Hospitalization Discharge Summary: Standardization of Information Model
de Souza, Aéia.Cristina.; Moro, C.; Reis, Z.S.N.
Studies in Health Technology and Informatics 216: 936
2015
ISSN/ISBN: 0926-9630 PMID: 26262238 Document Number: 685133
Brazil has a long tradition in the use of health information systems, however--until now--there is no consensus on the minimum data set from which to compose discharge summaries. This article describes the methodology used by a group of experts--members of WG1 of ISOTC 215 Health Informatics Brazilian mirror committee--to define the information model of the discharge summary. This paper describes the current status of the standardization process and the first pilot tests with this infomation content.