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References: Healthcare Interoperability and Care Coordination

  1. HL7 - Wikipedia - Overview of the HL7 standards family, including the pipe-delimited HL7 v2 messaging format, Clinical Document Architecture, and the Continuity of Care Document this chapter uses to trace Maria's record.

  2. Health information exchange - Wikipedia - Explains how regional and statewide networks let providers query patient records across organizations, the centralized-versus-federated architectures involved, and the consent rules that govern this chapter's HIE discussion.

  3. Accountable care organization - Wikipedia - Describes how provider networks share financial accountability for a population's cost and quality under the Medicare Shared Savings Program, the exact benchmark-and-savings mechanism this chapter models as a graph.

  4. The CDA Book (2011) - Keith W. Boone - Springer - Boone, who co-chaired HL7's Structured Documents working group, pioneered detailed, example-driven walkthroughs of Clinical Document Architecture, the XML standard underlying the Continuity of Care Document this chapter traces from hospital discharge to referral.

  5. Principles of Health Interoperability: FHIR, HL7 and SNOMED CT (4th Edition, 2021) - Tim Benson and Grahame Grieve - Springer - Long regarded as the field's standard text, now co-authored with FHIR creator Grahame Grieve, Benson organizes HL7 v2 messaging, CDA documents, and FHIR resources under one consistent interoperability framework this chapter builds toward.

  6. What Is HIE? - HealthIT.gov (ONC) - Official U.S. government explanation of directed and query-based health information exchange, the same query-versus-referral mechanism this chapter uses when Dr. Osei retrieves Maria's CCD from Riverside Clinic.

  7. Accountable Care Organizations (ACOs) - CMS.gov - The federal agency's own definition and program page for ACOs and the Medicare Shared Savings Program, the shared-savings benchmark example this chapter walks through for Riverside Clinic's ACO membership.

  8. Patient-Centered Medical Home (PCMH) Recognition - NCQA - The accrediting body's own description of PCMH recognition criteria, directly grounding this chapter's claim that a formally recognized primary care practice, not a specialist, coordinates a patient's comprehensive care.

  9. Social Determinants of Health - Healthy People 2030 (ODPHP) - The federal government's own five-domain framework for social determinants of health, closely matching the housing, food, transportation, literacy, and income factors this chapter models as SDOHFactor nodes.

  10. RxNorm - National Library of Medicine - The maintaining agency's own hub for RxNorm documentation, downloads, and APIs, explaining exactly how brand names, generic names, and NDC codes resolve to the single shared concept this chapter illustrates with Lipitor and atorvastatin.