Practise vocabulary for SMART on FHIR, CDA documents, HIE, TEFCA, patient matching, and care coordination.
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SMART on FHIR enables:
SMART on FHIR = Substitutable Medical Applications, Reusable Technologies. A developer builds one app (e.g. a clinical decision support tool) that launches in Epic, Cerner, and other EHRs using standard OAuth 2.0 + FHIR. Like an 'app store for healthcare'.
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A CCD (Continuity of Care Document) is used for:
CCD (based on HL7 CDA) is the standard format for patient summary exchange: when a patient is discharged from hospital or referred to a specialist, a CCD accompanies them. CCDA (Consolidated CDA) is the US Meaningful Use standard version.
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Patient matching in health information exchange (HIE) refers to:
Patient matching is one of healthcare IT's hardest problems: without a national patient ID, systems must match on demographics. Probabilistic matching uses algorithms to score whether records are the same person. Errors cause wrong-patient medication or test result delivery — a patient safety risk.
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TEFCA (Trusted Exchange Framework and Common Agreement) establishes:
TEFCA (ONC, 2022+) creates a 'network of networks': any organisation connecting to a QHIN can exchange data with any other QHIN-connected organisation. This aims to solve the current fragmentation where different HIEs cannot share data with each other.
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In healthcare IT, 'semantic interoperability' means:
Interoperability levels: Foundational (data can be exchanged), Structural (data structure is standardised — HL7/FHIR), Semantic (meaning is preserved — SNOMED/LOINC coded data), Organisational (governance, policy, workflow). Most exchanges achieve structural interoperability; true semantic interoperability remains the hard target.