Electronic Health Record E-Book

Pradeep K. Sinha

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 498

Veröffentlichungsjahr: 2012

Beschreibung

Discover How Electronic Health Records Are Built to Drive the Next Generation of Healthcare Delivery The increased role of IT in the healthcare sector has led to the coining of a new phrase "health informatics," which deals with the use of IT for better healthcare services. Health informatics applications often involve maintaining the health records of individuals, in digital form, which is referred to as an Electronic Health Record (EHR). Building and implementing an EHR infrastructure requires an understanding of healthcare standards, coding systems, and frameworks. This book provides an overview of different health informatics resources and artifacts that underlie the design and development of interoperable healthcare systems and applications. Electronic Health Record: Standards, Coding Systems, Frameworks, and Infrastructures compiles, for the first time, study and analysis results that EHR professionals previously had to gather from multiple sources. It benefits readers by giving them an understanding of what roles a particular healthcare standard, code, or framework plays in EHR design and overall IT-enabled healthcare services along with the issues involved. This book on Electronic Health Record: * Offers the most comprehensive coverage of available EHR Standards including ISO, European Union Standards, and national initiatives by Sweden, the Netherlands, Canada, Australia, and many others * Provides assessment of existing standards * Includes a glossary of frequently used terms in the area of EHR * Contains numerous diagrams and illustrations to facilitate comprehension * Discusses security and reliability of data

Leseprobe

Contents

Cover

Series Page

Title Page

Copyright

Preface

Motivation

Objective

Organization and Contents

Intended Audience

Disclaimer

Acknowledgments

Acronyms

Part One: Introduction

Chapter 1: Introduction to EHR

1.1 Introduction

1.2 Definition of EHR

1.3 Functions of EHR

1.4 Significance of EHR

1.5 Factors Affecting Implementation of EHR

1.6 Role of Standards

1.7 Role of Clinical Coding Systems

1.8 Role of Standard Frameworks

1.9 Case Studies of National EHR Implementations

Bibliography

Part Two: EHR Standards

Chapter 2: Standard for EHR Architecture Requirements

2.1 Introduction

2.2 ISO/TS 18308 Requirement Specification

2.3 Discussion

2.4 Conclusion

Bibliography

Chapter 3: Standard for Healthcare Concepts

3.1 Introduction

3.2 CEN/TC EN 13940-1

3.3 CEN/TC prEN 13940-2

3.4 Discussion

3.5 Conclusion

Bibliography

Chapter 4: Standard for EHR Functional Specifications

4.1 Introduction

4.2 HL7 EHR-S Functional Model

4.3 Comparison of HL7 EHR-S FM and ISO/TS 18308

4.4 Discussion

4.5 Conclusion

Bibliography

Chapter 5: Standard for EHR Communication

5.1 Introduction

5.2 CEN/ISO EN 13606 Requirement Specification

5.3 Discussion

5.4 Conclusion

Bibliography

Chapter 6: Messaging Standard for Healthcare Data

6.1 Introduction

6.2 HL7 v2.x

6.3 Discussion

6.4 Conclusion

Bibliography

Chapter 7: Model-Based Messaging Standard for Healthcare Data

7.1 Introduction

7.2 HL7 v3

7.3 HL7 v2.x and v3 Comparison

7.4 Discussion

7.5 Conclusion

Bibliography

Chapter 8: Clinical Document Standards

8.1 Introduction

8.2 Clinical Document Architecture (CDA)

8.3 Continuity of Care Document (CCD)

8.4 Clinical Document Exchange

8.5 Discussion

8.6 Conclusion

Bibliography

Chapter 9: Standard for Medical Imaging and Communication

9.1 Introduction

9.2 DICOM

9.3 Improvements in DICOM Standard

9.4 Discussion

9.5 Conclusion

Bibliography

Chapter 10: Standard for Patient Health Summary

10.1 Introduction

10.2 Continuity of Care Record (CCR)

10.3 Discussion

10.4 Conclusion

Bibliography

Part Three: Coding Systems

Chapter 11: Coding System for Classification of Diseases and Related Health Problems

11.1 Introduction

11.2 ICD

11.3 Improvements in ICD-10

11.4 Discussion

11.5 Conclusion

Bibliography

Chapter 12: Coding System for Laboratory Tests and Observations

12.1 Introduction

12.2 LOINC

12.3 Discussion

12.4 Conclusion

Bibliography

Chapter 13: Coding System for Patient Care Procedures

13.1 Introduction

13.2 CPT

13.3 Discussion

13.4 Conclusion

Bibliography

Chapter 14: Extended Coding System for Patient Care Procedures

14.1 Introduction

14.2 HCPCS

14.3 Discussion

14.4 Conclusion

Bibliography

Chapter 15: Comprehensive Coding System for Clinical Terms

15.1 Introduction

15.2 SNOMED CT

15.3 SNOMED CT Database Browsers

15.4 Discussion

15.5 Conclusion

Bibliography

Chapter 16: Unified Medical Language System

16.1 Introduction

16.2 UMLS-Supported Coding Systems

16.3 UMLS Architecture

16.4 UMLS Licensing

16.5 Discussion

16.6 Conclusion

Bibliography

Chapter 17: Other Coding Systems

17.1 Introduction

17.2 AHFS Drug Information (AHFS DI)

17.3 Current Dental Terminology (CDT)

17.4 International Classification of Diseases for Oncology (ICD-O)

17.5 International Classification of Functioning, Disability and Health (ICF)

17.6 Coding Systems for Nursing Practices

17.7 Radiology Lexicon (RADLEX)

17.8 RxNorm

17.9 Discussion

17.10 Conclusion

Bibliography

Part Four: Standard Frameworks

Chapter 18: openEHR

18.1 Introduction

18.2 openEHR Process Model

18.3 openEHR Architecture

18.4 Discussion

18.5 Conclusion

Bibliography

Chapter 19: Integrating the Healthcare Enterprise (IHE)

19.1 Introduction

19.2 IHE Domains

19.3 IHE Initiatives on Electronic Health Record

19.4 Exchange

19.5 Security

19.6 Discussion

19.7 Conclusion

Bibliography

Part Five: Case Studies: National EHR Efforts

Chapter 20: Australia's HealthConnect

20.1 Introduction

20.2 Overview

20.3 Architecture

20.4 Discussion

20.5 Conclusion

Bibliography

Chapter 21: Austria's ELGA

21.1 Introduction

21.2 Overview

21.3 Architecture

21.4 Functional Implementation

21.5 Exchange

21.6 Discussion

21.7 Conclusion

Bibliography

Chapter 22: Canada's EHRS Blueprint

22.1 Introduction

22.2 Overview

22.3 Architecture

22.4 Discussion

22.5 Conclusion

Bibliography

Chapter 23: Denmark's MedCom

23.1 Introduction

23.2 Overview

23.3 Architecture

23.4 Discussion

23.5 Conclusion

Bibliography

Chapter 24: Hong Kong's eHR Sharing System

24.1 Introduction

24.2 Overview

24.3 Architecture

24.4 Discussion

24.5 Conclusion

Bibliography

Chapter 25: India's Health IT Initiatives

25.1 Introduction

25.2 Overview

25.3 ITIH Framework

25.4 Recommendations on Guidelines, Standards, and Practices for Telemedicine in India

25.5 iHIND

25.6 Other Initiatives

25.7 Discussion

25.8 Conclusion

Bibliography

Chapter 26: Netherlands' AORTA

26.1 Introduction

26.2 Overview

26.3 Architecture

26.4 Discussion

26.5 Conclusion

Bibliography

Chapter 27: Singapore's NEHR

27.1 Introduction

27.2 Overview

27.3 Architecture

27.4 Discussion

27.5 Conclusion

Bibliography

Chapter 28: Sweden's NPO

28.1 Introduction

28.2 Overview

28.3 Architecture

28.4 Discussion

28.5 Conclusion

Bibliography

Chapter 29: Taiwan's Health Information Network

29.1 Introduction

29.2 Overview

29.3 Architecture

29.4 Exchange

29.5 Discussion

29.6 Conclusion

Bibliography

Chapter 30: United Kingdom's Spine

30.1 Introduction

30.2 Overview

30.3 Architecture

30.4 Discussion

30.5 Conclusion

Bibliography

Chapter 31: USA's EHR Meaningful Use

31.1 Introduction

31.2 Overview

31.3 EHR Meaningful Use

31.4 National Health Information Network (NHIN)

31.5 Discussion

31.6 Conclusion

Bibliography

Part Six: Findings and Conclusion

Chapter 32: Findings and Conclusion

32.1 EHR Standards

32.2 Coding Systems

32.3 Standard Frameworks

32.4 Case Studies: National EHR Efforts

32.5 Recommended Phases for Implementing A National EHR System

Glossary

Index

IEEE Press

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IEEE Press Editorial Board 2012

John Anderson, Editor in Chief

Kenneth Moore, Director of IEEE Book and Information Services (BIS)

Technical Reviewers

Rohit J. Kate, Department of Health Informatics and Administration, University of Wisconsin-Milwaukee

Copyright © 2013 by The Institute of Electrical and Electronics Engineers, Inc.

Published by John Wiley & Sons, Inc., Hoboken, New Jersey. All rights reserved.

Published simultaneously in Canada.

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Library of Congress Cataloging-in-Publication Data

Electronic health records : standards, coding systems, frameworks, and infrastructures / Pradeep Sinha . . . [et al.].

p. ; cm.

ISBN 978-1-118-28134-5 (cloth)

I. Sinha, Pradeep K. (Pradeep Kumar)

[DNLM: 1. Electronic Health Records–standards. 2. Forms and Records Control. 3. Medical Records Systems, Computerized. WX 175]

610.285–dc23

2012024681

Preface

Motivation

Information Technology (IT) is playing an increasingly important role in all sectors of economy, healthcare sector being no exception. In fact, the increased role of IT in the healthcare sector has led to coining of a new terminology, “Health Informatics,” which deals with the use of IT for better healthcare services. Health informatics applications often deal with the health record of individuals, in digital form, which is referred to as the Electronic Health Record(EHR).

For interoperability of health informatics applications, many health informatics standards have been proposed and made available. These include structural standards, data content standards, data exchange standards, security standards, and so on.

EHR being central to most health informatics applications, several countries have initiated programs for implementing national EHR infrastructures. Building and implementing a national EHR infrastructure requires understanding of healthcare standards, coding systems, and standard frameworks. Hence, for using, developing, and promoting any health informatics application (including EHR infrastructure), it is imperative for the concerned team/group to study and evaluate existing material on past and ongoing work in these areas. Due to the lack of a book or research monograph that would consolidate this information, the concerned team/group finds it frustrating and time-consuming to collect, study, analyze, and evaluate this information from multiple sources.

The authors of this book faced similar difficulty while working toward building a national EHR service framework. This motivated the authors to compile the study and analysis research work carried out by them in the form of a book, so that this body of knowledge will be readily available at one place to other researchers, technologists, and professionals working in similar areas. This will help accelerate research and development of future standards, coding systems, frameworks, EHR infrastructures, and healthcare applications for evolving better healthcare services for the benefit of mankind at large.

Objective

The book provides an overview of different Health Informatics Standards, Healthcare Coding Systems, and Standard Healthcare Frameworks that underlie design and development of interoperable healthcare systems and applications.

The objective of the book is to provide broad-level understanding of various healthcare standards rather than to provide implementation-level details of any one particular standard for someone to become an expert of that standard. Hence, the book aims at providing an understanding of what role a particular healthcare standard plays in EHR design and overall IT-enabled healthcare services along with the issues involved. However, if one wants to actually work with that standard at the implementation level, the book provides a set of references at the end of each chapter to enable such readers to obtain implementation-level details of any standard covered in the book.

The material in the book has been drawn largely from the research literature in the field. Of the vast amount of research literature available in this field, effort was made to select and give more emphasis to those concepts that are of practical value in real systems, rather than those that are only of theoretical interest.

For each Standard/Coding system/Framework covered in the book, there is a discussion section that provides an assessment of the Standard/Coding system/Framework with respect to the following important aspects of an EHR infrastructure:

Clinical process modelInformation modelExchange specificationsSecurity and privacy considerationsLegal aspects

These assessments are helpful in tackling issues involved in building national EHR infrastructures and health informatics applications. They are also useful in understanding the applicability of different standards, coding systems, and frameworks in various health informatics applications.

Organization and Contents

The book is organized into six parts covering introduction, EHR standards, coding systems, standard frameworks, case studies of national EHR efforts, and findings and conclusion. Except Part I and Part IV, each part contains separate chapters covering individual topics of that part. The six parts of the book and their chapterwise contents are briefly introduced below.

Part One: Introduction

This part provides an introduction to Health Informatics, the EHR concept, and the role of EHR in healthcare applications. It contains the following chapter:

Chapter 1. Introduction to EHR This chapter introduces EHR and describes other related concepts. It covers the various functions and significance of EHR with the probable reasons that affect its adaption. Finally, it explains the role of standards, coding systems, frameworks, and national case studies in implementation of an EHR infrastructure.

Part Two: EHR Standards

This part deals with various standards related to EHR. These include standards for EHR specifications, EHR communication/exchange, EHR concepts and processes, and EHR functional specifications. It contains the following chapters:

Chapter 2. Standard for EHR Architecture Requirements This chapter covers technical specifications defined by the International Organization for Standardization (ISO/TS 215) for EHR architecture. ISO/TS 18308 is an international standard for EHR requirements.

Chapter 3. Standard for Continuity of Care Concepts This chapter describes European standard CEN/TC 251 EN 13940, known as CONTsys. CONTsys is a two-part standard that standardizes the concepts and processes in healthcare. The chapter includes a description of both parts of the standard, that is, EN 13940-1 and prEN 13940-2.

Chapter 4. Standard for EHR Functional Specifications This chapter describes the EHR-S Functional Model from the perspective of supporting functional requirements of EHR.

Chapter 5. Standard for EHR Communication This chapter describes European standard CEN/TC 251 EN 13606, which was further evolved as ISO standard, commonly known as EHRcom. It is a five-part standard that provides specifications for structure of data for representation and communication, content of data, security, and communication protocol for two healthcare applications that share part or the whole EHR.

Chapter 6. Messaging Standard for Healthcare Data This chapter describes the American National Standards Institute (ANSI)-accredited Health Level 7 (HL7) v2.x developed by HL7 organization. The standard primarily defines specifications for exchange of health informatics data between healthcare IT applications.

Chapter 7. Model-Based Messaging Standard for Healthcare Data This chapter describes the HL7 v3 standard developed by the HL7 organization, which is significantly modified from its previous versions described in Chapter 6. It defines information model and exchange specifications for healthcare IT applications.

Chapter 8. Clinical Document Standards This chapter describes clinical document standards, Clinical Document Architecture (CDA) and Continuity of Care Document (CCD). These standards are specifically used in exchange of clinical documents across healthcare applications.

Chapter 9. Standard for Medical Imaging and Communication This chapter describes Digital Imaging and Communications in Medicine (DICOM) PS 3.0-2004 standard evolved by American College of Radiology (ACR) and National Electrical Manufacturers Association (NEMA).

Chapter 10. Standard for Patient Health Summary This chapter describes the American Society for Testing and Materials (ASTM) standard, Continuity of Care Record (CCR). It provides analysis of the standard from the perspective of identifying minimum artifacts required for referrals that can be incorporated in an EHR system.

Part Three: Coding Systems

This part deals with various standard code sets used for representation of health information recorded in EHRs. It contains the following chapters:

Chapter 11. Coding System for Classification of Diseases and Related Health Problems This chapter deals with the applicability of ICD to promote standardization, as well as to improve a system's capability to search for information following common semantics.

Chapter 12. Coding System for Laboratory Tests and Observations This chapter discusses usage of LOINC in development of EHR model. LOINC is a freely available code set developed by Regenstrief Institute Inc. for identifying laboratory results and clinical observations generated during patient care.

Chapter 13. Coding System for Patient Care Procedures This chapter presents CPT, its code structure, application scope, and coverage of medical procedures used in health services such as medical, surgical, and diagnostic services.

Chapter 14. Extended Coding System for Patient Care Procedures This chapter provides an overview of HCPCS, which is based on CPT. The chapter also discusses its scope and significance in improving healthcare delivery and its applicability in building EHR systems.

Chapter 15. Comprehensive Coding System for Clinical Terms This chapter describes different areas of healthcare information covered by SNOMED CT. It also discusses its significance in representing error-free and meaningful health information in electronic health records.

Chapter 16. Unified Medical Language System This chapter describes the Unified Medical Language System (UMLS) framework evolved by National Library of Medicine (NLM). UMLS primarily aims at providing mapping among coding systems.

Chapter 17. Other Coding Systems This chapter covers some other widely used coding systems that provide classifications of clinical codes for a particular specialty in healthcare domain. It covers coding systems for nursing, pharmacy, functional disability, and so on.

Part Four: Standard Frameworks

This part deals with various standard frameworks for building national EHR infrastructures. It contains the following chapters:

Chapter 18. openEHR This chapter describes the openEHR framework developed by openEHR Foundation. openEHR is an open source specification for management of EHR.

Chapter 19. Integrating the Healthcare Enterprise (IHE) This chapter describes the Integrating the Healthcare Enterprise (IHE) technical framework and integration profiles developed by IHE organization. IHE aims at facilitating integration among different healthcare systems supporting different standards (mainly HL7 and DICOM).

Part Five: Case Studies: National EHR Efforts

This part provides case studies of select national efforts to build national EHR infrastructures. It contains the following chapters:

Chapter 20. Australia's HealthConnect This chapter describes the healthcare IT initiatives in Australia, primarily carried out under the Health Connect program of the Government of Australia.

Chapter 21. Austria's ELGA This chapter describes the architecture of the national EHR project of Austria, called Elektronische Gesundheitsakte (ELGA).

Chapter 22. Canada's EHRS Blueprint This chapter describes the national framework for EHR in Canada. This framework is called the EHRS Blueprint. It provides the architecture of Electronic Health Record Infrastructure (EHRi) used by EHR systems in the country.

Chapter 23. Denmark's MedCom This chapter describes the national IT initiatives in health in Denmark. It describes the national health data network called MedCom, as well as the national Basic Electronic Health Record structure called GEPJ.

Chapter 24. Hong Kong's eHR Infrastructure This chapter describes different architectural components developed under the E-health Engagement Initiative(EEI) in Hong Kong.

Chapter 25. India's Health IT Initiatives This chapter describes the health IT initiatives in India, including regulatory guidelines and recommendations for healthcare practices, concept project, and initiatives toward national EHR.

Chapter 26. Netherlands' AORTA This chapter describes the architecture of national health IT infrastructure of Netherlands called AORTA.

Chapter 27. Singapore's NEHR This chapter describes the various healthcare services developed under the national EHR program of Singapore. It also covers the national interoperability framework called EMR Exchange (EMRX) and the National Electronic Health Record(NEHR) of Singapore.

Chapter 28. Sweden's NPO This chapter describes the National IT Strategy for eHealth in Sweden. It discusses national services, national EHR, and the national EHR implementation architecture called Nationell Patientöversikt(NPÖ).

Chapter 29. Taiwan's Health Information Network This chapter describes the health IT initiatives in Taiwan. It describes the structure of Taiwan Medical Record Template(TMT) and the architecture of Health Information Network(HIN) in Taiwan.

Chapter 30. United Kingdom's Spine This chapter describes the national EHR initiative, Spine, by the National Health Service (NHS) through the National Program for IT(NPfIT) in the United Kingdom.

Chapter 31. USA's EHR Meaningful Use This chapter describes the national initiatives in the United States of America for enabling integrated healthcare practices across the nation. It covers the architecture of Nationwide Health Information Network(NHIN), regulatory guidelines for Meaningful Use of EHR, and relevant federal regulations in the country.

Part Six: Findings and Conclusion

This part concludes the book with a summary of key findings of the study and analysis research carried out by the authors. It contains the following chapter:

Chapter 32. Findings and Conclusion This chapter concludes the book by summarizing the findings of the study and analysis of different standards, frameworks, coding systems and case studies of EHR initiatives taken by various countries.

Intended Audience

This book is designed for use by beginners as well as experts dealing with Health Informatics. For a beginner, this text will be valuable to get a broad idea about all the standards and resources that are out there and about EHRs. For an expert, this book will be useful as a ready reference. The book is particularly valuable for anyone involved in making decisions about building a large-scale (e.g., national) EHR infrastructure. More specifically, readers can benefit from this book in the following manner:

The coverage of study of all aspects of EHR with inclusion of current situations for development of national EHR infrastructures makes it a vital resource for researchers, professionals, students, and administrators working in the health informatics area.Using Information Technology for storage, retrieval, and exchange of health data has become the need of the hour. This book can, therefore, help healthcare specialists, hospital administrators, and hospital consultants in acquiring knowledge of Healthcare Information Technology (HIT) standards, current international affairs and issues, while selecting and investigating health information systems and healthcare applications for their organizations.It can be also useful for professionals needing knowledge to advance the use and value of health informatics. The book can be used as a professional resource for analyzing methods to improve health information for building better healthcare applications.Information Technology (IT) professionals who want to move into health informatics domain can use the book to gain knowledge of requirement specifications for building standardized healthcare applications.A wide range of stakeholders from the healthcare industry and the HIT industry (such as Insurance Industry, Public Health Sector, Software Companies, Medical and Public Libraries, etc.) will also find the book a useful learning aid to improve the quality of use of HIT.

Disclaimer

The material contained herein including case studies of various national programs are compiled from the information, opinions, and analysis/reports in publically available documents. However, due to continuous advancements happening at a rapid pace in these domains and national programs, their current status might have changed from what is given in this book. The authors make no representation, expressed or implied, as to its accuracy, completeness, or correctness.

The authors hope that the material presented in this book serves the purpose stated earlier and that readers will benefit from our work in the domain by using the book as a starting point in their pursuit to explore further.

Acknowledgments

Many people have contributed to this book, either directly or indirectly. To start with, we would like to thank all the researchers who have contributed to the field of health informatics. This book is based on their research work.

The book covers various standards that are useful in the design and development of interoperable healthcare systems and applications. We thank all international standards bodies who have put efforts toward evolving such standards. National EHR efforts carried out in various countries are covered as case studies in the book. We thank the people, government bodies, health organizations, and other agencies who contributed to the healthcare/EHR initiatives in these countries.

The Department of Electronics & Information Technology (DeitY), the Ministry of Communications and Information Technology (MCIT), the Government of India and VINNOVA, and the Government of Sweden jointly approved and supported the project titled “Technology Development for Building Distributed, Scalable, and Reliable Healthcare Information Store.” The project provided an opportunity to the authors to carry out research in the area of Electronic Health Record (EHR) infrastructure and associated technologies. The book is based on the knowledge gained by the authors during the project. We would like to thank both DeitY and VINNOVA for providing us this opportunity.

The Centre for Development of Advanced Computing (C-DAC), Pune, India and the Swedish Institute of Computer Science (SICS), Kista, Sweden provided the fertile ground where our ideas in this domain could grow and take this shape through the joint project. We are thankful to both C-DAC and SICS for this support. Members of the Medical Informatics Group and our staff Arpita Kulkarni and Sushma Pawar helped us in drafting the manuscript.

Lively discussions with several technical members including Mr. B. S. Bedi, Dr. S. K. Srivastava, Mr. R. C. Meharde, Dr. T. K. Sarkar, Dr. Suman Bhattacharya, Prof. A. K. Majumdar, Prof. S. K. Mishra, Dr. Jim Dowling, and Prof. Seif Haridi helped us in broadening our knowledge in this area. We are thankful to all of them.

Several anonymous reviewers of our draft manuscript provided invaluable feedback regarding the book's title, organization, topic coverage, typographical errors, and obscure parts and helped in overall improvement of the material. We thank all the reviewers for their valuable inputs.

Our production editor at IEEE PRESS Danielle Lacourciere, did an excellent job in numerous ways to present the book in its current form. IEEE PRESS Director Kenneth Moore and Senior Acquisitions Editor Taisuke Soda were of great help in improving the overall quality of the book and in bringing it out in a timely manner. We thank them all for their support and help.

We specially thank European Committee for Standardization (CEN), Health Level Seven International (HL7), National Electrical Manufacturers Association (NEMA), The Institute of Engineers and Technology (IET), IHE International Inc., International Health Terminology Standards Development Organization (IHTSDO), Canada Health Infoway Inc., National E-Health Transition Authority (nehta), The openEHR Foundation, Department for Innovation and Technology Italy, National Board of Health and Welfare Sweden, Elsevier Science Ireland Ltd, Ringholm bv, and Jan Petersen and Lone Asp for permitting us to use the material from their publication(s).

Special thanks from Pradeep K. Sinha to his wife Priti, his son Deeptanshu, and his parents for their patience, sacrifice, loving support, and understanding. Thanks to coauthors of the book for their lively discussions, dedication, and untiring efforts.

Special thanks from Gaur Sunder to his wife Sudha, his son Kartik, his parents, and his family members for being the pillar of strength and constant source of inspiration. Also thanks to coauthors, especially Dr. Pradeep Sinha, for sharing the vision and push against all odds.

Special thanks from Prashant Bendale to his wife Chetana, his son Yash, his mother Ashalata, and his family for their support and personal sacrifices. This effort is dedicated to his father the late Mr. Prabhakar Bendale. Also, thanks to Gaur Sunder and Dr. Pradeep Sinha for mentoring.

Special thanks from Manisha Mantri to her husband Dinesh, her son Aalok, her sister Sonika, and her parents and family members for being a constant source of inspiration and support during this work. Thanks to Gaur Sunder and Dr. Pradeep Sinha for their guidance and support. Also, thanks to coauthors and team members for their support and help.

Special thanks from Atreya Dande to his whole family for their continued understanding, love, and affection. Thanks go to Dr. Pradeep Sinha and Gaur Sunder for encouraging with insightful direction during this endeavor. Thanks go to co-authors for their continued support. Also, he would like to express his gratefulness to his friends and team members for their help in innumerable ways.

The authors hope that this book is useful in your work, research, and development and in exploring the exciting possibilities that may exist.

Pradeep K. SinhaGaur SunderPrashant BendaleManisha MantriAtreya Dande

Acronyms

A

AAFPAmerican Academy of Family PhysiciansAASMAmerican Academy of Sleep MedicineABACAttribute Based Access ControlACFAccess Control FrameworkACRAmerican College of RadiologyADAAmerican Dental AssociationADLArchetype Definition LanguageADTAdmissions/Registration, Discharge or TransferAHFSAmerican Hospital Formulary ServiceAHSLApollo Health Street Ltd.AIHWAustralian Institute of Health and WelfareAMArchetype ModelAMAAmerican Medical AssociationANAAmerican Nurses AssociationANSIAmerican National Standards InstituteAPAAmerican Psychiatric AssociationARRAAmerican Recovery and Reinvestment ActASTMAmerican Society for Testing and MaterialsATCAnatomical Therapeutic ChemicalATNAAudit Trail and Note AuthenticationAUIAtom Unique Identifiers

B

BIFBastjänster för Informations Försörjning (Basic Services for Information)BSNBurgerservicenummer (Citizen Identification Number)

C

CACertification AuthorityCAPCollege of American PathologiesCCDContinuity of Care DocumentCCHITCertification Commission for Health Informatics TechnologyCCRContinuity of Care RecordCDAClinical Document ArchitectureC-DACCentre for Development of Advanced ComputingCDSCommon Data SetsCDTCurrent Dental TerminologyCFRCode of Federal RegulationsCIR