The profiles below depict the historic participation activities of the different professional specialty societies over the years in the different activities that have lead to the EHR. Each discipline has taken a different route in the contribution it has made to one or more aspects of the EHR evolution. This section sketches the contributions made by a number of the participants in the evolution. Some have worked to a great extent in consensus standards activities, others have evolved marketable products (largely coding schemes and vocabularies) for use across disciplines. Still others have contributed educational programs. Each professional specialty will have its particular areas of interest and its informational and educational events dedicated to inculcating mastery of informatics concepts vital to that specialty. This section of the Web site is directed at describing these activities and events and making the list known to the entire healthcare community so that each specialty can draw on the events of related specialties and perhaps join forces with other disciplines to sponsor common forums that provide even more enlightenment than specific focused ones. These are judgments that each specialty must make individually and act upon, but which are hopefully helped by the information given in this section. Links to these organization’s sites and related Web pages will be used to draw on existing information without repetition.
The American Association for Clinical Chemistry (AACC)
The American Association for Clinical Chemistry, a major clinical laboratory professional society, together with its Academy - the National Academy of Clinical Biochemistry (NACB), became formally active in health informatics and the EHR in 1984 with the formation of the Laboratory Information Systems and Medical Informatics (LISMI) Division, a cooperating organization for this Web Site. This AACC Division has participated in the ASTM E-31 Technical Committee activities and in the formation of the ANSI HISB and its precursor organizations. Its Web site (http://www.aacc.org/AACC/members/divisions/lis/) and that of the NACB (http://www.nacb.org/) depict the activities of the each organization. AACC members also participate in the clinical laboratory and informatics standards activities of the ANSI HISB SDO member the National Committee for Clinical Laboratory Standards (NCCLS: http://www.nccls.org).. Other AACC Divisions, such as the Point-of-Care and Therapeutic Drug Monitoring/Toxicology Divisions, are being encouraged to become involved in informatics issues via liaison with the AACC LISMI Division. The AACC, its Divisions, and the NACB collaborate in sponsoring meetings, listservers, online instruction, audio conferences and other media presentations of topics relating to the EHR and related informatics issues. A recent activity was the NACB sponsored meeting in Philadelphia PA 15-16 September 2000 “Connecting the Laboratory to the Electronic Medical Record: Issues and Opportunities”; a CD of the Proceedings is available. Consult http://www.nacb.org for details.
The AACC LISMI Division was formed to pursue all of the informatics issues that relate the clinical laboratory to the practitioner community served by the laboratory. It has pursued informatics standards by participating in ASTM E-31 and in the coordination of laboratory related informatics standards activities being produced by other Standards Developing Organizations (SDOs) such as NCCLS and HL7. It has collaborated in these activities with the NACB, most notably in sponsoring the September 2000 meeting. This meeting was the first specific meeting on the Electronic Health Record and its particular implications for the clinical laboratory that has been organized by a clinical laboratory professional organization. It was intended to be the first of several such meetings that will help guide clinical laboratorians into a mastery of EHR concepts and the ways to shape their contribution to this new information environment. Further AACC/NACB activities will appear in this section of the Web site
American Dental Association ( ADA)
In addition to its ANSI accredited standards activities, the ADA also hosts informational activities at its semiannual meetings.
American Dental Education Association (ADEA)
The American Dental Education Association (renamed in April 2000 from American Association of Dental Schools), http://www.adea.org, is an organization directed at all aspects of education for oral health professionals. It has a constituent Dental Informatics Committee that deals with the EHR among the range of informatics subjects that are related to the education of its professional constituency. It works closely with AMIA in addressing such informatics issues and with ADA on informatics standards.
American Health Information Management Association ( AHIMA)
The American Health Information Management Association is the key professional association for health information administrators and technicians who design, develop and manage patient data in manual and electronic health records and patient data collection systems in hospitals, ambulatory care, long term care, rehabilitation, behavioral health and home health environments. Health Information Management professionals also work in systems consulting, health insurance, government agencies, peer review organizations, research facilities and more. They oversee federal and state regulatory impact on institutional patient information and provide organizations with leadership and direction for voluntary and mandatory certification and accreditation activities related to information management such as required for Medicare/Medicaid, JCAHO and NCQA. AHIMA works collaboratively to jointly sponsor work with other professional organizations in promoting technology for health information processing, including endorsement and participation in the formation of the Computer-based Patient Record Institute. The Association provides leadership in diagnostic and procedural coding at the national policy level and advances credentials for certifying coders. AHIMA participates in national legislative initiatives with a special interest in privacy and confidentiality of patient information. AHIMA leadership has supported work in health informatics standards development since 1986 through representatives to ASTM E31 Committee on Health Informatics and HL7 work groups. It has been a member of ANSI HISB. AHIMA provides educational opportunities in its national meetings and through publications; and offers commentary on current topics on its web site. See: www.ahima.org .
American Medical Informatics Association (AMIA)
(see: www.amia.org) The American Medical Informatics Association arose in 1988, as described by Morris Collen (Ref A5 p 47), from the assembly of several previous organizations. The Society for Computer Medicine (SCM) and the Symposium on Computer Applications to Medical Care (SCAMC) began in the 1970s to hold forums to discuss informatics issues in healthcare while the American College of Medical Informatics arose from a parallel effort. When it became clear that these independent activities would function best as a combined organization, the merger occurred. AMIA publishes a journal, Journal of the American Medical Informatics Association, and hosts two Symposium Meetings in the Fall and Spring. The Association has numerous work groups.
American Nurses Association (ANA)
The American Nurses Association has been active in informatics for over 25 years and has a documented “Scope and Standards of Nursing Informatics Practice” (Ref B3). There is an American Nursing Informatics Association which meets regularly and has relationships with the American Medical Informatics Association.
College of American Pathologists (CAP)
The College of American Pathologists' (CAP) primary area of activity is in vocabulary, namely the Systematized Nomenclature of Medicine (SNOMED). This nomenclature arose in the 1970s as Systematized Nomenclature of Pathology through the work of Arthur Wells; it contained four components (“axes”): Topography, Morphology, Etiology, Function. These have since expanded into a greater number. As the scope of the project has increased. the most recent versions of this product have been called “Reference Terminology (RT)” and “Comprehensive Terminology (CT)” which will included concepts from the UK’s Read system. The College is a member of the ANSI HISB and it collaborates with other specialty disciplines on other aspects of the EHR. [ See: http://www.cap.org ]