E-health standards are essential for the effective use of electronic health information and to achieve interoperability of health information. The Minnesota e-Health Initiative (Initiative) and the Minnesota Department of Health (MDH) developed the Minnesota e-Health Standards Guidance (PDF) (Standards Guidance) to support the use of e-health standards and advance interoperability. The Standards Guidance purposes are to:
- Provide an overview of e-health standards, interoperability and the Minnesota e-Health Standards Approach.
- Direct stakeholders to nationally-recognized e-health standards resources.
- Share Minnesota-specific e-health standards recommendations and resources.
Three key resources to find nationally-recognized e-health standards key to interoperability are listed below.
Interoperability Standards Advisory (ISA)
The ISA is a catalog of standards and implementation specifications for health, public health and research that support interoperability. It includes information on e-health standards including the standard process maturity, implementation maturity, adoption level, federally required, cost, and test tool available are listed. Any limitations, dependencies, and preconditions for consideration, applicable value sets and starter sets, and applicable security patterns for consideration are also included. The ISA is updated annually by the Office of the National Coordinator.
Common Clinical Data Set (CCDS)
CCDS is a required element of the 2015 Edition certification for electronic health records for the Meaningful Use program; EHRs are required to be able to transmit CCDS via open Application Programming Interface (API). An API is a set of programming protocols for accessing a software application online. The CCDS is to facilitate greater interoperability and enable health information exchange by focusing on representation of clinical data during exchange.
Draft U.S. Core Data for Interoperability (USCDI)
The Draft USCDI aims to support the goals set forth in the 21st Century Cures Act by expanding upon the CCDS to specify a minimum common set of data classes that are required for interoperable exchange. The USCDI is only in draft form but provides a glimpse into the future direction of securely exchanging electronic health information by including both the current USCDI data classes as wells as candidate and emerging classes under consideration. In addition, it provides a brief description of each factor and the related standard, tool, or measure used.
The following recommendations and resources are not meant to supersede the nationally-recognized standards but are complementary and address specific needs identified in Minnesota.
The Initiative and MDH developed Recommendations Regarding the Use of Standard Nursing Terminology in Minnesota (PDF) for the use of standardized nursing terminology in health and health care settings. The ISA also identifies the interoperability need for nursing including nursing assessments, interventions, outcomes, and patient problems.
Public Health Reporting for Incentive Programs
Certain MDH programs are ready to receive public health reporting electronically for incentive programs such as Promoting Interoperability and the Merit-based Incentive Payment System (MIPS). The e-health standards used and additional information are listed on the Public Health Reporting & Meaningful Use webpage.
Administrative standards streamline and accelerate the flow of routine administrative transactions that are essential to meet accountable care and health transformation goals. These include financial transactions such as claims and remittance advices, as well as authorization requests, insurance and benefits verifications, and others that are needed for billing and payment, planning and evaluation, and for improving care coordination and the patient care experience. Administrative standards, also known as Minnesota Uniform Companion Guides that have been adopted as state rules, are found on the Rules (MN Uniform Companion Guides) webpage.
Factors that Influence Health (Social Determinants of Health)
The Initiative and MDH have examined e-health standards relating to health equity, specifically factors that influence health, since 2014. Nationally there has been increased recognition that factor such as housing, income and food security, exposure to violence, access to transportation, and other issues have a great impact on a person’s health. The e-Health Standards and Health Equity (PDF), including the 2014 Review of Social Determinants of Health Used in Electronic Health Records and Related Semantic Standards (PDF), compiles the factors that influence health and the resources to identify the nationally-recognized e-health standards.