René Spronk, Sr.Consultant, Ringholm GmbH

Transcriptie

1 Wat is HL7 Structuur en opbouw van de standaard René Spronk, Sr.Consultant, Ringholm GmbH

2 Ter memorie: HL7 is.. Een standaardorganisatie Wereldwijd: 1750 organisaties, 1400 individuele leden (ca. 45% Europa) Standaarden HL7 versie 2: (1987+) Ondersteunt processen in ziekenhuizen HL7 versie 3: (1996+) Berichten: ondersteunt processen tussen organisaties Documenten: ondersteunt overdracht van een persistente set gegevens tussen zorgverleners Geen applicaties! 2

3 Mission Statement HL7 creates practical standards for the exchange, management and integration of electronic healthcare information. Standards for electronic data interchange in all healthcare environments. A way for inherently disparate [healthcare] applications and data architectures to communicate 3

4 HL7 v2 (A01-)message MSH ^~\& ZIS AMC ADT^A P 2.2 AL NE <cr> EVN A PID "" ^9^M11 Vandenberg^Anne^E^^"" F Prinsengracht^22^Amsterdam^^1000PJ^""^P "" "" "" "" <cr> 4

5 HL7 v3: XML-Fragment XML-Syntax: <tag1 attribuut1= waarde attribuut2= waarde > <tag2>waarde</tag2> </tag1> Voordelen: Leesbaar Testbaar door middel van XML Schema Grote hoeveelheid standaardtools XML-Syntax is echter niet essentieel voor HL7: semantische eenduidigheid is essentieel 5

6 Lego.. sinds

7 Reference Information Model RIM Vier+twee basisklassen van het RIM (backbone) Role Relationship Act Relationship Entity Role Participation Act 7

8 RIM (Reference Information Model) Basic (Abstract) data model 8

9 Hoe worden HL7 berichten gemodelleerd? Use-Case Storyboard Dynamic Static Domain analysis: D-MIM Interaction analysis/design: Interaction Model Message design: R-MIM; HMD Abstract Message Specification (Implementable) TYPE MPSLOC CONTAINS TYPE MPSLOC { id[id].type CONTAINS IID { nm[name].type id[id].type IID ST ad[addr].type nm[name].type XAD ST ph[phon].type ad[addr].type XTN XAD _address ph[phon].type XTN [emladr].type _address XTN } [emladr].type XTN } 9

10 Person classcode*: <= PSN determinercode*: <= PSN name: EN [0..*] birthtime: TS [0..*] model voorbeeld Person A Practitioner perfomer Anamnese 1..1 patientperson Person B Patient subject Zorgvragende 1..1 patient Anamnese classcode*: <= PAT id*: II [1..1] addr: AD [0..1] subject typecode*: <= SBJ classcode* <= xy moodcode* <= xy id*: II [1..1] Person telecom: TEL [0..*] practitioner Organization playedby scopedby Practitioner classcode*: <= PRT id*: II [1..1] telecom: TEL [0..*] performer typecode*: <= PRF time: IVL<TS> 10

11 Workflow 11

12 Aandachtsgebied van HL7 Versie 3 Communicatie tussen organisaties Healthcare System Patient Aftercare Information flow Gen. Pract. Lab Specialist Hospital Rad Chir 12

13 Context Issues: examples Regional exchange of data: Information related to patient is sent from provider A to provider B. Has this number been created by A? By B? Or by yet another organization? Regional order for laboratory test: A hospital sends an order for test B345 to a regional laboratory. Is this a hospital code for a test? A code as known by the laboratory? Or a reference value from an international vocabulary? 13

14 V3 identificatiesysteem (voorbeeld) 14

15 V3 coderingssysteem (G- Standaard als vocabulary domain) 15

16 Domeinen in de HL7 standaard Accounting & Billing Claims & Reimbursement Materials Management Patient Administration Personnel Management Scheduling Bloodbank Care Provision Clinical Decision Support Clinical Document Architecture Clinical Genomics Diagnostic Imaging Immunization Laboratory Medical Records Medication Orders and Observation Pharmacy Public Health Regulated Products Regulated Studies Specimen Therapeutic Devices 16

17 Patient LivingSubject CMET Entry Point CMET (ORG) E_Organization [contact] (COCT_MT150003) PatientRole classcode: <= PAT Id: SET<II> [1..*] Addr: Telecom: effectivetime: IVL<TS> 1..1 Provider Organization 1..1 PatientEntity Choice Subset Person classcode <= PSN Id: SET<II> [0..*] Name: administrativegender: NonPersonLivingSubject classcode <= NLIV Id: SET<II> [0..*] 17

18 PatientLivingSubject (PRPA_RM201101) 18

19 Patient Model NL Constraint 19

20 Observation - ADL Entry Point sourceof / targetof typecode: <= ActRelationshipType classcode: OBS moodcode: <= ActMood id: II [0..*] code: [0..1] <= ObservationType statuscode [1..1] <= ActStatus effectivetime: GTS [0..1] value: ANY [0..1]... verifier typecode <= VRF subject typecode <= SBJ * author typecode <= AUT 0..* 0..* CMET (Assigned) R_AssignedEntity [universal] CMET (Assigned) R_Patient [universal] 20

21 Model Hierachie RIM Lab Pharmacy Structured Documents Slide courtesy of Ramsey systems (modified) 21

22 Lokalisatie Noodzakelijk Keuze van coderingen eenheid van taal Inperken van generieke modellen opdat zij passen bij NL workflows HL7 NL en NICTIZ hebben al een hele reeks implementatiegidsen gepubliceerd 22

23 Vragen? 23