May 29, 2008

ASTM International Committee E31 on Healthcare Informatics notes the innovative use of the Continuity of Care Record within the Google Health application launched on May 20. Formally known as ASTM E2369, Specification for Continuity of Care (CCR), the CCR standard is an XML-based format for access to, transport of and interoperable exchange of core summary health information. The CCR is intended to support continuity of care, reduce medical errors and increase efficiency by eliminating duplication of tests and procedures. ASTM E2369 was developed by Subcommittee E31.25 on Healthcare Data Management, Security, Confidentiality and Privacy.

 

Google Health, which was unveiled last week as beta and made open to the public after a pilot project with the Cleveland Clinic, is a personal health record service that allows users to create an online health profile by importing personal health data from organizations such as pharmacies and lab companies, as well as by entering the data themselves. Google Health also permits users to send their summary health information using the CCR standard XML format to other web portals and services for the purpose of personalizing searches, helping patients organize and remember when to take their medications, and automatically retrieving news items relevant to their conditions and treatments. Within the Google Health beta application, information is always under the control and direction of the user or individual, and all transfers of data require opt-in and consent.

 

"This is a significant event, and Google's support of the CCR standard validates all the hard work that has gone into its development by the many volunteer members of ASTM E31," comments David C. Kibbe, M.D., M.B.A., chair of E31, senior advisor to the American Academy of Family Physicians and principal of The Kibbe Group LLC. "The major breakthrough here, apart from the global presence of Google's personal health records platform, is the computability that the CCR standard confers on the healthcare content in the Google Health PHR. It is one thing to store health data on the Web as a text file, for example one's medications or lab results, where they can be viewed. It is a giant leap forward to make the data both human and machine readable, so that these same data can be acted upon in some intelligent way by a remote server, kept up-to-date and improved upon in terms of accuracy and relevance. That is what the CCR XML format achieves for the consumer that is really new and different."

Google Health beta currently supports a subset of the CCR standard's content, including vital signs, medications, problems and conditions, allergies, procedures, lab results and vaccinations. Incoming CCR XML files from sources such as another PHR and electronic health records or a pharmacy database may include additional sections of the CCR standard's content, for example, advance directives or family history data. At present, these more complete medical records will be stored within the Google Health application as "notices" and are available for use at a later date. It is expected that, over time, Google Health's CCR profile will expand in terms of the content areas it includes.

 

Kibbe adds, "Google Health engineers have worked closely with a number of developers who are members of ASTM E31 to work out the kinks that are always present in a major use of a new standard like the Continuity of Care Record. It is highly likely that some of the changes that have been made in the CCR's schema by Google and by the many partners of Google Health will eventually find their way into the next version of the CCR standard. This is the ideal situation for an IT standard, to have industry acceptance and use, through which improvements can be made quickly based on real world experience with the standard."

 

ASTM International standards can be purchased from Customer Service (phone: 610-832-9585; https://www.astm.org/contact) or at www.astm.org.

 

For technical Information, contact David Kibbe, The Kibbe Group LLC (phone: 919-960-5290; kibbedavid@mac.com). For meeting or membership information, contact Daniel Smith (phone: 610-832-9727; dsmith@astm.org).

 

Release #7990