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The Health Story Story Continues

November 7, 2012
by David Raths
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Standards group adds focus on patient-authored documents

“Our motto is get the data flowing,” Joy Kuhl told me in an interview last week. And the Health Story Project, of which Kuhl is executive director, is doing just that. Besides helping EHR vendors adopt and test Consolidated Clinical Document Architecture (CDA) implementation, the nonprofit organization is adding a focus on patient-authored documents.

Formed five years ago, the collaborative of over two dozen healthcare vendors, providers and associations has made a significant contribution to the interoperability movement by focusing on clinical information that is not always available in an accessible format in an EHR, such as History and Physical, Discharge Summary, Diagnostic Imaging Report, and Procedure Note.

“The members realized that the industry is sitting on massive amounts of clinical documents, and the question was how to get that information into structured data,” Kuhl said. Health Story accelerates development of HL7 CDA implementation guides for common types of clinical documents, brings them through the HL7 ballot process and promotes their adoption within the industry.

After supporting development of eight HL7 implementation guides for common clinical documents, last year Health Story worked with HL7, IHE and the ONC Standards & Interoperability Framework to consolidate them into one implementation guide along with the HL7 Continuity of Care Document standard. The resulting “Consolidated CDA” offers a standard for exchange of information collected in clinical documents. Stage 2 of meaningful use establishes the Consolidated CDA as the standard for communicating the summary of care.

But Health Story is not resting on its laurels. “We still have big challenges,” Kuhl said, including getting more EHR vendors and HIE companies to use Consolidated CDA. “So far, it has been lower down on their list of priorities, given all they have to do,” she added. “Now that it is referenced in Stage 2 of meaningful use, we hope to see more adoption. It will raise the awareness of providers.”

IHE USA and the Health Story Project will offer testing of Consolidated CDA at the annual IHE North American Connectathon 2013 in January. (The Connectathon allows health IT systems to test information exchange across organizational boundaries to demonstrate the capabilities and benefits of those systems.)

Another recent development is a focus on patient-entered data. “Because we focus on documents that tell a patient’s story, we started getting lots of attention from the patient engagement community,” Kuhl explained, “so we decided to work with people in that arena and sponsor an HL7 project on patient-authored notes.

Health Story is supporting a project team within HL7 that is working to create a standard for “Patient Authored Documents” using the HL7 CDA standard. Kuhl said this is a first step toward getting the industry thinking about using available standards for collecting and sending patient-generated information.

Finally, as it did last year, Health Story will feature a demonstration at the HIMSS meeting in New Orleans. This year it will work with the American College of Physicians and the American Society of Clinical Oncologists to demonstrate a use case of how a patient’s story, including narrative, can be maintained throughout the transition of care.


David Raths

Contributing Editor

David Raths


David Raths’ blog focuses on health IT policy issues ranging from patient privacy to health...