HL7 & KMEHR. A comparison. Medical informatics AJ 2013/2014. Authors: Tessa Borloo Nele Pien
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1 HL7 & KMEHR A comparison Medical informatics AJ 2013/2014 Authors: Tessa Borloo Nele Pien
2 2 Overview 1988 HL7 v KMEHR 2004 HL7 v3 Introduction HL7 v2 KMEHR HL7 v3 Comparison Overview
3 3 Health care Communication & interoperability Introduction HL7 v2 KMEHR HL7 v3 Comparison Introduction
4 4 Communication Problem: different organizations, different systems and different software difficult / impossible sharing data Need: interoperability Solution: standards Introduction
![[1] 5 Interoperability Process interoperability](/docs-images/27/10645831/images/5-0.jpg "Semantic interoperability Technical")
5 [1] 5 Interoperability Process interoperability Semantic interoperability Technical interoperability XXX
6 6 Interoperability Standards: consensus e.g. ISO 13606: EHR HL7: healthcare interoperability, clinical & administrative information KMEHR: healthcare interoperability, clinical information Introduction
7 7 Health care HL7 v2 standard Introduction HL7 v2 KMEHR HL7 v3 Comparison HL7 v2
8 8 HL7: general Health Level 7 (OSI) v2/v3 partially open standard (no software) exchange of structured clinical information ANSI accredited certification through affiliates collaboration: ISO TC215 & CEN TC251 HL7 v2
9 9 HL7 affiliates Belgium: KMEHR local HL7 XXX
10 [8] 10 HL7 V2.7 core segments: MSH, EVN, PID, PVI, OBR, OBX, Z-segments segment definition: SEQ, LEN, DT, usage, cardinality, table#, item#, element name identify code scheme & code value HL7 v2
11 11 Related software Siemens Soarian interoperable HIS design processes multi-institutional communication and integration HL7 v2
12 12 Health care KMEHR Introduction HL7 v2 KMEHR HL7 v3 Comparison KMEHR
13 [9] 13 KMEHR: general Kind Messages for Electronic Healthcare Record Belgium (local HL7) HUB/metaHUB open standard exchange of structured clinical information fourth recommendation (Belgian Healthcare Telematics Commission) fgov: ehealth platform mandatory in software KMEHR
14 14 Document based Human readability Wholeness Persistence Document metaphor Authentication Stewardship KMEHR
![[7] 15 Standard markup language: XML core elements: header, folder, patient, section, heading,](/docs-images/27/10645831/images/15-0.png "item Document Header Folder Patient Sections Heading Item Item Heading Heading Item Item KMEHR")
15 [7] 15 Standard markup language: XML core elements: header, folder, patient, section, heading, item Document Header Folder Patient Sections Heading Item Item Heading Heading Item Item KMEHR
16 16 Elements Id XML scheme: specification and validation Cd KMEHR (key) elements Reference tables: codes Lnk Transaction: medical procedure KMEHR
17 [7] 17 Validation XML validator XML validation Well formed document XML document Document validation Valid document XML scheme KMEHR
![[5,6] 18 Related software Careconnect cloud application](/docs-images/27/10645831/images/18-0.png "connection with ehealthbox, Recip-e, Hubs, Vitalink,")
18 [5,6] 18 Related software Careconnect cloud application connection with ehealthbox, Recip-e, Hubs, Vitalink, Mutualities XXX
19 19 Health care HL7 v3 standard Introduction HL7 v2 KMEHR HL7 v3 Comparison HL7 v3
20 20 Communication Problem v2: high flexibility no reliable conformance test process interoperability (same optional features) Need: definitive & testable standards certify vendors conformance Solution: reference information model incorporated in HL7-v3 HL7 v3
21 [7,8] 21 Differences to HL7 v2 fully XML based RIM CDA (ISO approved) seemingly not operational Similarities to KMEHR document based XML validation RIM Reference Information Model RMIM Refined Message Information Model CDA Clinical Document Architecture HL7 v3
22 22 RIM & RMIM HL7 v3
23 23 RIM & RMIM HL7 v3
24 24 RIM & RMIM HL7 v3
25 25 RIM & RMIM HL7 v3
26 [7] 26 Standard Document Header Body Sections Text Entries Component sections HL7 v3
27 27 Health care KMEHR vs HL7 Introduction HL7 v2 KMEHR HL7 v3 Comparison KMEHR vs HL7
28 [1,4,6,9] 28 KMEHR vs HL7: similarities standards (no software) XML-based clinical information exchange external encryption validation software (medidocs, epic, cerner) no freeware KMEHR vs HL7
![[6] 29](/docs-images/27/10645831/images/29-0.png "KMEHR vs")
29 [6] 29 KMEHR vs HL7
30 [1,8] 30 KMEHR vs HL7: differences HL7 v2 KMEHR HL7 v3 USA and most of West Europe Belgium Very slow integration Data based Document based Document based Not human readable Human readable Human readable Short messages Long messages (XML) Long messages (XML) Easy to master Easy to master Difficult to master KMEHR vs HL7
31 [1,8] 31 KMEHR vs HL7: differences HL7 v2 KMEHR HL7 v3 Many data types (89) Few data types Many data types Too flexible dialects interpretation Extensible Not extensible Not mandatory Mandatory in software Not mandatory Accreditation (conformity testing difficult) No accreditation necessary (e-health mandatory) Accreditation (conformity testing possible) KMEHR vs HL7
32 32 Links Lesson 1 (20/2): introduction, notable e-health Lesson 2 (27/2): toolbox, internet, web and database Lesson 3 (6/3): medical data and data qualtity Lesson 4 (13/3): toolbox, data security and encryption Lesson 5 (20/3): social security data systems Lesson 6 (27/3): hospital information systems Lesson 7 (3/4): XML in medicine Lesson 8 (24/4): databases and dynamic web applications Lesson 9 (8/5): e-health in Belgium References
33 33 References Tim Benson; Principles of Health Interoperability HL7 and SNOMED (second edition); Springer; Special thanks to: Prof. Dr. Bart Sijnave, UZ Gent Pieter Baeyaert, Healthconnect References
34 34 Health care Extra information Extra information
35 35 HL7: history Extra inforation
36 36 OSI (open systems interconnect) model layer 7 (7) Application (6) Presentation User interface (OSI) communication protocols abstraction layer e.g. byte stream I/O model Linux Data translator Application programs, e.g. using XML (5) Session (4) Transport (3) Network (2) Data-link Opening, losing, managing sessions Connection recovery Protocols e.g. TCP Services such as reliability, flow control, connectionoriented communication Routing of data protocols e.g. IP Computer addresses Data packages (frames) Transport of data (1) Physical Extra information Conversion to signal Mechanical characteristics
37 37 CDA Extra information
38 38 CDA Extra information
39 [7] 39 XML-DOM Extra information
40 40 HL7 Implementation Extra information
41 41 HL7 Implementation Extra information
42 42 HL7 Related software RIM toolbox creating CDA-structures interconnecting software EHR ICT-department / medical staff / patient Extra information
43 43 HL7 Related software MD Link Studio integration and interface engine input: linking tasks, resources, events output: execute integration solution Extra information
44 44 HL7 Related software Orion Health Rhapsody Extra information
45 [5,7] 45 HL7 Related software HAPI HL7 Application Programming Interface open source HL7 v2 parser for JAVA elements: Java API, HAPI testpanel Extra information
46 46 HL7 Related software Orion Concerto real-time patient summary adjustable to clinicians workflow enquiries in data sources Extra information
47 47 HL7 Related software InteliChart patient portal elements: schedule appointments, interactive PHR, reminders, ensurance, lab results, etc. Extra information
48 [1,6] 48 KMEHR Related software Medidoc input: patient data, results, agenda journal prescriptions lab results register doctors certificate connection to CEBAM nomenclature database Extra information
![[1,5] 49 KMEHR Related software Patient Health Viewer Vitalink](/docs-images/27/10645831/images/49-0.jpg "manage vaccinations, medication scheme sharing of SumEHR Extra")
49 [1,5] 49 KMEHR Related software Patient Health Viewer Vitalink manage vaccinations, medication scheme sharing of SumEHR Extra information
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