Omaha System Omaha System
Latest Update via UMLS 2005 Original Publication 1975
The Omaha System includes terminology and an implicit information model. In the 1970s, the Visiting Nurse Association (VNS) of Omaha revised its home health and public health client records to adopt a problem-oriented approach. This new approach, with the goal of providing a guide for practice, a method for documentation and a framework for information management, yielded Omaha System. Based on rigorous development, it incorporated an integrated, valid and reliable computerized clinical information system organized around the clients receiving services (Frequently Asked Questions, 2016) (Learning about the Omaha System, n.d.). Today, Omaha System is a “research-based, comprehensive practice and documentation standardized taxonomy” designed with three relational components (Solving the Clinical Data-Information Puzzle):
Problem Classification Scheme: Client assessment; Intervention Scheme: Care plans and services; and Problem Rating Scale for Outcomes: Client change/evaluation component.
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Omaha System exists in public domain and is not under copyright. The terms, definitions and codes are available for use without permission or a licensing fee from the publisher or software developer; however, parts of the 2005 book are under publisher copyright. Companies which design and sell software based on Omaha System are required to observe copyright laws. Individual customers must use the taxonomy as published.
Process for Updating/Publishing Standard The most recent publication of Omaha System is 2005 and a new version is in use. The update process requires a multi-step, triangulated approach and includes the presentation of user-submitted suggestions at the biennial Omaha System International Conference. In addition to that process, a 12- member international board of directors reviews and revises Omaha System on an ongoing basis using the results of current research, expert opinion and user experience and feedback (Frequently Asked Questions, 2016). It was noted that the update process, intended to maintain the integrity and consistency of the taxonomy, is time-consuming, with some revisions taking years to complete.
Usage/Activity Originally developed for home care, public health and school health settings, Omaha System today is a multidisciplinary or inter-professional system used across the continuum of care. In 2015, a survey indicated more than 22,000 multidisciplinary clinicians use the Omaha System. User types include “nurses, physicians, occupational therapists, physical therapists, registered dietitians, recreational therapists, speech and language pathologists, and social workers” (Garvin, Martin, Stassen, & Bowles, 2008).
By 2000, Minnesota had 87percent of its counties – both public and private sector – using the Omaha System in one of three software EHRs (Meaningful Use of the Omaha System for Program Evaluation in Public Health Nursing, 2010). In 2001, state and county public health nurses started the Minnesota Omaha System Users Group, now the Omaha System Community of Practice (OSCOP). OSCOP is a “collaborative working group of public health and home care agencies, educators and software vendors who use the Omaha System…it is also an active workgroup with the purpose of improving and standardizing public health practice, documentation, data collection and outcome reporting” (Learning about the Omaha System, n.d.). Under the Minnesota e-Health Initiative and the Minnesota Department of Health (MDH), Minnesota recommends the use of one of the ANA-recognized standard nursing terminologies within the EHR. The state has designated the Omaha System for exchange between public health entities or community-based reporting if both are already using the Omaha System (e-Health Standards, n.d.). Exchange between providers not using the Omaha System should use SNOMED CT and LOINC.
Several EHR developers are using Omaha System and have given permission to be listed on Omaha’s website (Links, 2005). Without a prescribed, standardized implementation process, each EHR developer implements Omaha System differently; however, per the subject matter expert, a common consultant ensures correct usage.
Challenges The Omaha System is reported to be widely used; however, there is no way to track use since taxonomy is in public realm. Many EHR developers may be implementing the system differently and allowing user customization.
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Opportunities Omaha System has no licensing fee and is interdisciplinary across the continuum of care, regardless of setting or timeframe.