Interoperability Progress and Remaining Data Quality Barriers of Certified Health Information Technologies

Area of Science:

• Health Informatics
• Clinical Data Exchange Standards

Background:

• The Consolidated Clinical Document Architecture (C-CDA) is the standard for clinical document exchange in the US.
• Previous studies identified challenges in achieving high-quality, effective interoperability with the C-CDA standard.
• Recent federal programs have led to new electronic health record (EHR) certifications using an updated C-CDA version.

Purpose of the Study:

• To evaluate the conformance and data quality of C-CDA testing artifacts generated by recently certified EHRs.
• To identify progress and persistent barriers in clinical data exchange interoperability.
• To emphasize the need for data quality evaluation beyond basic conformance checks.

Main Methods:

• Automated tooling and manual inspection were used to analyze C-CDA documents.
• The study examined example documents from 52 health information technologies.
• Conformance and data quality metrics were applied to the testing artifacts.

Main Results:

• The research cataloged advancements in clinical data exchange capabilities.
• Identified remaining barriers that hinder effective and safe data exchange.
• Demonstrated variability in data quality among the evaluated C-CDA documents.

Conclusions:

• While progress has been made, achieving seamless clinical data interoperability requires addressing data quality issues.
• Programs evaluating data quality beyond schematron conformance are crucial for safe clinical data exchange.
• Further efforts are needed to ensure high-quality and safe exchange of clinical data using C-CDA.