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Antepartum Record Interoperability for Improved Pregnancy Care Coordination

Efficiently transmit comprehensive antepartum data to enhance care coordination during pregnancy, avoiding errors and delays in treatment, using industry and IHE standards and key technical properties.

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Antepartum Record Interoperability for Improved Pregnancy Care Coordination

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  1. Antepartum Record Profile HIMSS 2009 Interoperability Showcase IHE Patient Care Coordination Tone Southerland Greenway Medical Technologies

  2. Value Proposition • Over 4 million live births per year in the US alone. • Average cost of pregnancy care*: (medical- 84.1%, lab and imaging- 11.2%, drugs- 4.7%) • vaginal delivery: $7,737 • cesarean delivery: $10,958 • $4,000,000 x $9,347 = $37,388,000,000 (That’s billion with a B) *Thomson Healthcare. The Healthcare Costs of Having a Baby. Santa Barbara, CA: Thomson Healthcare; June 2007

  3. Problem • The patient’s data pertaining to the pregnancy that is being transmitted is often: • Incomplete • Incorrect • Not sent • This can result in • Repeating unnecessary labs/imaging studies • Inadequate treatment • Undesirable outcomes

  4. Use Case • Pregnant patient is seen by obstetric care provider for initial visit and subsequent visits. • Obstetric provider transmits patient’s antepartum information to central data repository or directly to the intended delivery facility. • Patient’s record is accessed when she arrives at the birthing facility.

  5. Scope Capability to electronically communicate the following type of information to care providers and institutions: • Antepartum History and Physical • Antepartum Summary • Antepartum Laboratory • Antepartum Education

  6. Standards Used • Industry Standards: • American College of Obstetrician and Gynecologists (ACOG) Antenatal Form • Clinical Document Architecture Release 2.0 (CDA R2) • Logical Observation Identifiers Names and Codes (LOINC) • Systemized Nomenclature of Medicine – Clinical Terms (SNOMED CT) • IHE Standards: • Medical Summary (MS) • Sharing Laboratory Reports (XD-LAB) • Cross Enterprise Document Sharing (XD*) • Document Digital Signature (DSG) • Notification of Document Availability (NAV)

  7. Key Technical Properties • Use of technologies such as: • HTTP • TLS • XML/XSLT • Use of XDS folder construct to contain one or more of the antepartum documents • Use of an inheritance model with existing IHE profiles • Use of a replace model for all of the antepartum documents • Data is both human and machine readable

  8. References • Antepartum Record http://wiki.ihe.net/index.php?title=PCC_TF-1/APR • American College of Obstetrics and Gynecology http://www.acog.org/acb-custom/aa128.pdf

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