National Projects Requiring HL7 Standards Il Kon Kim, PhD Kyungpook National Univ., IHIS

Transcription

1 National Projects Requiring HL7 Standards Il Kon Kim, PhD Kyungpook National Univ., IHIS

2 Contents 1. Health Information Exchange (HIE) 2. Clinical Information in BioBank 3. Personal Health Device (PHD) CDA (Clinical Document Architecture)

3 Health Information Exchange Messaging: HL7 V2.4, V2.5 Document: Clinical Document Architecture Registry Cross-Enterprise Document Sharing(XDS): IHE Document Registry Framework(DRF): ISO TS Retrieve, Locate and Update Service (RLUS) SOA in Healthcare

4 HIToolkit: V2.4 Messaging Toolkit Project Edit the HL7 message structure Generate a Project Client UI Server UI Coding User of the Tool HL7 Message Toolkit (HIToolkit) Engine Engine System Developer Client HL7 Message Server A Dept. Client HL7 Message C Dept. B Dept.

5 CDA Build Process Selection of document code and data elements CDA template 헤더정보템플릿 바디정보템플릿 Diagnosis/ Problems Medication Surgery Allergies History Immunizati Diagnosis ons /problem 스타일시트템플릿 Document Code Health Summary CDA 가대표하는문서코드를표시한다. CONF-4 : ClinicalDocument 는정확히한개의 code 를가진다. CONF-5 :"ClinicalDocument/code" 의값은 복지부검사용어의 "Summarization of episode note" 을갖는다. Vital sign Lab test result Plan of care Rendering Map data elements to CDA 5

6 Document level Template Referring Transfer of Care Referral Note Referred LOINC: Local Document Template ID Code Data Element Name Scale System class Method 진료의뢰서 진료회신서 Transfer of Care Referral note Doc {setting} {Provider}

7 Referring/Referred CDA Templates Data Element Index- LOINC Codes Data Element Name. Parents Template Id Diagnosis Reason of Referral History of Past Medical Medications Laboratory Studies Radiology Studies Pathology Studies Procedure History Assessment and Plan Physical Examination Referring Referred Common

8 Health Summary CDA Header Person Identification Author Custodian Legal Authenticator Signature

9 Health Summary CDA Body Diagnosis/Problems Pertinent History Vital Signs, Significant Test Results Medications Procedure, Surgery Plan of Care Allergies, Immunizations, Functional Status Dental Care

10 CDA Registy/Repository CDA Generator using Templates OASIS ebxml CDA Registry/Repository Standard of CDA Reg/Rep DRF: Document Registry Framework ISO DRF

11 Document Registry WSDL WSDL: Web Service Definition Language

12 SNUH: Seoul National Univ. Hospital Registry server Tertiary Care Hospital - Bundang SUNH Primary Care Clinics G G REPOSITORY REPOSITORY Secondary Care Hospitals Health Center G G REPOSITORY REPOSITORY Registry Data Notify Message CDA DOCUMENT G Interface Server

13 HIS, HIE, PHRS, u-health/e-health HIE HIS u-health/ e-health Silos PHRS

14 What information will be necessary for HIE, u-health, and PHRS? HIE HIS u-health/ e-health Silos PHRS

15 What information should be added from HIE, u- Health, and PHRS? HIE HIS u-health/ e-health Silos PHRS

16 How to integrate EHRS with HIE, u-health, and PHRS? HIE EHRS u-health/ e-health Silos PHRS

17 Beyond EHR-S FM DSTU Beh. Health Legal EHR Child Health ED ED Alignment Lifecycle EHR Interop Model PHR-S FM & Profiles SOA Release 1 Adjustments, Enhancements EHR-S FM Release 2 Fraud Mgt Other Industry Initiatives Certification (CCHIT, Q-Rec) Health Info Exchange Privacy, Security, Confidentialit y Inter- National Standards (ISO TC215, CEN 18308, 13606) Others? [HL7 EHR TC]

18 Electronic Health Record System We need to simplify it or change thinking point of view Record events clearly and shortly Understandable and Interoperable

19 Kyungpook National University BioBank: Stubborn Senile Diseases Resources Bank Pathogenic Microorganisms Resources Bank

20 BioBank Acquire various human origin biological materials such as cells, tissues/organs, plasma/serum Store and manage the acquired human origin biological materials systematically with related information including donors past medical history, current illness, pathology findings, image findings, and treatment histories. Share the stored human origin biological materials and relevant information with researchers

21 National BioBank Korea Network CI EI MI MG EI CI QC BioBank A BioBank B QC HB Central Information System HB Researcher/User MI: Management Info EI: Epidemiological Info CI: Clinical Info QC: Quality Control HR: Human Origin Biological Materials

22 Architecture Operational Management Program HIS System Bridge System HL7 Message Linux Server (Ensemble) CDR System Hospital BioBank Lab Report CDA Radiology Report CDA Pathology Report CDA HIS: Hospital Info. System CDR: Clinical Document Registry

23 Data Elements Table: Category, Element Name, Code Category 변수 5 대암분류 KOSTOM 1차 2차변수명컬럼명간대장유방위폐코드챠트번호 Patient_ID 모든질환공통 KS 기본사항 간기능 방사선검사 내시경검사 수술관련 이름 Patient_Name 모든질환공통 KS 나이 Patient_Age 모든질환공통 KS 키 Patient_Height 모든질환공통 KS 몸무게 Patient_Weight 모든질환공통 KS 생년월일 Patient_DOB 모든질환공통 KS 성별 Patient_Sex 모든질환공통 KS 진단명 Diagnosis_Name 모든질환공통 KS 수행능력 (ECOG) ECOG 모든질환공통 KS 최초진단일 First_Diagnosis_Date 모든질환공통 KS 장기명 Organ_Name 모든질환공통 KS etiology Etiology O X X X X KS 간경화동반 Cirrhosis_Check O X X X X KS 간기능 Child ( 간기능 Function_Child O X X X X Child-pugh class) KS varix 존재여부 Varix_Check O X X X X KS 간성혼수존재여부 복수존재여부 ( 복수존재유무 ) portal vein thrombosis Hepatic_Encephalopathy O X X X X KS Ascites_Check O X X X X KS Portal_Vein_Thrombosis_C heck O X X X X KS abdomen CT Abdomen_CT O O X O X KS bone scan Bone_Scan X X O X X KS PET CT PET_CT 모든질환공통 KS Mammography Mammography X X O X X KS breast USG(breast sono) Breast_USG X X O X X KS 대장내시경검사 X O X X X KS 위내시경검사 X X X O X KS 수술일 Surgery_Date 모든질환공통 KS 수술명 Surgery_Name 모든질환공통 KS

24 [Continua Health Alliance Sample CDA: HL7 Implementation Guide for PHM Report Release 1.0 ]

25 PHD CDA Header Data Element Header Attributes Participants classcode moodcode typeid Id Code Title effectivetime confidentialitycode languagecode setid versionnumber copytime(deprecated) Author Authenticator legalauthenticator informationrecipient Informant participant Home Gateway Custodian recordtarget Patient Related Acts Parentdocuemnt serviceevent Consent Order EncompassingEncounter Service Provider PHD: Personal Health Device

26 PHD CDA Body Template Data Element Index- LOINC Section Category Codes Medical Equipment Data Element Name Medical Equipment section Parents Template Id Vital Signs Vital Signs section * Korea ISO 3166 Code: 410 (USA: 840 )

27 Thank you 福人奉德人 Happy person meets Virtuous person 복있는사람이덕있는사람을만난다