Vital Signs

A longitudinal health record is a comprehensive summary of a person’s health information across time, organizations, and settings, organized around the patient rather than individual encounters or providers. This post explains how it differs from traditional records, how exchange networks, standards, and apps help assemble it, the challenges of matching and reconciling data, and nursing roles.

Electronic data interchange (EDI) is the standardized electronic exchange of business documents between organizations. In healthcare, EDI uses X12 and NCPDP standards adopted under HIPAA for claims, eligibility, remittance, prior authorization, and enrollment. This post explains key transactions, clearinghouses, operating rules, the shift toward FHIR for some processes, and nursing impacts.

A trigger event is an occurrence that causes a system to start a response, such as sending a message, firing an alert, or notifying another system. This post explains trigger events in HL7 Version 2 messaging, FHIR subscriptions, and CDS Hooks, how they drive interfaces and decision support, the different meaning of trigger tools in patient safety, and nursing impacts.

The NCPDP SCRIPT standard defines how prescription information is exchanged electronically among prescribers, pharmacies, intermediaries, facilities, and payers. This post explains SCRIPT transactions, from new prescriptions to cancellations and medication history, federal requirements including the move to SCRIPT version 2023011 by 2028, electronic prescribing of controlled substances, and nursing roles.

A unique patient identifier (UPI) is a value permanently assigned to one person and used to identify them across the healthcare system. This post explains why the United States has no national patient identifier, the long-standing funding restriction, how organizations match patients today, the safety and interoperability risks of mismatches, and how nurses help get identification right.

Long-term and post-acute care (LTPAC) includes the settings that provide ongoing or recovery care outside acute hospitals, such as skilled nursing facilities, home health, inpatient rehabilitation, long-term care hospitals, hospice, assisted living, and PACE. This post explains LTPAC settings, why interoperability has lagged, how the IMPACT Act standardized assessment data, the importance of care transitions, and nursing roles.

The National Drug Code (NDC) is the FDA’s unique three-segment identifier for drug products, identifying the labeler, product, and package. This post explains how NDCs are structured, why 10- and 11-digit formats cause confusion, what the FDA’s final rule moving to a 12-digit NDC means, how NDCs relate to RxNorm, and how they support barcode medication safety.

A standards development organization (SDO) creates and maintains the technical standards that allow health information systems to exchange and use data consistently. This post explains the major health IT SDOs, how consensus standards are developed, the difference between standards, implementation guides, and profiles, how government adoption works, and why clinicians should participate.

The Direct Project created a secure, standards-based way to send health information over the internet to known, trusted recipients, much like secure email. This post explains how Direct messaging works, including Direct addresses, HISPs, and certificates, where it fits among exchange methods, its strengths and limits, and what it means for care transitions.

The Da Vinci Project is an HL7 FHIR Accelerator that brings payers, providers, and technology vendors together to build FHIR implementation guides for value-based care and administrative data exchange. This post explains its major guides, including those for prior authorization, how they relate to CMS interoperability rules, and what they mean for clinicians.

The Unified Medical Language System (UMLS), produced by the National Library of Medicine, links many biomedical vocabularies and provides tools that help software recognize when different terms mean the same concept. This post explains the Metathesaurus, Semantic Network, and SPECIALIST Lexicon, how the UMLS supports mapping and NLP, and how it differs from the terminologies it contains.

Semantic interoperability is the ability of systems to exchange data in a way that preserves its meaning, using common models and standard codes so the receiving system understands it as the sender intended. This post explains the levels of interoperability, how terminologies and value sets create shared meaning, where meaning gets lost, and why it matters at the bedside.

OAuth is an open standard that lets an application access a user’s data on another service without seeing the user’s password, using limited, revocable access tokens. This post explains how OAuth works, how SMART on FHIR uses it for health apps, the difference between authorization and authentication, and what patients and clinicians should know.

A terminology is a system of words or concepts used to name things in a particular field. In health IT, clinical terminologies give computers a shared, coded vocabulary so data keeps its meaning across systems. This post explains how terminologies differ from classifications and code sets, the major U.S. terminologies, how mapping works, and why it matters at the bedside.

Integrating the Healthcare Enterprise (IHE) is an initiative of healthcare professionals and industry that improves how health IT systems share information by specifying how established standards such as HL7 and DICOM should be used together. This post explains IHE profiles, technical frameworks, Connectathons, key profiles for exchange and imaging, and why IHE matters to clinicians.

The Argonaut Project is a private-sector initiative that brought EHR vendors and health systems together to speed adoption of FHIR-based APIs. This post explains why it formed, what it produced, how its work led to US Core and today’s patient access APIs, and how the HL7 FHIR Accelerator model carries the approach forward.

The International Classification of Diseases (ICD), published by the World Health Organization, is the global standard for classifying diseases and health conditions for statistics, epidemiology, and payment. This post explains ICD-10-CM and ICD-10-PCS in the United States, what ICD-11 changes, how ICD differs from clinical terminologies like SNOMED CT, and why documentation drives coding.

HL7 Version 2 (HL7 V2) is the widely implemented healthcare messaging standard that carries admissions, orders, results, and other events between clinical systems. This post explains how V2 messages, segments, and trigger events work, why the standard remains so common, its weaknesses, and how it compares with FHIR.

A unique device identifier (UDI) is a code on a medical device’s label that identifies the specific device model and, when applicable, its lot, serial number, and dates. This post explains how FDA’s UDI system works, what the device and production identifiers contain, how UDIs flow into the EHR and national databases, and why perioperative nurses scan them.

An interface engine is software that receives messages from one system, translates them into the format another system expects, and routes them to the right destinations. This post explains how interface engines work, why hospitals use a hub-and-spoke design, how engines relate to HL7, FHIR, and APIs, and how interfaces show up in nursing workflow.