The purpose of this Discussion is to explore the different standards used for medical records and how the records get managed and exchanged
between health care providers or systems that use different standards. The American National Standards Institute (ANSI) Accredited Standards
Committee (ASC) X12 Insurance Subcommittee, the Health Care Task Group, publishes transactions standards, such as the ANSI X12N Health Care
Claim Payment/Advice (835). Health Level Seven (HL7) is an organization that creates standards for clinical and administrative data
interoperability.
To prepare for this Discussion, search the Internet for information on the HIPAA EDI, HL7, and other standards as might be found at ASC X12 ,
Health Level Seven (HL7) and Veterans Health Information Systems and Technology Architecture (VistA)
For this Discussion, answer the following questions:
• Compare and contrast the 835, 837, 270, and 275 EDI standards in terms of similarities and differences.
• What are the strengths and weaknesses of HL7?
• What challenges, in terms of interoperability, are presented by using different standards?
• Consider a patient who has seen a general practitioner, a specialist, and has been to the hospital. How can all of the patient’s records be
shared in real-time if they are encoded and managed discretely?
• Why might a business unit in a medical setting choose to use one standard over another?
• Choose a business unit and recommend a standard to use. Justify your recommendation.
Illustrate your points in the context of a patient’s visit to a health care provider.
• Resources Overview
During Week 4, you will use a variety of resources, both required and supplemental, including selections from the course textbook, Web
resources, and a video. The Weekly Schedule (a navigation link under Week 4) outlines the resources you will need to participate in the
Discussion and complete the Application and Group Project.
This page contains the Learning Resources for this week. Be sure to scroll down the page to see all of this week’s assigned Learning Resources.
To access select media resources, please use the media players below.
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Media
Video: Week 4 Overview
Note: The approximate length of this media piece is 21 minutes.
This video provides an introduction to the week’s resources and assignments.
Accessible player
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Reading
Course Text: Wager, K. A., Lee, F. W., &Glasser, J. P. (2013). Health care information systems: A practical approach for health care management
(3rd ed.). San Francisco: Jossey-Bass.
• Chapter 10, “Health Care Information System Standards”
Chapter 9 reviews electronic data interchange (EDI) standards, including the organizations that set the standards and processes by which
standards are set. You can also find information about the Continuity of Care Record (CCR) initiative and the Health Level Seven (HL7) Model.
You will also be exposed to health care IT emerging trends, challenges within adoption, and the overall value that successful implementation
delivers.
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Web Resource
ASC X12
The Accredited Standards Committee (ASC) develops EDI standards and related documents including those pertaining to the health care vertical.
Explore this site for more information about the X12 international standards development.
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Web Resource
American Society for Testing and Materials
The Continuity of Care Document
The Continuity of Care Record (CCR) is the set of data about a patient’s health care encounters. It provides a mean for practitioners to share
information about the patient. Theses Web site provide an abstract and overview of the scope of the CCR standard.
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Web Resource
Health Level Seven (HL7)
Health Level Seven (HL7) is one of the American National Standards Institute (ANSI) standards developing organizations. The Web site explores
the vision, mission, and strategies of the organization under the “What is HL7?” link. Explore the Frequently Asked Questions and HL7 Standards
under the Resources section of the site to support the Discussion this week.
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Web Resource
Sample 837 File
This Web site provides a sample 837 file within a table view that you can easily import into a Microsoft Excel or similar program worksheet. You
will use a sample 837 file in the Application this week.
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Media
Video: Laureate Education (Producer). (n.d.). Continuity of care [Video file]. Retrieved from https://class.waldenu.edu
Note: The approximate length of this media piece is 2 minutes.
In this video, Dr. Vincent Grasso discusses the CCR Standard. He explains the importance of the components of the code (header, body, footer),
how the data is represented as XML, and why that is of value to other third-party systems.
Accessible player
Rubric
Week 4 Discussion: Standards Assessment Rubric
• (4 Points) Exceptional, complete, clear, exceeds performance indicators
• (3 Points) Excellent, complete, meets performance indicators
• (2 Points) Approaching performance indicators, missing some detail, not fully developed
• (1 Point) Developing competence, vague, weak, needs more detail
• (0 Points) Not present
Points Earned
Response to Discussion—The response includes comments related to each part of the Discussion prompt.
Quality of Comments—The content of the posts is substantive and enhances the quality of the Discussion. The response illustrates a point with
examples, presents new ideas, and asks questions that help further discussion. The response to peers’ posts is constructive and subject-related.
Insightful Feedback—The response provides insightful feedback to a response that agreed or disagreed with the original post. If the response
disagrees with the post, the response includes a constructive rationale.
Critical Analysis—The post exhibits critical analysis of posted ideas by asking for evidence to support claims, providing evidence to support
claims, and revisiting the Discussion to respond to other responses about the posting.
Form and Style—The post is well-organized and uses grammatically correct complete sentences that are free of spelling errors. The post provides
a correct reference of sources by using page numbers or URLs.
http://www.ehealth.va.gov/VistA.asp
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