Clinical data exchange standards and vocabularies for messages.

Motivation for the creation of electronic data interchange (message) standards is discussed. The ISO Open Systems Interface model is described. Clinical information models, message syntax and structure, and the need for a standardized coded vocabulary are explained. The HIPAA legislation and subsequent HHS transaction recommendations are reviewed. The history and mission statements of six of the most popular message development organizations (MDOs) are summarized, and the data exchange standards developed by these organizations are listed. The organizations described include Health Level Seven (HL7), American Standards for Testing and Materials (ASTM) E31, Digital Image Communication in Medicine (DICOM), European Committee for Standardization (Comité Européen de Normalisation), Technical Committee for Health Informatics (CEN/TC 251), the National Council for Prescription Drug Programs (NCPDP), and Accredited Standards Committee X12 Insurance Subcommittee (X12N). The locations of Internet web sites for the six organizations are provided as resources for further information.