Techniques for ensuring interoperability in an Electronic health Record
|
|
- Prudence Naomi Webster
- 8 years ago
- Views:
Transcription
1 Techniques for ensuring interoperability in an Electronic health Record Author: Ovidiu Petru STAN 1. INTRODUCTION Electronic Health Records (EHRs) have a tremendous potential to improve health outcomes but, given the fact that they contain and work with socio-demographical and medical data, it is imperative to provide a high level of security and accuracy. EHRs should contain all the significant events of a person s health history, from minor issues to the most critical medical situations and has to be available at least the entire life of the patient [1]. Nothing is allowed to be excluded or deleted. Generally the medical information systems that exist nowadays in Romania store the clinical information in their own format and they don t guarantee that after the exchange of the information, the original meaning of the medical records was kept. In papers [2] and [3] it is described why the standardization in this field is important and crucial to reduce medical errors caused by wrong data interpretation and representation. Taking into consideration the issues of common terminology and coding systems, integration and interoperability, security and reliability, it is obvious that solid and well agreed standards are needed. Because the medical information has to be accessible anytime from everywhere and without regard to where the patient lives or travels the medical information systems must allow the transfer of medical records between different medical units, but without modifying their original medical meaning. Therefore, a medical information system should provide a high level of semantic interoperability. This avoids fragmentation of health data, overloads the databases with the same information, provides a high quality of healthcare and reduces the cost of patient care [4]. The term Interoperability is defined by The Institute of Electrical and Electronics as the ability of two or more systems or components to exchange and use the information that has been exchanged [5]. This definition encompasses two separate ideas: the first one is the exchange of the information - technical interoperability - so that it is human readable by the receiver and the second one is the ability to understand and to use the information - semantic interoperability. These concepts are interdependent and we need both of them to bring significant benefits. In fact, in order to achieve semantic interoperability we need primarily the technical interoperability. In medical informatics field, the European Commission brings forward three types of interoperability [6]: "interoperability of electronic health record systems": the data exchanged is both computer and human readable information and knowledge
2 "cross-border interoperability": interoperability between different countries and their entire territories "semantic interoperability": the precise meaning intended by the original author is understandable by any other system or application 2. CORE CONCEPTS 2.1 openehr Specifications The openehr Specifications are developed by an independent nonprofit community. The aims of the foundation are to facilitate the creation and sharing of health records by consumers and clinicians via open-source and standard-based implementations. The registered online community is composed of 1200 members from 75 different countries. It publishes evolving EHR design specifications, strongly underpinned by live clinical demonstrators, using a multimodel approach, including archetypes [7]. The key innovation of the openehr architecture is the two level modeling structures obtained by separating record keeping concerns from clinical data collection using archetypes. The first level, Reference Model, is used to represent the generic properties of health record information. It represents the global characteristics of health record components, the way they are aggregated and the context information required to meet ethical, legal and provenance requirements. This model defines the set of classes forming the generic building blocks of the EHR. It reflects the stable characteristics of an electronic health record [7]. The second level, Archetypes and Templates, are meta-data used to define patterns for the specific characteristics of the clinical data representing the requirements of each particular profession, specialty or service. This level creates a semantic link to the terminologies, clinical guidelines and classifications in the EHRs. The Archetypes are developed by medical staff and, basically, represent a set of constraints on the openehr Reference Model. Archetypes are all expressed in the same formalism. In general, they are defined for wide re-use; however, they can be specialized to include local particularities. They can accommodate any number of natural languages and terminologies [8]. The Template is a locally usable definition which composes archetypes into larger structures often corresponding to a screen form, document, report or message. A template may add further local constraints on the archetypes it mentions, including removing or mandating optional sections, and may define default values. The Template Object Model (TOM) defines the template [11]. The Archetype Object Model (AOM) describes the object model equivalent, in terms of a UML model. It is a generic model, meaning that it can be used to express archetypes for any reference model in a standard way and it defines the semantic of an archetype [9]. Archetype Definition Language (ADL) is a formal language for expressing archetypes developed by openehr and it was also adopted by the European Committee for Standardization (CEN) [10]. In paper [7] is presented in detail the architecture of a correct and efficient openehr based information system. 2.2 EN/ISO Electronic Health Record Communication
3 For the health data communication, there are two important standards: HL7 and EN/ISO While HL7 is well known worldwide, the EN/ISO is a European Communication Standard and the first part of it is an ISO Communication Standard and it is derived from the Electronic Health Record Communication Standard ENV Currently this standard is under development at the Technical Committee on Health Informatics of the CEN (CEN/TC 251) and describes the information architecture for interoperability of systems and components needed to communicate (access, transfer, add or modify) EHR data via electronic messages or as distributed objects. As presented in paper [12], it is a five part standard: The Reference Model, Archetype Interchange Specification, Reference Archetypes and Term Lists, Security Features and Exchange Models. This new Electronic Health Record Communication Standard is an extract of openehr and, according to a report of the European Union, complies with the highest level of interoperability [6]. Taking into consideration that EN/ISO represents a subset of the full openehr specifications, a system based on openehr information model can easily comply with EN/ISO communication standard and can solve the semantic gap between health professionals and IT professionals (Fig 1). The dual model architecture of openehr and EN/ISO also influenced the Clinical Document Architecture of HL7. INFORMATION Repository EHR 0101 EHR 0101 EHR 0101 SEMANTIC GAP KNOWLEDGE WORDS MEDICAL TERMS CLINICAL CONCEPTS REFERENCE MODEL ARCHETYPES ONTOLOGY TERMINOLOGY Figure 1 Semantic gap solved by the two level modelling structures 2.3 General Clinical Observation File (GCOF) The General Clinical Observation File, created in the Romanian healthcare system, represents the medical file for recording the evolution of the patient s state in a continuous hospitalization episode. An episode denotes the period while a patient is hospitalized, without interruption and in the same ward. The content of the GCOF is controlled by the Ministry of Public Health. This file contains two sections: the first one contains demographic information and the second one consists of medical data. In the demographic section are fields like name, address, occupation, identity card number, personal identity number, phone number etc. and in the medical section are included all the medical information from the general health state at the admission to epicrisis (diagnostics, treatments, laboratory tests, exams, etc.) 3. PLATFORM ARCHITECTURE
4 Functionally, the platform architecture can be viewed from two separate perspectives: the first involves a local level, corresponding to a medical unit, while the second the national level representing the whole medical system of country. 3.1 Local level The software architecture at local level refers to the components and functionality that will be reflected in a medical unit in Romania. The design is composed of three levels: the Data level, the Logical management level and the Presentation level (Fig 2). PostgreSQL Server DATA LEVEL EHR 0101 EHR 0101 EHR 0101 PostgreSQL Connector LOGICAL MANAGEMENT LEVEL Template Data Object (TDO) Composition Smarty+ XSLT PRESENTATION LEVEL User/Browser/Workstation Figure 2. Local level structure The connection between the Data level and the Logical management level is insured by the PostgreSQL connector, while Smarty and the XSLT Processor supply the communication between the last two levels. I chose to use PostgreSQL Database Server because of its greatest advantage: stable and efficient support for working with XML documents. It offers a special xml data type used to store XML data. Its advantage over storing XML data in a text field is that it checks the input values. Besides storing well-formed documents, xml data type can store content fragments, which can have more than one top-level element or character node. Because the archetypes and templates of this application are saved in xml format, they will be stored as xml data type. Along with this support, PostgreSQL also offers a set of functions to perform type-safe operations on XML documents. They enable to produce a value of type xml from character data, producing character string type values from xml and safe processing of the xml documents. These functions have the advantage of being stable, unlike the corresponding ones offered by Mysql 5.1 It is also recommended for the present application because it is highly scalable both in the quantity of data
5 it can manage and in the number of concurrent users it can work with. It is used in collaboration with PHP5. Data level store system information s in a secure environment. Besides information s from GCOF (medical or demographic) data level manages openehr artifacts such as archetypes and templates. In order to fulfill the system security, demographic information is stored separately from patient s medical data. We therefore have three databases: DESP: store and manage the patient s medical data. Demographic: store and manage the patient s demographic data Index: the role of this database is to ensure a connection between the unique demographic identifier and the medical data identifier of a patient. This database is an encrypted one. Logical management level provides mechanisms and processes for: Create and store operational templates Create the composition. Save form data in composition and then save composition in database. Search and display patient medical file. Validate data before saving. An Operational Template (OPT) represents a dynamically created object based on an openehr Template (OET) in combination with the openehr Archetypes. The medical record is displayed on the interface by applying an XSLT on the XML format of the OPT which renders an HTML form. All XML documents are validated using XSD files (XML Schema Definition). The presentation level is used to present and to acquire data to the user. Basically, this level represents the user interface. The separation of the Logical Management Level and Presentation Level represents the separation of the application code and graphic interface. Figure 3 shows the steps that are needed to complete the process of collecting and saving data in a composition. The first step is a database search for openehr archetypes and templates, then are realized the operational template. The HTML form is presented on the screen after applying an XSLT file. After a user inserts information (demographical or medical) is validated and saved in composition type object that are associated with folders. Finally the composition and folders objects are saved in the database. Figure 3 Runtime example
6 3.2 National level The national level presents how to interconnect different local unit systems to create a national network. Our platform is based on a National Reference Registry and a National Archetype Repository (Fig. 4). For communication we use the EN/ISO standard. The National Archetypes Repository contains all necessary archetypes defined at national level in openehr format. These are used to ensure the highest semantic interoperability level. For speed and stability reasons, each archetype is saved locally. When changes occur within an archetype, a new version will be created and the old one will not be deleted but it will be used for compatible older records. All the medical units are notified about this change through a SOAP message, so they can download the new version. National Archetype Repository National Reference Registry Archetype definitions Patient references Medial Unit 1 (local level) Patient data Medical Unit 2 (local level) Figure 4 National level architecture The National Reference Registry is an index server storing links to patient data. This is the most important component and it contains demographic and certain medical data (ex: allergies, insurance type, epicrisis). This approach has the advantages that it avoids overloading the system with data. However, a minimum of information must be doubled on the national level because, in the worst case scenario, there may be a time when a link to the medical facility that has the information cannot be determined. The information stored in this repository can be changed according to law. The national reference registry will also contain information regarding the medical unit that stores patient data. Combining this information, an electronic healthcare record about a patient is created. This repository will also meet openehr specification. This means that every change in a patient file will be saved in an audit field. In order to create an EHR for a patient the following steps needs to be proceeded: As seen in figure 5, the medical unit 1 connects to the national references register and requests data for patient. The National References Register checks if the medical unit 1 has access rights within the system so that it can access the patient s data. If the right conditions aren't met, the access will be denied. In case the Medical Unit 1 has the right to connect to the system, the National References Register will send a message, to the other linked medical units in the net, demanding the data of a specific patient.
7 The Medical Unit 2, checks if the access is legitimate and - if so - it will send the patients data to the National Reference Register. On this same occasion, various updates can be made concerning the demographic and medical data, if needed. The National References Register combines the demographic as well as the medical data of a patient, that exist in the system, in a message in the form of EHR_EXTRACT, specific to the EN/ISO standard, adding in this message all the other data locations of the patient. If there aren't found any locations, an empty EHR_EXTRACT will be submitted. If the message received from the National Reference Registry contains a reference towards Medical Unit 2, it means that this particular Medical Unit holds data on that specific patient, while Unit 1 needs the whole medical file of the patient, then Medical Unit 2 will connect directly to Medical Unit 1 The Medical Unit 2 checks if the Medical Unit 1 has the right to access the medical information and if so it will send the requested data. Medial Unit 1 (local level) National Reference Registry Medical Unit 2 (local level) Request patient data Unauthorized access Request patient data Unauthorized access Send patient data Send patient data Figure 5 Communication sequence between a medical units and the National Reference Registry.
8 3. PROBLEMS and SOLUTIONS An important problem was to match every concept from the GCOF with an archetype or element from openehr archetypes. Even though most of them was found in the international database of the openehr Foundation, some fields from the GCOF, that are particular to the Romanian healthcare system, had to be develop and implement. All the archetypes that were created or extend in this process follow the openehr specifications. The next step was to divide the GCOF in smaller pieces, each represent or correspond to an openehr template. In total eighteen different templates were created to record demographic data, exam results, patient transfers, admission and discharge ward, treatments, surgical events, etc. All this was created following the patient s path through a hospitalization episode. Another problem was that the openehr templates only contain references to the elements which must be excluded from the archetypes. The combination of templates and archetypes on the fly is inefficient due to the high processing cost. The solution was the creation of.opt operational templates which are kept in the database. The standard format for defining the archetypes is the ADL (Archetype Definition Language) and the one for querying is the AQL (Archetype Query Language). To use these formats it would have been necessary to implement an ADL as well as an AQL parser, which in turn would have been an expensive undertaking as far as performance is concerned. Therefore the XML format of an archetype was used for storing while xpath was used for querying. The standard language used to specify the templates is the TDL (Template Definition Language), however, the specifications for this are yet to be finished within the openehr documentation. The XML template format was used here as well. Another critical issue of this project is the two-way conversion between the openehr and EN/ISO standards. The main problem was that the exact requirements for an accurate conversion were not yet defined but left to the standard users to decide upon. Moreover, keeping in mind that the data types EN/ISO are ISO types based, it becomes necessary to create a mapping between the openehr and ISO data types. The EHR Extract EN/ISO part 1 model resembles a simplified form of the openehr reference model. A major difference refers to the representation of the ENTRY data type: openehr works with several ENTRY data types while EN/ISO only works with a single one. An algorithm for the twoway conversion between the two standards encompasses two mapping types: Predefined classes and attribute conversions; A genetic algorithm for conversion between ENTRY type representations. The conversion between the openehr and EN/ISO is used by applying a XSLT implemented filter over the record data that exists in the databases as the XML version of the openehr format. After the conversion, the data is wrapped in a SOAP message and transmitted to the requesting medical unit for interpretation. Keeping in mind that a medical information system should provide data loss, the system does not allow deleting health record information. These system s users have rights only to the extent of interrogation, modification and adding. In case of a mistake being made while filing in the files, the correction may be done by updating, not deleting the file. So, logical deletion is achieved by marking the data in such way that it only appears deleted (but actually remains).
9 4. CONCLUSION This paper is a response to the need of the Romanian healthcare system to improve its services. According to the 2009 European Health Consumer Index, Romania is on the 32th place from 33 states compared. According to this index, our country has a very low score because healthcare personnel do not have access to healthcare records in an electronic format. Out of the 446 hospitals in Romania, only in 93 of them information systems exist. The major drawbacks of the existing software solutions are: incompatibility with the patients steps during a hospitalization episode, incompatibility among themselves and impossibility of medical information exchange [13]. An adoption of the EHRs in Romania will immediately increase the quality of the medical services. This platform addresses a way to standardize the usage of medical concepts that are common around the world, but also elements that are specific to the Romanian healthcare systems (managing the clinical data from the GCOF). Even if it is adapted to the Romanian healthcare systems, it can be easily modified to any healthcare. The main goal of this project is to achieve interconnection systems used in medical units in order to achieve the exchange of medical data of patients. Communication must be made remotely over the Internet from any location. A computer system must be able to access a patient's medical data stored by any other system. The concept of this project is meant to create a solution that serves patients throughout the medical system and for effective operation in a high security environment. Looking at the global level, it might seem hard to implement it with reasonable price and time, but the advantage being so great and important it deserves it. REFERENCES [1] The Healthcare Information and Management Systems Society (HIMSS), EHR definition [2] Beale Thomas, Health Information Standards Manifesto, White Paper Press, 2001 [3] Rahil Qamar, Semantic Mapping of Clinical Model Data to Biomedical Terminologies to Facilitate Interoperability, Manchester Info press, 2008 [4] Tang Christian, Key Capabilities of an Electronic Health Record System, National Academy Press, 2003; [5] Institute of Electrical and Electronics Engineers. IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries. New York, NY: 1990 [6] European Commission Commission Recommendation of 2 July 2008 on cross-border interoperability of electronic health record systems [7] T. Beale, S. Heard, openehr Architecture - Architecture Overview, 12 April 2007 [8] T. Beale, S Heard, Archetype Definitions and Principles, 14 March 2007 [9] T. Beale, Archetype Object Model, 20 March 2007 [10] T. Beale, S Heard, Archetype Definition Language - ADL 1.4, 13 March 2007 [11] T. Beale, S Heard, The Template Object Model (TOM), 13 March 2007 [12] Eichelberg Marco, Aden Thomas, Riesmeier Jörg, Dogac Asyman, Laleci Gorkce, Electronic Healthcare Record Standards A Brief Overview, ACM, 2005 [13] Euro Health Consumer Index 2009 Report, Health Consumer Powerhouse
Integration Information Model
Release 1.0.1 The openehr Reference Model a. Ocean Informatics Editors: T Beale a Revision: 0.6 Pages: 15 Date of issue: 22 Jul 2006 Keywords: EHR, reference model, integration, EN13606, openehr EHR Extract
More informationHow To Write An Electronic Health Record
EHR Requirements David LLOYD and Dipak KALRA CHIME Centre for Health Informatics and Multiprofessional Education, University College London N19 5LW, by email: d.lloyd@chime.ucl.ac.uk. Abstract. Published
More informationWhat s next for openehr. Sam Heard Thomas Beale
What s next for openehr Sam Heard Thomas Beale Current situation (2010-) General industry movement toward SOA, growing use of terminology SOA: IHE Information / messages HL7 v3 failed, org in fresh look
More informationThe Template Object Model (TOM)
Release 1 (in development) The openehr Archetype Model The Template Object Model (TOM) Editors: {T Beale, S Heard} a Revision: 0.5 Pages: 19 Date of issue: 13 Mar 2007 a. Ocean Informatics Keywords: EHR,
More informationAdvanced Aspects of Hospital Information Systems
Advanced Aspects of Hospital Information Systems EHR- and related Standards DI Harald Köstinger (harald.koestinger@inso.tuwien.ac.at) INSO - Industrial Software Institut für Rechnergestützte Automation
More informationComparing Different Approaches to Two-Level Modelling of Electronic Health Records
113 Comparing Different Approaches to Two-Level Modelling of Electronic Health Records Line Michelsen, Signe S. Pedersen, Helene B. Tilma, Stig K. Andersen Abstract Department of Health Science and Technology
More informationUsing Archetypes with HL7 Messages and Clinical Documents. Heath Frankel HL7 Working Group Meeting 14 January 2011
Using Archetypes with HL7 Messages and Clinical Documents Heath Frankel HL7 Working Group Meeting 14 January 2011 Ocean Informatics 2011 Template Data Schema (TDS) XML Schema representation of a clinical
More informationThe next generation EHR
The next generation EHR European EHR standard OpenEHR Ocean Informatics Gerard Freriks v1 7-11-2007 Electronic Patient Record What do we expect? We need and expect EHR-systems that: 2 Electronic Patient
More informationTemplates and Archetypes: how do we know what we are talking about?
Templates and Archetypes: how do we know what we are talking about? Sam Heard, Thomas Beale, Gerard Freriks, Angelo Rossi Mori, Ognian Pishev Version 1.2, 12th February 2003 This discussion paper is addressed
More informationopenehr The Reference Model Thomas Beale Sam Heard
openehr The Reference Model Thomas Beale Sam Heard 1:N openehr Semantic architecture Screen Forms Messages 1:N Reports Templates Data conversion schemas 1:N Archetypes Terminology interface Terminologies
More informationEHR Standards Landscape
EHR Standards Landscape Dr Dipak Kalra Centre for Health Informatics and Multiprofessional Education (CHIME) University College London d.kalra@chime.ucl.ac.uk A trans-national ehealth Infostructure Wellness
More informationEvaluation of a Persistent Store for openehr
Evaluation of a Persistent Store for openehr Jon Patrick 1, Richard Ly 1, Donna Truran 2 1 School of Information Technologies University of Sydney 2 National Centre for the Classification in Health University
More informationPractical Implementation of a Bridge between Legacy EHR System and a Clinical Research Environment
Cross-Border Challenges in Informatics with a Focus on Disease Surveillance and Utilising Big-Data L. Stoicu-Tivadar et al. (Eds.) 2014 The authors. This article is published online with Open Access by
More informationOpen Source Modular Units for Electronic Patient Records. Hari Kusnanto Faculty of Medicine, Gadjah Mada University
Open Source Modular Units for Electronic Patient Records Hari Kusnanto Faculty of Medicine, Gadjah Mada University Open Source Initiatives in Patient Information System electronic health records, scheduling
More informationIntegration of Distributed Healthcare Records: Publishing Legacy Data as XML Documents Compliant with CEN/TC251 ENV13606
Integration of Distributed Healthcare Records: Publishing Legacy Data as XML Documents Compliant with CEN/TC251 ENV13606 J.A. Maldonado, M. Robles, P. Crespo Bioengineering, Electronics and Telemedicine
More informationThe use of ehealth standards in Norway
The use of ehealth standards in Norway Torbjørn Nystadnes, KITH Archetypes and Architecture Oslo, 26 November 2009 In the beginning... KITH was established in 1990 The same year as CEN/TC251 - Norway has
More informationObject-relational EH databases
Proceedings of the 7 th International Conference on Applied Informatics Eger, Hungary, January 28 31, 2007. Vol. 1. pp. 335 342. Object-relational EH databases Lajos Kollár a, Henrietta Sipos b, Krisztián
More informationHL7 CDA, Clinical Modelling and openehr
HL7 CDA, Clinical Modelling and openehr Thomas Beale NHS Scotland, February 2007 Thomas Beale Introductions Chief Technology Officer Ocean Informatics Senior Researcher, Centre for Health Informatics,
More informationIl lavoro di armonizzazione. e HL7
Il lavoro di armonizzazione tra CEN 13606, openehr e HL7 Dr Dipak Kalra Centre for Health Informatics and Multiprofessional Education (CHIME) University College London d.kalra@chime.ucl.ac.uk Drivers for
More informationOntology-based Archetype Interoperability and Management
Ontology-based Archetype Interoperability and Management Catalina Martínez-Costa, Marcos Menárguez-Tortosa, J. T. Fernández-Breis Departamento de Informática y Sistemas, Facultad de Informática Universidad
More informationElectronic Medical Records Getting It Right and Going to Scale
Electronic Medical Records Getting It Right and Going to Scale W. Ed Hammond, Ph.D. Duke University Medical Center 02/03/2000 e-hammond, Duke 0 Driving Factors Patient Safety Quality Reduction in cost
More informationMD Link Integration. 2013 2015 MDI Solutions Limited
MD Link Integration 2013 2015 MDI Solutions Limited Table of Contents THE MD LINK INTEGRATION STRATEGY...3 JAVA TECHNOLOGY FOR PORTABILITY, COMPATIBILITY AND SECURITY...3 LEVERAGE XML TECHNOLOGY FOR INDUSTRY
More informationA Metabolic Syndrome Health Check EHR based on openehr
Seagaia Meeting 2009, Okinawa A Metabolic Syndrome Health Check EHR based on openehr 2009/05/15 早 稲 田 大 学 国 際 情 報 通 信 研 究 科 Waseda University, GITS Kano Lab Hsu WanYen (Nora) 徐 婉 晏 1 Research Background
More informationElectronic Health Record (EHR) Standards Survey
Electronic Health Record (EHR) Standards Survey Compiled by: Simona Cohen, Amnon Shabo Date: August 1st, 2001 This report is a short survey about the main emerging standards that relate to EHR - Electronic
More informationClinical Knowledge Manager. Product Description 2012 MAKING HEALTH COMPUTE
Clinical Knowledge Manager Product Description 2012 MAKING HEALTH COMPUTE Cofounder and major sponsor Member and official submitter for HL7/OMG HSSP RLUS, EIS 'openehr' is a registered trademark of the
More informationClinical Information Security. The norm EN ISO 13606
Clinical Information Security - The norm EN ISO 13606 Unidad de Investigación en Telemedicina y esalud Instituto de la Salud Carlos III Madrid - Spain Clinical information and security Non-repudiation
More informationEHR Standards and Semantic Interoperability
EHR Standards and Semantic Interoperability Setting the Frame of Reference Dr. Marco Eichelberg OFFIS - Institute for Information Technology E-Mail: eichelberg@offis.de Page 1 Introduction Semantic Interoperability:
More informationSemantic interoperability of dual-model EHR clinical standards
Semantic interoperability of dual-model EHR clinical standards Catalina Martínez-Costa Departamento de Informática y Sistemas, Facultad de Informática Universidad de Murcia, CP 30100, Murcia cmartinezcosta@um.es
More informationISO EN 13606 TECHNICAL REVISION
ISO EN 13606 TECHNICAL REVISION Dipak Kalra!! with support from! Shanghua Sun, Tony Austin! and EN13606 Association EN ISO 13606 EHR Communications A means to exchange part or all of a patients EHR! between
More informationArchetype-Based Knowledge Management for Semantic Interoperability of Electronic Health Records
Medical Informatics in a United and Healthy Europe K.-P. Adlassnig et al. (Eds.) IOS Press, 2009 2009 European Federation for Medical Informatics. All rights reserved. doi:10.3233/978-1-60750-044-5-1007
More informationEnabling medical research on clinically collected data using openehr archetypes
FACULTY OF SCIENCE AND TECHNOLOGY DEPARTMENT OF COMPUTER SCIENCE Enabling medical research on clinically collected data using openehr archetypes Leykun Melkamu Gebeyehu INF-3997 Master's Thesis in Telemedicine
More informationImproving EHR Semantic Interoperability Future Vision and Challenges
Improving EHR Semantic Interoperability Future Vision and Challenges Catalina MARTÍNEZ-COSTA a,1 Dipak KALRA b, Stefan SCHULZ a a IMI,Medical University of Graz, Austria b CHIME, University College London,
More informationU.S. Department of Health and Human Services (HHS) The Office of the National Coordinator for Health Information Technology (ONC)
U.S. Department of Health and Human Services (HHS) The Office of the National Coordinator for Health Information Technology (ONC) econsent Trial Project Architectural Analysis & Technical Standards Produced
More informationA MODEL OF OPENEHR-BASED ELECTRONIC MEDICAL RECORD IN INDONESIA
A MODEL OF OPENEHR-BASED ELECTRONIC MEDICAL RECORD IN INDONESIA 1 A.B. MUTIARA, 2 A. MUSLIM, 3 T. OSWARI, 4 R. ASRITA 1 Prof., Faculty of Computer Science and Information Technology, Gunadarma University,
More informationModeling Temporal Data in Electronic Health Record Systems
International Journal of Information Science and Intelligent System, 3(3): 51-60, 2014 Modeling Temporal Data in Electronic Health Record Systems Chafiqa Radjai 1, Idir Rassoul², Vytautas Čyras 3 1,2 Mouloud
More informationA MODEL OF OPENEHR BASED ELECTRONIC MEDICAL RECORD IN INDONESIA
A MODEL OF OPENEHR BASED ELECTRONIC MEDICAL RECORD IN INDONESIA 1 A.B. Mutiara, 2 A. Muslim, 3 T. Oswari, 4 R.A. Miharja 1,2,4 Faculty of Computer Science and Information Technology, Gunadarma University,
More informationThe Journal on Information Technology in Healthcare 2003; 1(5): 369 380. Archetypes, GEHR, openehr and Electronic Health Records
HT I J The Journal on Information Technology in Healthcare 2003; 1(5): 369 380 Archetypes, GEHR, openehr and Electronic Health Records Ping Yu School of Information Technology and Computer Science, The
More informationInteroperable Medical Record Exchange System among Hospitals in Ethiopia using EMR
Interoperable Medical Record Exchange System among Hospitals in Ethiopia using EMR Tigist Tedla HiLCoE, Computer Science Programme, Ethiopia tgyetedla@gmail.com Abrehet Omer HiLCoE, Ethiopia Department
More informationPatterns of Information Management
PATTERNS OF MANAGEMENT Patterns of Information Management Making the right choices for your organization s information Summary of Patterns Mandy Chessell and Harald Smith Copyright 2011, 2012 by Mandy
More informationbusiness transaction information management
business transaction information management What CAM Is The CAM specification provides an open XML based system for using business rules to define, validate and compose specific business documents from
More informationStandardised and Flexible Health Data Management with an Archetype Driven EHR System (EHRflex)
Standardised and Flexible Health Data Management with an Archetype Driven EHR System (EHRflex) Anton Brass 1, David Moner 2, Claudia Hildebrand 1, Montserrat Robles 2 1 Helmholtz Zentrum München, Germany
More informationThe ERS IC-EHR as Local, Regional and National ehealth Infrastructure July 2010
The ERS IC-EHR as Local, Regional and National ehealth Infrastructure July 2010 Table of contents Present situation!... 1 What healthcare wants!... 2 ERS IC-EHR: Introduction!... 4 ERS IC-EHR: Integrating
More informationPatient-Centric Secure-and-Privacy-Preserving Service-Oriented Architecture for Health Information Integration and Exchange
Patient-Centric Secure-and-Privacy-Preserving Service-Oriented Architecture for Health Information Integration and Exchange Mahmoud Awad and Larry Kerschberg Center for Health Information Technology George
More informationThe Big Picture: IDNT in Electronic Records Glossary
TERM DEFINITION CCI Canada Health Infoway Canadian Institute for Health Information EHR EMR EPR H L 7 (HL7) Canadian Classification of Interventions is the Canadian standard for classifying health care
More informationAdvanced and secure architectural EHR approaches
International Journal of Medical Informatics (2006) 75, 185 190 Advanced and secure architectural EHR approaches Bernd Blobel Chair of the EFMI WG Electronic Health Records, University Hospital Magdeburg,
More informationA Repository of Semantic Open EHR Archetypes
International Journal of Artificial Intelligence and Interactive Multimedia, Vol. 3, Nº 2. A Repository of Semantic Open EHR Archetypes Fernando Sánchez, Samuel Benavides, Fernando Moreno, Guillermo Garzón,
More informationWeb services to allow access for all in dotlrn
Web services to allow access for all in dotlrn German Moreno 1, Olga C. Santos 2, Jesus G. Boticario 2, Ramon Fabregat 1 1 Institute of Informatics and Aplications (IIiA), Universidad de Girona, Spain,
More informationThe Model for Managing Real Media Contents in Terms of EHR
The Model for Managing Real Media Contents in Terms of EHR You-Jin Song 1, Jang-Mook Kang 2 and Jaedoo Huh 3 1 Department of Information Management, Dongguk University, 707 Seokjang-dong, Gyeongju, Gyeongsangbuk-do,
More informationTitle Draft Pan-Canadian Primary Health Care Electronic Medical Record Content Standard, Version 2.0 Data Extract Specifi cation Business View
pic Title Draft Pan-Canadian Primary Health Care Electronic Medical Record Content Standard, Version 2.0 Data Extract Specifi cation Business View Primary Health Care Who We Are Established in 1994, CIHI
More informationSetting the World on FHIR
Setting the World on FHIR W. Ed Hammond. Ph.D., FACMI, FAIMBE, FIMIA, FHL7 Director, Duke Center for Health Informatics Director, Applied Informatics Research, DHTS Director of Academic Affairs, MMCi Program
More informationIntroduction to openehr Archetypes & Templates. Dr Ian McNicoll Dr Heather Leslie
Introduction to openehr Archetypes & Templates Dr Ian McNicoll Dr Heather Leslie Traditional Application Development Clinical Knowledge Data Model Ocean Informatics 2010 Tradi&onal Informa&on model 2 level
More informationElectronic Health Records: An introduction to openehr and archetypes
Electronic Health Records: An introduction to openehr and archetypes Dr. Sebastian Garde CCR Workshop Munich 29 th April 2008 Expectations Timely information and reports for ALL professions with a minimum
More informationLightweight Data Integration using the WebComposition Data Grid Service
Lightweight Data Integration using the WebComposition Data Grid Service Ralph Sommermeier 1, Andreas Heil 2, Martin Gaedke 1 1 Chemnitz University of Technology, Faculty of Computer Science, Distributed
More informationNASCIO EA Development Tool-Kit Solution Architecture. Version 3.0
NASCIO EA Development Tool-Kit Solution Architecture Version 3.0 October 2004 TABLE OF CONTENTS SOLUTION ARCHITECTURE...1 Introduction...1 Benefits...3 Link to Implementation Planning...4 Definitions...5
More informationVersion: January 2008 ASTM E-31: EHR and Informatics Standards Education For Health Professional Disciplines. Background
Version: January 2008 ASTM E-31: EHR and Informatics Standards Education For Health Professional Disciplines Background Work on standards for the EHR in the context of all such standards for the Health
More informationMeasuring the Interoperability Degree of Interconnected Healthcare Information Systems Using the LISI Model
Measuring the Interoperability Degree of Interconnected Healthcare Information Systems Using the LISI Model Mihaela Vida*, Lăcrămioara Stoicu-Tivadar*, Elena Bernad**, *Faculty of Automatics and Computers,
More informationHL7 NCPDP e-prescribing harmonization: using the v3 HDF for as a basis for semantic interoperability
HL7 NCPDP e-prescribing e harmonization: using the v3 HDF for as a basis for semantic interoperability Mark Shafarman HL7 Chair Applications Architect, Oracle Corporation mark.shafarman@oracle.com 1 415
More informationSimplifying e Business Collaboration by providing a Semantic Mapping Platform
Simplifying e Business Collaboration by providing a Semantic Mapping Platform Abels, Sven 1 ; Sheikhhasan Hamzeh 1 ; Cranner, Paul 2 1 TIE Nederland BV, 1119 PS Amsterdam, Netherlands 2 University of Sunderland,
More informationIntroduction to Service Oriented Architectures (SOA)
Introduction to Service Oriented Architectures (SOA) Responsible Institutions: ETHZ (Concept) ETHZ (Overall) ETHZ (Revision) http://www.eu-orchestra.org - Version from: 26.10.2007 1 Content 1. Introduction
More informationEHR Definition, Scope & Context. Sam Heard for Peter Schloeffel ISO/TC 215 WG1 Aarhus, Denmark 3 Oct 2003
EHR Definition, Scope & Context Sam Heard for Peter Schloeffel ISO/TC 215 WG1 Aarhus, Denmark 3 Oct 2003 2 Agenda Background to the project A taxonomy and definitions of the EHR Scope of the EHR Context
More informationDesign principles of the Drupal CSC website
CERN IT Department Report Design principles of the Drupal CSC website Stanislav Pelák Supervisor: Giuseppe Lo Presti 26th September 2013 Contents 1 Introduction 1 1.1 Initial situation.........................
More informationComparing Microsoft SQL Server 2005 Replication and DataXtend Remote Edition for Mobile and Distributed Applications
Comparing Microsoft SQL Server 2005 Replication and DataXtend Remote Edition for Mobile and Distributed Applications White Paper Table of Contents Overview...3 Replication Types Supported...3 Set-up &
More informationHIT Workflow & Redesign Specialist: Curriculum Overview
HIT Workflow & Redesign Specialist: Curriculum Overview Component - Description Units - Description Appx. Time 1: Introduction to Health Care and Public Health in the U.S. Survey of how healthcare and
More informationVerification of Good Design Style of UML Models
Verification of Good Design Style of UML Models Bogumiła Hnatkowska 1 1 Institute of Applied Informatics, Wrocław University of Technology, Wybrzeże Wyspiańskiego 27, 50-370 Wrocław, Poland Bogumila.Hnatkowska@pwr.wroc.pl
More informationAN OVERVIEW OF INTEROPERABILITY STANDARDS FOR ELECTRONIC HEALTH RECORDS
Integrated Design and Process Technology, IDPT-2007 Printed in the United States of America, June, 2007 2007 Society for Design and Process Science AN OVERVIEW OF INTEROPERABILITY STANDARDS FOR ELECTRONIC
More informationISO 18308 INTERNATIONAL STANDARD. Health informatics Requirements for an electronic health record architecture
INTERNATIONAL STANDARD ISO 18308 First edition 2011-04-15 Health informatics Requirements for an electronic health record architecture Informatique de santé Exigences relatives à une architecture de l'enregistrement
More informationDIPS Arena New Archetype-based EHR. Sigurd From, DIPS ASA
DIPS Arena New Archetype-based EHR Sigurd From, DIPS ASA The largest EHR vendor in Norway Product areas Clinical Process Support - EHR Administative Process Support Medical Services & Integration Main
More informationTowards a Repository for Managing Archetypes for Electronic Health Records
Towards a Repository for Managing Archetypes for Electronic Health Records Sebastian Garde 1, Evelyn J.S. Hovenga 1, Jana Gränz 1,2, Shala Foozonkhah 1,3, Sam Heard 1,4 1 Health Informatics Research Group,
More informationAn overview of Health Informatics Standards
An overview of Health Informatics Standards Management and Information Systems in Health Care in the Russian Federation, Moscow Y.Samyshkin, A.Timoshkin Centre for Health Management The Business School
More informationStrategies and experiences in Sweden
Strategies and experiences in Sweden Inger Wejerfelt Head of information structure group National Center for Coordination of ehealth NCCEH inger.wejerfelt@skl.se National IT strategi organisation Ministry
More informationService Oriented Architecture
Service Oriented Architecture Charlie Abela Department of Artificial Intelligence charlie.abela@um.edu.mt Last Lecture Web Ontology Language Problems? CSA 3210 Service Oriented Architecture 2 Lecture Outline
More informationSOACertifiedProfessional.Braindumps.S90-03A.v2014-06-03.by.JANET.100q. Exam Code: S90-03A. Exam Name: SOA Design & Architecture
SOACertifiedProfessional.Braindumps.S90-03A.v2014-06-03.by.JANET.100q Number: S90-03A Passing Score: 800 Time Limit: 120 min File Version: 14.5 http://www.gratisexam.com/ Exam Code: S90-03A Exam Name:
More informationHealth Data Management with an Archetype Driven EHR System in Low Ressource Environments
Health Data Management with an Archetype Driven EHR System in Low Ressource Environments Dipl.-Inform. Med. Anton Brass Helmholtz Zentrum München IBMI München, 16.04.2010 Content Introduction ISO 13606
More informationA Mapping of the Victorian Electronic Records Strategy Schema to openehr
VERS openehr Mapping Commentary A Mapping of the Victorian Electronic Records Strategy Schema to openehr Electronic Health Records: Achieving an Effective and Ethical Legal and Recordkeeping Framework
More informationXML for Manufacturing Systems Integration
Information Technology for Engineering & Manufacturing XML for Manufacturing Systems Integration Tom Rhodes Information Technology Laboratory Overview of presentation Introductory material on XML NIST
More informationTranslational & Interoperable Health Infostructure - The Servant of Three Masters
Translational & Interoperable Health Infostructure - The Servant of Three Masters Amnon Shabo (Shvo) PhD Haifa research 26th Annual EuroMeeting 25-27 March 2014 ACV, Vienna Austria Disclaimer The views
More informationFederated, Generic Configuration Management for Engineering Data
Federated, Generic Configuration Management for Engineering Data Dr. Rainer Romatka Boeing GPDIS_2013.ppt 1 Presentation Outline I Summary Introduction Configuration Management Overview CM System Requirements
More informationHow To Understand The Difference Between Terminology And Ontology
Terminology and Ontology in Semantic Interoperability of Electronic Health Records Dr. W. Ceusters Saarland University Semantic Interoperability Working definition: Two information systems are semantically
More informationWhat do clinical data standards mean for clinicians? Dr Nick Booth GP and Informatician, Warden, Northumberland, UK
What do clinical data standards mean for clinicians? Dr Nick Booth GP and Informatician, Warden, Northumberland, UK Outline of Presentation Assertions What are we trying to do in the English NHS IT programme?
More informationONTARIO EHR INTEROPERABILITY STANDARDS WHY STANDARDS MATTER
www.ehealthontario.on.ca ONTARIO EHR INTEROPERABILITY STANDARDS WHY STANDARDS MATTER At ehealth Ontario we are building new health care IT systems and connecting existing ones that allow clinicians to
More informationSOA, Cloud Computing & Semantic Web Technology: Understanding How They Can Work Together. Thomas Erl, Arcitura Education Inc. & SOA Systems Inc.
SOA, Cloud Computing & Semantic Web Technology: Understanding How They Can Work Together Thomas Erl, Arcitura Education Inc. & SOA Systems Inc. Overview SOA + Cloud Computing SOA + Semantic Web Technology
More informationDevelopers Integration Lab (DIL) System Architecture, Version 1.0
Developers Integration Lab (DIL) System Architecture, Version 1.0 11/13/2012 Document Change History Version Date Items Changed Since Previous Version Changed By 0.1 10/01/2011 Outline Laura Edens 0.2
More informationReport on a preliminary analysis of the dataflow(s) in HealthConnect system
Report on a preliminary analysis of the dataflow(s) in HealthConnect system Electronic Health Records: Achieving an Effective and Ethical Legal and Recordkeeping Framework Australian Research Council Discovery
More informationGetting Started with Service- Oriented Architecture (SOA) Terminology
Getting Started with - Oriented Architecture (SOA) Terminology Grace Lewis September 2010 -Oriented Architecture (SOA) is a way of designing, developing, deploying, and managing systems it is neither a
More informationBusiness Object Document (BOD) Message Architecture for OAGIS Release 9.+
Business Object Document (BOD) Message Architecture for OAGIS Release 9.+ an OAGi White Paper Document #20110408V1.0 Open standards that open markets TM Open Applications Group, Incorporated OAGi A consortium
More informationInteroperability within Health & Social Care Systems
Interoperability within Health & Social Care Systems 1. Introduction: The purpose of this short paper is to provide a set of working definitions for the concept of interoperability within the Health and
More informationHL7 and DICOM based integration of radiology departments with healthcare enterprise information systems
international journal of medical informatics 76S (2007) S425 S432 journal homepage: www.intl.elsevierhealth.com/journals/ijmi HL7 and DICOM based integration of radiology departments with healthcare enterprise
More informationI n t e r S y S t e m S W h I t e P a P e r F O R H E A L T H C A R E IT E X E C U T I V E S. In accountable care
I n t e r S y S t e m S W h I t e P a P e r F O R H E A L T H C A R E IT E X E C U T I V E S The Role of healthcare InfoRmaTIcs In accountable care I n t e r S y S t e m S W h I t e P a P e r F OR H E
More informationFive Essential Components for Highly Reliable Data Centers
GE Intelligent Platforms Five Essential Components for Highly Reliable Data Centers Ensuring continuous operations with an integrated, holistic technology strategy that provides high availability, increased
More informationEHR Systems: an Introduction
ehealth Week 2007 EuroRec Institute / ProRec Germany Workshop EHR Systems: an Introduction Bernd Blobel 1 & Dipak Kalra 2 1 ehealth Competence Center University of Regensburg Medical Center Regensburg,
More informationRotorcraft Health Management System (RHMS)
AIAC-11 Eleventh Australian International Aerospace Congress Rotorcraft Health Management System (RHMS) Robab Safa-Bakhsh 1, Dmitry Cherkassky 2 1 The Boeing Company, Phantom Works Philadelphia Center
More informationDesign of a Multi Dimensional Database for the Archimed DataWarehouse
169 Design of a Multi Dimensional Database for the Archimed DataWarehouse Claudine Bréant, Gérald Thurler, François Borst, Antoine Geissbuhler Service of Medical Informatics University Hospital of Geneva,
More informationEHR Interoperability Framework Overview
Hospital Health Information System EU HIS Contract No. IPA/2012/283-805 Final version July 2015 Visibility: Public Target Audience: EHR Developers EHR Administrators EPR Systems Developers This document
More informationSCORM Users Guide for Instructional Designers. Version 8
SCORM Users Guide for Instructional Designers Version 8 September 15, 2011 Brief Table of Contents Chapter 1. SCORM in a Nutshell... 6 Chapter 2. Overview of SCORM... 15 Chapter 3. Structuring Instruction...
More informationTalend Metadata Manager. Reduce Risk and Friction in your Information Supply Chain
Talend Metadata Manager Reduce Risk and Friction in your Information Supply Chain Talend Metadata Manager Talend Metadata Manager provides a comprehensive set of capabilities for all facets of metadata
More informationMySQL databases as part of the Online Business, using a platform based on Linux
Database Systems Journal vol. II, no. 3/2011 3 MySQL databases as part of the Online Business, using a platform based on Linux Ion-Sorin STROE Romanian Academy of Economic Studies Romana Sq, no 6, 1 st
More informationRequirements engineering
Learning Unit 2 Requirements engineering Contents Introduction............................................... 21 2.1 Important concepts........................................ 21 2.1.1 Stakeholders and
More informationClinical Document Exchange Integration Guide - Outbound
Clinical Document Exchange Integration Guide - Outbound Integrate your healthcare IT system with Practice Fusion s Electronic Health Record (EHR) System Table of Contents 1 Introduction... 2 2 Integration
More informationEHR Business Process Models for Care Coordination and MU
EHR Business Process Models for Care Coordination and MU OSEHRA 2014 Conference Bethesda, MD Dr. Aneel Advani SVP Healthcare, everis Group Assoc. Prof (Adj.), Johns Hopkins 2012, everis Spain, S.L. September
More information