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The Importance of Data Communication Standards for EMR in Canada

Posted Oct 30 2008 3:21pm

One of the great challenges that we still face in Canada with regard to the uptake and use of EMR systems is the lack of data communication standards specifically for EMR. A significant amount of work has been done by Canada Health Infoway in order to create a national set of standards to which large scale clinical systems must conform in order to provide interoperability between systems. The result of the work by Infoway is the HIAL (Health Infomation Access Layer). The HIAL essentially creates a set of requirements in order for parts of the system to interoperate with one another. By building and maintaining interfaces that conform to the standards and HIAL, large systems are esablishing their ability to be sustainable over the long term and not become obsolete.

Unfortunately, this level of development has not occurred in the EMR space. The data communication standards for EMR are yet to be published (work is currently taking place to define certain of these standards, however I am not certain of the exact status of this work at the time of writing this posting). As Canada moves towards greater system interoperability for EMR and other clinical information, this delay is creating significant risk in terms of project failure and adoption of EMR. Vendors of EMR have to conform with provincially mandated standards in order for their products to be supported in those provinces in terms of funding and interfaces to provincial and regional systems. However it is my opinion that the needs of the provinces, regions and the physicians are closer than one may think and a single set of national data communciation standards for EMR for the entire country would allow resources to be more effectively utilized and would ensure that systems would be able to work in any province as long as they conformed to the standard.

A very good example of this approach is the Danish solution in which a single body is responsible for establishing and maintaining standards for data communication, not just in large clinical systems, but also in EMR. Could an approach similar to Denmark be successful in Canada? What are your thoughts on both the importance of data communication standards at this juncture, but also whether establishing standards could provide improved stability and ultimately lower the total costs and sustainability of EMR systems in the future?

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