a comparative study on the functions of pioneer organizations (astm, hl7 and iso) in developing electronic health record

in order to reach the electronic health record's (ehr's) goals and also for the users to employ it with confidence, integrated standards in the field of structure, content, data exchange, information production, architecture and system security must be formulated. before establishment of ehr, we should accept current standards or change them due to meet the needs of society and/or patterns from organization standards. american society for testing and materials (astm), health level 7 th (hl7) and international standard organization (iso) have started doing spread ehr-related activities and standardizations from years ago. therefore, these organizations would be pioneers and good patterns in expanding ehr. considering the wide range of ehr-related activities, international acceptance and accessible information offered by astm, hl7 and iso, the present applied comparative study reviewed the features (including structure, content, exchange, vocabulary, confidentiality, data types, clinical documents, infrastructure, financial, messaging, auditing and quality), activities and standards of ehr in these selected organizations. data was collected from printed texts, periodicals, the internet and reliable databases. finally, data comparison was made in comparative tables. studying the features of these non-governmental organizations revealed that hl7 is the newest. in addition, iso has the broadest scope of activities including report making, data recording, structure and content standardization. astm was the only organization that makes special standards. all three have a comprehensive definition for ehr, but astm pays more attention to the needs of users, hl7 takes a structured data set, features, communication and messaging into consideration, whereas iso gives more priority to computerized processing capabilities. although iso has the aspects of confidentiality, infrastructure and different data, is offers the lowest diversity and accuracy.