Page 50 - Proceedings of the 2017 ITU Kaleidoscope

2017 ITU Kaleidoscope Academic Conference

Their main concern does not remain only at the adoption of development organization that is dedicated to providing a
data exchange or terminology standards but extends to the comprehensive framework and related standards for the
exchange of health information across networks and the exchange, integration, sharing and retrieval of electronic
achievement of harmonization or normalization of disparate health information [46]. CDA is one of its product lines of
data standards that facilitates communication across messaging standards as well as its preponderant v2.x,
healthcare organizations, regions and also internationally. slowly evolving v3.0 and the emerging Fast Healthcare
Interoperability Resources (FHIR). Under the parameters of
Developing countries have been increasingly seeking the HL7 standard, a guide for dental digital imaging reports
actions for national and regional standardization on e- was developed that can benefit patients, providers, insurers
Health. A study on the Millennium Villages Project (MVP), and dentists in terms of increased efficiency and agility with
a deployment of e-Health architecture running across 14 respect to data management, monitoring and treatment [27].
sites in sub-Saharan Africa, illustrated the development of HL7 is said to be an important component of an Electronic
open source solutions and common standards [22]. In order Healthcare Record (EHR) along with other relevant EHR
to achieve Millennium Development Goals that are closely standards that structure the clinical content for the purpose
related to healthcare and to develop an accessible and of exchange that are developed by formal standardization
interoperable e-Health system, the study stressed that it is organizations like CEN and ISO working on Health
important to use open source technologies and standards. At Informatics or is a de facto standard like the DICOM [28].
a country level, Kenya Ministry of Health developed Data standards relevant to both research and industry for the
standards and guidelines for electronic medical record capture and exchange of clinical trial information were
systems (EMRs), focusing on the minimum requirements developed also by a consortium, which is the Clinical Data
for national roll-out [23]. Conformity to EMR standards Interchange Standards Consortium (CDISC) [29]. Data
(e.g., reporting, security, system features) is significant for standards come into play in a variety of healthcare settings
such developing countries to manage the functionalities of such as in support of the exchange of health information
the system that determine the quality of services related to between emergency departments and poison control centers
prevalent HIV. [30].

A common problem that developing countries encounter is As important as data standards are device standards. A
the lack of standards and barriers to the adoption of family of standards, IEEE 11073 Personal Health Devices
standards. China has adopted standards for vocabulary, (PHD) standards, ensures the transfer of information
classification, coding and messaging, but despite its rapid between medical devices. Such medical device standards
progress in health informatics, it confronted problems with are needed to facilitate the development of safe and
lacking standards that should be solved to comprehensively interoperable medical device systems [31]. We can say that
utilize hospital information systems [24]. An investigation e-Health standards including data standards and device
of tertiary hospitals’ barriers to the adoption of health data standards that are created by different modes of
standards in Saudi Arabia revealed that technological, standardization serve crucial functions like ensuring
organizational and environmental factors as the critical interoperability, usability, quality, security and privacy.
factors influencing the adoption decision [25]. Next, we examine the particular effects that are performed
by these standards.
When we compare between e-Health actions that have
relevance to standards in developed countries and Interoperability is one of the most cited aspects of e-Health
developing countries, the latter tends to be witnessing when discussing the role of standards and challenges of
developments in more recent timings. Also, they tend to standardization. Interoperable solutions are needed for
remain centered on the development and adoption of advancing continuity of care, providing efficient and
standards such as health data standards. It is most likely that effective healthcare services and supporting decisions of
developing countries will face similar issues of stakeholders in healthcare organizations. However, it has
interoperability currently being experienced by developed been challenging to achieve because of heterogeneous and
countries, which makes initiatives such as MVP in sub- independent systems in existence. Here, research about
Saharan Africa more important. ‘why’ and ‘how’ for linking standards to interoperability are
found. In the case of radiology, standards such as DICOM
3.2. Types and effects of standards and HL7 define formats and protocols of transmitting
medical images and signals within and across healthcare
Literature encompasses a wide array of the types of e- organizations. With the increased production of big data, e-
Health standards differentiated by their core functions and Health standards including Virtual Medical Record,
healthcare settings. A widely mentioned standard in the DICOM Structured Reporting and HL7 FHIR are becoming
searched literature is the HL7 Clinical Document a key to data interoperability for the objective of
Architecture (CDA), which is a standard that specifies the simplifying and speeding up the exchange of patient
“structure and semantics of clinical documents for the information [32]. More regarding the question on ‘why’,
purpose of exchange between healthcare providers and standards are needed to support cross-border patient
patients” [26]. HL7 is a not-for-profit, standards summary exchange. The U.S. has set harmonized CDA

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