronic laboratory results toeligible professionals. All of these steps require integratinginformation that may have been gathered, documented and codeddifferently among various organizations. Using a language engine, existing local terminologies can be mappedto standards. Going forward, that gives providers the ability toaccess all of these standard terminologies using their own familiarverbiage, without having to re-train themselves to speak anddocument. Without needing to know the precise details of SNOMED orICD, for instance, a provider could still search for problems ordiagnoses in his or her own words; the language engine wouldprovide the right codes to the right application. By not forcing physicians to try to adjust to ever-changingstandards, productivity, billing accuracy and efficiency can beimproved. Generating reports and conducting quality analysis isalso enhanced because the most current data is compiled andavailable from disparate providers. In some situations, a language engine"s ability to conductreal-time quality analysis might detect nuances critical to patientcare, otherwise missed because it was transmitted via an un-codedterm. Additionally, the capability exists to incorporateconsumer-friendly terminology so that providers can give patientsonline access to their health information and supply them withclinical summaries for each office visit—both of which alsoare requirements of Stage 2 meaningful use. The importance of being able to easily translate local terminologyto various standards will grow exponentially as providerstransition to ICD-10, adjust to practicing with EHRs, and findtheir way in the evolving reimbursement landscape. Providers"attention should be devoted to caring for their patients; the lastthing they should have to do is change how they document that care.Through the use of technology, we can remove that burden whilestill obtaining all the patient care benefits of standardized data.That"s the very essence of meaningful use. George T. Schwend is the co-founder, president and chief executiveofficer of Health Language Inc. (HLI), a global provider ofsoftware for managing and updating standard and localizedhealthcare terminology. Brian Levy, MD, is the senior vice president and chief medicalofficer for HLI. Dr. Levy is also a practicing board-certifiedinternist who has spent years in the field of medical informatics.He has helped develop terminologies, clinical content, and the useof the Internet by patients and physicians to improve caredelivery. I am an expert from udpf.com, while we provides the quality product, such as Buried Light , LED Control System, China LED manufacturers,and more.
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