Messaging Standards for Electronic Health Records in Selected Organizations

In today's world of knowledge with increasing complexity, the need for exchanging data, information, and knowledge is undeniable. Electronic health record is undoubtedly a key technology in health care which facilitates the recovery and processing of health information from multiple locations and provide more efficient and more effective treatment for the patient. Automatic data transfer on the other hand, increases the rate of services, reduces errors, and improves the quality of services. For distribution and exchange of information, development and use of a messaging standard in electronic health records is required. A descriptive-comparative study was conducted on messaging standards provided by Health Level Seven International (HL7), International Organization for Standardization (ISO), and the European Committee for Standardization (CEN) whose standards in field of electronic health records are more comprehensive and complete than other organizations. Using a checklist, data was collected from articles, books, and magazines and English language websites. The validity of the checklist had been approved by some academic experts in the field of electronic health records. The collected data was analyzed using comparative and qualitative methods. The obtained results showed that several organizations and institutions such in the world, as HL7, ISO, and CEN, have standards related to electronic health records. While HL7 has a messaging standard, CEN developed a standard named EN13606 which was later adopted by ISO. Therefore, EN13606 is currently updated by ISO. Most activities in providing a messaging standard for electronic health records have been done by ISO and HL7. Messaging standards of the two organizations, despite the similarity in some cases, have some unique differences. Comparing these two standards showed that although these two different standards tried to exchange messages, HL7 messaging standard was not successful in creating interoperability and had some inconsistency in its model's classes. ISO13606 standard however, used some features in definition of clinical concepts and could create interoperability.