Lisa R Nelson
Medical Informatics and Health Information Technology Consulting

"I work in creative collaboration with smart, inspiring people on projects that contribute to the healing of the world.”

  -   Louise Hay

"Let us be about setting high standards for life, love, creativity, and wisdom. If our expectations in these areas are low, we are not likely to experience wellness. Setting high standards makes every day and every decade worth looking forward to"

  -   Greg Anderson


HIT Integration, Interoperability and Standards
MED INF 405 / Nicholas Bertram, Sr., Consultant Beacon Partners
Course objectives

This course covered many details about healthcare information technology standards and interoperability. We explored the value proposition associated with the use of standards. We reviewed health information models and looked at the IHE Initiative, HL7, DICOM, CCOW, and other standards. We also examined the role of non-medical standards in medical informatics, such as HTTP, XML, etc. The course covered multi-institutional issues and touched on subjects such as telemedicine, e-commerce and the Health Insurance Portability and Accountability Act (HIPAA).

The goals for this course were to:

  • Describe the benefits of standards-based HIT interoperability
  • Identify the resources necessary for an HIT integration project
  • Utilize appropriate HIT standards in an integration project
  • Be able to navigate through US national interoperability standards
  • Understand the policy issues in intra- and inter-institutional health data exchange
Text and selected readings CITL, The value of Health Information Exchange.
Gartner Study – a network of networks.
Course artifacts Paper: Transforming Vision into Reality
Presentation: Transforming Vision into Reality, Part I
Presentation: Transforming Vision into Reality, Part II
Presentation: Transforming Vision into Reality, Part III
Paper: Terminology Sustainability
Presentation: Terminology Sustainability
Reflection statement

The artifacts posted for this course titled “Transforming Vision into Reality,” demonstrate how medical data is used to facilitate patient care. The object of our project was to design an information architecture that would facilitate the integration of information contained within a personal health record with information contained within the various systems used to treat an oncology patient. Our approach included evaluating the stakeholders involved in our scenario on both a micro and macro level and identifying their business needs in order to clarify the value proposition of the proposed technology. We also identified the information systems currently used within the domain of our solution space, acknowledging that existing systems represent a major constraint that any new solution must address. We used our understanding of these fundamental components to explore the data integration opportunities and determine how we could tie all of these components together to develop a valuable solution.

The project was structured into a three-part framework which addressed the business-, technology- and data-related dimensions of the cancer patient scenario.  We found this well defined structure made analyzing the situation more straightforward.  The framework also ensured that all the system functionality we specified tied directly to supporting valuable needs of the stakeholders.

The project represents an excellent outcome and reinforced my belief that a team with passion for a subject naturally produces a better work product. The team was small, just two members, but our backgrounds were strong In all the needed areas. The well defined structure for the analysis made it easy to address the research and logic development of the needed material in a modular way that combined together smoothly.

My personal interest in the data terminologies needed to support semantic interoperability inspired me to research this topic further. The paper I posted, titled “Terminology Sustainability” demonstrates my critical thinking about the operational issues related to maintaining the data terminologies we will depend on to make true interoperability possible. This work product demonstrates my ability to apply to a topic in medical informatics, knowledge we have about sustainability from other industries. This is the type of critical thinking that’s aimed a avoiding problems rather than solving them.

The research and reflection associated with the Terminology Sustainability artifact lead me to pursue a position working with terminology standards. After learning about the terminologies, investigating the standards development organizations involved in creating them and the companies working to facilitate their adoption, I secured a position in the heart of this niche HIT space. I even got to have dinner with one of the experts who authored some of the papers I gathered doing my research.  It just goes to show how sound critical thinking applied to an area of strong interest can lead to very powerful action and highly specific results.