Introduction to Green CDA. CDA Forum, 17 th January Robert Worden

Transcription

1 Introduction to Green CDA CDA Forum, 17 th January 2013 Robert Worden

2 Outline: 30 Minutes + Questions What is Green CDA? How do you use it? 5 Origins of Green CDA 5 Green CDA Example - PHMR 5 Questions (1) (5) CDA Implementation Routes Compared 10 Green CDA in ITK and ISCF 5 Questions (2) (5) Additional Topics 5+

3 What is Green CDA? How do you use it? Green CDA is a way of interfacing applications to standard CDA It consists of: An intermediate XML structure which is much simpler than full CDA (this structure is called Green CDA XML) Supplied transforms, to convert the simple XML to full CDA, or full CDA to the simple XML Transforms depend on templates Interface your application to the simple XML; then use the supplied transforms to read or write full CDA. Get ITK accreditation for the full CDA Short-cuts the technical complexity of CDA Avoids a long CDA learning curve

4 Green CDA XML is Simpler than Fragment of full CDA: Standard CDA XML <custodian typecode="cst"> <npfitlc:contentid extension="cocd_tp145018uk03#assignedcustodian" root=" " > <assignedcustodian classcode="assigned"> <templateid extension="cocd_tp145018uk03#assignedcustodian" root=" "/> <representedcustodianorganization classcode="org" determinercode="instance"> <templateid extension="cocd_tp145018uk03#representedcustodianorganization" root=" "/> <id extension="ryx" root=" "/> <name>central London Community Healthcare Trust</name> </representedcustodianorganization> </assignedcustodian> </custodian> Corresponding fragment of Green CDA: <documentowner id="ryx"> <name>central London Community Healthcare Trust</name> </documentowner>

5 How to use Green CDA Application A Green CDA Simple-to- Full Transform Full CDA Full-to- Simple Transform Green CDA Application B Full CDA Application C Reliable transforms to full CDA are supplied; (but may need to be extended for your application requirements, commercially or using Open Source tools) Transforms can be deployed as XSLT (licenced), or as a Java runtime engine (Open Source) You only need to interface applications to Green CDA This is a simple vanilla XML interfacing job

6 History of Green CDA Experiments with simplified XML ITS in UK (2006) automated transforms to full XML ITS; not taken up by HL7 International. Green CDA implementation technique proposed by HL7 Structured Docs Working Group (2010): Transforms only go one way: Green => full CDA Transforms written by hand or low-level mapping tools (so unreliable) SDWG published the method only, few transforms See HL7 wiki for current status Promoted by HL7 International as an implementation method (CCD vs CCR for Meaningful Use?) Development of Green CDAs for ITK with reliable, automated, two-way transforms UK (2011).

7 Example Green CDA ITK PHMR Personal Health Monitoring Report for telehealth devices in the home DHID published CDA definition in summer 2012 Green CDA version developed shortly afterwards; now in use on one ISCF project Templates included so far: Header templates (Patient, etc.) Device definitions Blood pressure series Blood glucose series Oxygen saturation series Pulse Rate series Thresholds and target values for these observations Other templates can be easily included Full round-trip transforms, 100% accurate (demo) Full PHMR passes ITK CDA checker (demo)

8 Green-Full CDA Transforms: Autogenerated and 100% Reliable Green to Full Xform Green CDA Full ITK CDA Full to Green Xform The round trip (full=>green=> full) is 100% accurate Easily and automatically testable Implemented in Java or XSLT

9 Questions (1) Offline questions to

10 Green CDA v. Other CDA Implementation Routes Buyer s Guide Criterion Technical simplicity Templates covered Extensible within templates Deployment flexibility Dependence on others Use as CDA receiver Modelbased Examplebased Green CDA CDA API * ** *** *** *** ** ** * *** ** ** ** ** ** *** ** ** ** ** * ** *** *** * (Three stars good, one star bad)

11 ITK Green CDAs Available There are Green versions of the following ITK CDAs: Non-Coded Document Discharge Summary Section 2 / Section 5 Discharge (actually V3) CAF (for HSCI) PHMR (telehealth) These can pass the ITK CDA checker and TKW now Extra templates are easily added Extensions for further application requirements are commercially available, or can be built with Open Source tools XSLT transforms licensed commercially

12 Green CDA in ISCF The following projects in the Information Sharing Challenge Fund are using Green CDA to implement ITK CDA: Trust CDA Application Summary CDA in use Worcestershire Health & Care NHS Trust South Devon Healthcare NHS Foundation Trust Central London Community Healthcare NHS Trust Health and Social Care Integration; sharing demographic data and CPA assessments Use of discharge letters for Out of Hours care; stored in XDS (IHE) repository Telehealth monitoring and alerts for COPD Non-coded document (containing CPA assessment) Non-coded document (containing discharge letter) PHMR ( Oxygen Saturation & Pulse Rate)

13 Questions (2) Offline questions to

14 Additional Topics CDA Rendered Text Entries how do you handle them? Investigate the requirement very carefully ITK-supplied transforms render header data Some text is free-standing, not related to coded entries Additional hand-coded transforms can generate HTML tables from coded entries Mapping and transforming CDA to other XML, V2, etc. Making mappings is quicker than writing interface code Generates translations to CDA in both directions Open Source tools available (Eclipse based) Generated Java CDA API Simple classes and getter/setter methods for Green CDA fields API can read or write full CDA Open Source tools available (Eclipse) CDA Editor/Viewer Green CDA fields are just those a clinician may need to edit Web-based, automatically generated editor Configurable user interface Outputs or reads full CDA Open Source tools available (Eclipse)