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Friday, October 30, 2015

A “PubMed” for HealthIT Standards

By way of a short introduction, this was the outline I submitted for my capstone project at OHSU.  As you might guess, starting my capstone means I'm in the home stretch.  I'll be writing more about this over the next six months.

  -- Keith

Capstone Project Charter for Keith W. Boone


Newcomers to the use of health IT standards often ask the question “Where do I start?”.  It is often difficult to find applicable standards from the various organizations who are often the sole publishers of these documents.  This project will develop an online index supporting search and retrieval of the standards.  During the project, the index will be populated with content from several standards organizations.  The search capabilities will be piloted by interested individuals.  Data will be collected about usage of the system, and the utility of it to end users.

Introduction and Background

One of the most common questions asked by people who are trying to understand health IT standards is “Where do I start?”  Each standards development organization (SDO) has its own web site and is often the principle (and possibly the only) publisher of its standards.  Health IT implementers may need to identify or access content from multiple standards developers, either to compare the capabilities of each, or to implement a system that users each possibly in different ways.  Other health IT leaders have suggested that there be a common way to access this information[1], but none is yet available.

While the American National Standards Institute (ANSI) in the US provides an index[2] of all its approved standards and is an authorized source for standards from the International Organization for Standards (ISO), many organizations developing health IT standards are not members of ANSI, nor are all health IT standards necessarily available through ISO.  Furthermore, both organizations publish standards for more than just health IT systems, making it difficult to locate healthcare specifications by themselves.

Health Level 7 (HL7) has developed several specifications that can be applied to this effort.  The HL7 Templates Registry Business Requirements[3] specification describes metadata, policies, navigational, security, search and other capabilities for a registry of specifications using one or more of the HL7 standards.  They also published a metadata specification based upon a review 20 different standards or specifications from four different SDOs in support of unifying metadata across clinical quality standards[4].  Both specifications are applicable, but have not yet been implemented in a system that searches across specifications from multiple SDOs.

The United States Health Information Knowledgebase (USHIK)[5] provided by the Agency for Healthcare Research and Quality provides a standards portal[6] describing the data elements found in the ANSI Health Information Technology Standards Panel (HITSP), American Standards Committee (ASC) X12, and National Council on Prescription Drugs (NCPDP) standards.  This portal enables search for data elements available in a limited number of standards, but does not support searching for the standards themselves.

Project Design and Scope

The purpose of this project is to pilot a source of entry into the variety of different standards available to health IT implementers, informaticists and educators who want to learn more about health IT standards.  The concept is based loosely upon PubMed, a singular source of information for information from medical journals, but is applied to standards published by SDOs.  Rather than populating the information in the index manually, this project proposes to use existing information resources via RSS and/or Atom feeds provided by an authoritative source (e.g., the SDO itself).  Metadata information will be captured from this feed and indexed in a repository, allowing those interested in Health IT standards to search for, and compare applicable standards for different use cases.


The project will develop a metadata model for health IT standards based upon existing work, create a database to support search of this metadata, enable population of the database via commonly available Internet subscription formats (RSS and Atom feeds), and develop and test a search interface for accessing health IT standards.  The database will be populated with content from at least three SDOs.  Once populated, the pilot will be publicized to members of these SDOs and other organizations with an interest in learning more about health IT standards.

Data Collection

The site will be instrumented to capture usage statistics in two ways.  Google analytics will be used to capture specific details about web site interactions (links clicked, search paths used, et cetera).  Some individually identifiable data may be present in data captured via Google Analytics results (network and location).  The site will also be instrumented to collect other data from users including specific search requests, time on site, and feedback about the usefulness of the site.  Individually identifiable user information will not be captured or stored from this instrumentation (e.g., user identity, computer or network characteristics, et cetera).

Success Criteria

Upon completion of this project, I expect to have shown the capability to readily create an index of standards from multiple SDOs, the utility of such a site to the health IT community, and to have gathered feedback about how to improve searching of health IT standards.  Hopefully such a standards index will find a permanent home within the health IT standards community.

[1].     Halamka, J. The United States Health Information Knowledgebase. November 7, 2012. Life as a Healthcare CIO.  Available on the web at
[2].     ANSI Standards Store. American National Standards Institute. Available on the web at
[3].     Gower C, Curry J, Stechishin A, Shafarman M, Roberts J. HL7 Templates Registry Business Process Requirements Analysis, Release 1. December 2013. Health Level 7 International, Inc. Available on the web at
[4].     Boone K, Boxwala A, Rhodes B, Moehrke J. Clinical Quality Metadata Conceptual Model. December 11, 2014. Health Level 7 International, Inc. Available on the web at
[5].     Fitzmaurice JM, Donnelly J, Barnes R. The Standards and Interoperability Framework Portal in the United States Health Information Knowledgebase. September 29, 2011.  Standards and Interoperability Framework Initiative. Available on the web at
[6].     United States Health Information Knowledgebase. the Agency for Healthcare Research and Quality. Available on the web at


  1. Such a nice blog you have shared here with us I really like the information you have shared with us.Keep updating more useful blogs with us.

  2. Something similar to your idea, which is used in germany: