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Health Level 7 Messaging Standards

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Among the wide range of standards available for the integration and interoperability of medical information systems is data exchange or messaging standards. The purpose is to broadly provide instructions or specifications for the structure, format, and elements for data pertaining to health related operations that involve clinical, financial and administrative data. More specifically messaging standards defines the relationship among data elements for structuring data as they are interchanged. 7.1.1 HL7. V3 - Health Level 7 Messaging Standards Version 3
The HL7 version 3 standard has the aim to support all healthcare workflows. Development of version 3 started around 1995, resulting in an initial standard publication in 2005. HL7 V3 is based on consensus standards, developed by volunteers who come from countries around the world to undertake practical informatics. They also welcome new participants and are open to suggestions with the development of the standard that involves a balloting process. Subsequently, once requirements are approved a collection of message formats and related clinical standards that loosely define an ideal presentation of clinical information are compiled and together the standards provide a framework in which data may be exchanged. Furthermore, the use of HL7 standards require membership to the organization and licensing fee. …show more content…

For instance, HL7 V3 builds upon much of what was learned during the development of its predecessor HL7 V2, but without the burden of V2 legacy issues. Nonetheless, HL7 V3 remains in the infant maturity stage, especially within the United States, where HL7 V2 is the preferred

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To lay the groundwork for portability, this rule set standardized codes and formats for the interchange of medical data and for administrative purposes. HIPAA mandates two types of codes for the transfer of data. First and most importantly, uniform codes are needed to describe diseases and injuries, describe the causes of the diseases and injuries, and to describe the preventions and treatments used. Secondly, there are smaller sets of codes for many administrative purposes—for describing ethnicity, the type of facility or the type of unit where care was performed. As much as possible, the major codes have been chosen based on code sets that are already in use, known as "legacy

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This rule adopts standards for eight electronic transactions and for code sets to be used in those transactions. It also contains requirements concerning the use of these standards by health plans, health care clearinghouses, and certain health care providers. The use of these standard transactions and code sets will improve the Medicare and Medicaid programs and other Federal health programs and private health programs, and the effectiveness and efficiency of the health care industry in general, by simplifying the administration of the system and enabling the efficient electronic transmission of certain health information. It implements some of the requirements of the Administrative Simplification subtitle of the Health Insurance.

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The purpose of the HIPAA transactions and code set standards is to simplify the processes and decrease the costs associated with payment for health care services. The transactions and code set standards apply to patient-identifiable health information transmitted electronically. Physician practices will continue to be able to submit paper claims. When the regulations take effect in October 2002, standard formats and code sets will take the place of any payer-specific or location-specific formats or requirements. ICD-9-CM Volume 1 and 2: Diagnosis Coding - ICD-9-CM is used to code and classify morbidity data from the inpatient and outpatient records, physician offices, and most National Center for Health Statistics (NCHS) surveys.

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The accredited standards committee has been charged with developing the standards for EDI. The department of health and human services embraced the ASC X12 standards. The goal of EDI standards is to make seamless transfers of information between providers and healthcare plans and payers. ASX X12N 837 is a messaging standard that covers the electronic submission of healthcare claims (Sayles, 2013). The Pan American EDIFACT Board (PAEB) directs activities regionally for EDI message development, maintenance, and technical assessment.

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