Mark Diehl

MarkDiehl.com

Health Information Architecture, Modeling, and Enterprise Architecture Planning

History of the Specification

The origin of the ANSI/ADA Specification 1000 for the Structure and Content of a Computer based Patient Record is the ADA House of Delegates Resolution 18H-1992 (Trans 1992:597) to facilitate development of the computer-based dental patient record. The ADA Council on Dental Practice established a Computer-based Oral Health Record (COHR) workgroup to implement this resolution. An important result of this work effort was the designation of the American Dental Association as the steward of data content and policy in Dentistry by ADA Board Resolutions B-118-1995 to B-121-1995.

In February,1996, the CDP COHR Workgroup completed its work with publication of the Computer-based Oral Health Record Concept Model. The COHR Concept Model presented a view of the clinical process and basic data needed to support these processes. This concept model forms the foundation for the standardization of clinical data.

Also in 1996 the ADA House of Delegates approved Resolution 92H-1996 advocating seamless availability of patient health data across the healthcare professions, specialties, and care delivery environments. This landmark resolution for patient safety and health considers the health of the entire patient, noting that patient well-being and optimum outcomes often need provider access to patient health information sources beyond the traditional boundaries that artificially compartmentalize care delivery.

In 1998 the ADA began publishing the Proposed ANSI 1000 Specification as a draft standard for public review and comment. The draft standard was published by subject areas that correspond to the major processes identified in the Concept Model. Public review included document distribution and symposium review at numerous professional meetings. Following all-parties review and balloting according to ANSI and ADA standards development rules, the Specification was adopted as an American National Standard in February, 2001. With this action, this specification becomes the first and only model-based, comprehensive, data-level standard for electronic health information in the United States.