Electronic Information Standards to Support Obesity Prevention and Bridge Services Across Systems, 2010–2015
TOOLS AND TECHNIQUES — Volume 14 — October 26, 2017
This timelines shows that in 2010, the following activities were undertaken (needs and priorities identified): clinicians identified the need for improvements in obesity-related data in EHRs, health departments communicated the need for electronic information standards and timely surveillance, and Healthy Weight informatics were prioritized in policies and initiatives. From approximately 2011 through 2013, the following activities were undertaken (development and harmonization of standards): developed screening standards, advanced standards, and 6 interoperability specifications; convened stakeholders and invited public comment; and ongoing work to harmonize and maintain standards. During 2014 and 2015, the following activities took place (testing and demonstrations): partner with health systems and engage vendors; build and test capacity of systems to capture, send, and accept data; and demonstrate use-case scenarios. In 2016, deployment consisted of piloting and disseminating.
Figure 1. Process for creating Healthy Weight standards. All activities were undertaken in collaboration with stakeholders: state and local partners (via webinars), the Healthy Weight EHR Expert Panel, professional academies, and information technology (IT) vendors. Abbreviations: EHR, electronic health record.
Left-hand box titled “Health Care Providers” says, “Capturing quality Healthy Weight data in EHR systems, improving care: A (Assessment), B (Behaviors), C (Continuity of Care), D (Identify resources), s (set goals and supply a care plan).” Right-hand box titled “Public Health” says, “Establishing a Healthy Weight information system and informing improvements: Programs, practices; and Policy, systems, environments.” Bottom box (which spans entire flow chart and is connected to each of the 2 previous boxes by double-headed arrows) says, “Centered on Patients and Communities: Allowing secure interfaces for electronic HW information input and benefits from output.” Arrow pointing from right-hand box to left-hand box is titled “Feedback” and text says “Providing reports and populating dashboards for patient education, priority setting, and patient care quality improvements.” Arrow pointing from left-hand box to right-hand box is titled “CDA and ORU.” Arrow pointing from left-hand box back to itself is titled “CDA” and is accompanied by text that says, “Exchanging electronic information using HL7 v2.5.1 and IHE-based standards.”
Figure 2. Electronic Healthy Weight information exchange process flow chart, 2015. Information flow between participants (boxes) via interactions (arrows) is enabled by standards using the Healthy Weight ORU assessment and CDA advanced message content. The “ABCDs” are captured in EHR systems in health care providers’ offices. Selected data can be securely transmitted between health care providers and public health agencies for coordination and improvement of individual and population-level care. Processed, enhanced data are shared for use in education, priority setting, and quality improvement. Abbreviations: CDA, clinical document architecture; EHR, electronic health record; HL7, Health Level Seven International; HW, Healthy Weight; IHE, Integrating the Healthcare Enterprise International; ORU, observational result; v, version.
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