Standard for improving emergency information interoperability: the HL7 data elements for emergency department systems.

BACKGROUND: Emergency departments in the United States service over 130 million visits per year. The demands for information from these visits require interoperable data exchange standards. While multiple data exchange specifications are in use, none have undergone rigorous standards review. This paper describes the creation and balloting of the Health Level Seven (HL7) Data Elements for Emergency Department Systems (DEEDS). METHODS: Existing data exchange specifications were collected and organized into categories reflecting the workflow of emergency care. The concepts were then mapped to existing standards for vocabulary, data types, and the HL7 information model. The HL7 community then processed the specification through the normal balloting process addressing all comments and concerns. The resulting specification was then submitted for publication as an HL7 informational standard. RESULTS: The resulting specification contains 525 concepts related to emergency care required for operations and reporting to external agencies. An additional 200 of the most commonly ordered laboratory tests were included. Each concept was given a unique identifier and mapped to Logical Observation Identifiers, Names, and Codes (LOINC). HL7 standard data types were applied. DISCUSSION: The HL7 DEEDS specification represents the first set of common ED related data elements to undergo rigorous standards development. The availability of this standard will contribute to improved interoperability of emergency care data.

Telehealth practice recommendations for diabetic retinopathy.

Telehealth holds the promise of increased adherence to evidenced-based medicine and improved consistency of care. Goals for an ocular telehealth program include preserving vision, reducing vision loss, and providing better access to medicine. Establishing recommendations for an ocular telehealth program may improve clinical outcomes and promote informed and reasonable patient expectations. This document addresses current diabetic retinopathy telehealth clinical and administrative issues and provides recommendations for designing and implementing a diabetic retinopathy ocular telehealth care program. The recommendations also form the basis for evaluating diabetic retinopathy telehealth techniques and technologies. Recommendations in this document are based on careful reviews of current evidence, medical literature and clinical practice. They do not, however, replace sound medical judgment or traditional clinical decision-making. "Telehealth Practice Recommendations for Diabetic Retinopathy" will be annually reviewed and updated to reflect evolving technologies and clinical guidelines.