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27 January 2005Copyright 2005, HL71 HL7s National Library of Medicine (NLM) Contract Introduction Three year contract with 2 major projects: 1.Develop.

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Presentation on theme: "27 January 2005Copyright 2005, HL71 HL7s National Library of Medicine (NLM) Contract Introduction Three year contract with 2 major projects: 1.Develop."— Presentation transcript:

1 27 January 2005Copyright 2005, HL71 HL7s National Library of Medicine (NLM) Contract Introduction Three year contract with 2 major projects: 1.Develop and apply methods to ensure UMLS Meta- Thesaurus is in step with HL7 Vocabulary Standards 2.Develop and pilot test an HL7 Implementation Guide for the transmission of patient information between disparate electronic health record (EHR) systems using HL7 Messaging Standards

2 27 January 2005Copyright 2005, HL72 Project Management Team Management: –Phil Barr, HL7 Project Manager –Chris Chute and Stan Huff, Co-leaders for Vocabulary –Bill Braithwaite and Ed Hammond, Co-leaders for EHR Work: –voluntary and contract personnel using the approved HL7 Policies/Procedures –results will feed into the HL7 standards creation processes

3 27 January 2005Copyright 2005, HL73 Vocabulary Project - briefly Make HL7 vocabularies available from within the Universal Medical Language System (UMLS) Where possible replace HL7 vocabularies with designated Consolidated Health Initiative (CHI)* vocabularies Specify vocabulary bindings from specific HL7 messages to the UMLS (first v2.x, then v3) –Vocabulary access, maintenance and collaboration tooling will also be developed as required for the project. –All activity will be coordinated using established HL7 processes and documented in implementation guides. * Specified by (US) Departments of Health and Human Services, Defense, and Veterans Affairs

4 27 January 2005Copyright 2005, HL74 EHR Project - briefly Develop implementation guides that: enable the transmission of patient information between disparate electronic health record (EHR) systems. maintain clinical meaning of information in computable form. –leverage existing work within HL7. –increase the utility/uniformity/usability of HL7 messages. –each successive task producing a useable working product.

5 27 January 2005Copyright 2005, HL75 Two Phases Phase I will produce –a short-term solution that will allow implementation of information flow between EHR systems –using existing HL7 formats in a standardized, simple, query-response message set –including instructions and tools for implementation of a secure transmission mechanism encompassing encryption, authentication, and transport verification. Phase II will expand Phase I –messages will enable more semantic interoperability and a richer query set.

6 27 January 2005Copyright 2005, HL76 EHR Project – Tonights Agenda Project Description – Bill Braithwaite Phase I Status Report – Liora Alschuler Reference Table of Potential Data Elements – Ed Hammond Related HL7 Activities – Dan Russler, Michael van Campen Discussion of Next Steps (RFI & RFQ)

7 EHR Project Project Description Technical Co-Leaders Bill Braithwaite Ed Hammond HL7 Project Manager Phil Barr

8 27 January 2005Copyright 2005, HL78 Additional Work Formation of a stakeholder focus group Identification and analysis of various alternative local and international models for the exchange of EHR data Definition of a clinical data element dictionary Live data pilot project Balloting of new artifacts as necessary Implementation guides will be prepared for all functional activity.

9 27 January 2005Copyright 2005, HL79 EHR Project: Phase I Create a simple, 2 step Query/Response between 2 EHR systems: 1.Query for the type of information available on a given patient… Response describes what type of information is available. Followed by 2.Query (by type or date range) for any of the available information… Response uses CDA to wrap the information payload. Provides varying levels of granularity, from (required) text to (optional) HL7 structured data in any HL7 format. Includes secure,verifiable transmission over the internet To be demonstrated by February 2005

10 27 January 2005Copyright 2005, HL710 EHR Project: Phase II Adds additional specificity at all levels: – robust instance identification paradigms for all objects (e.g. patients, practitioners, documents, and origin of all information) – allows (arbitrarily) greater specificity in query and response definitions (what information is requested/what is available) –Uses CDA release 2 with clinical statements to support variable levels of semantic interoperability (from plain text to fully structured clinical information) depending on the capabilities of the record holder system

11 27 January 2005Copyright 2005, HL711 Phase II: Review Contract Review current EHR information exchange implementations –GP2GP, openEHR, CCR, NICTIZ (National ICT Institute for Healthcare in The Netherlands), medEmed (a project of the NetLab group in the Department of Computer Science, University of Victoria), CEN 13606, CDA release 2, and other closely related initiatives. –High level and a detailed analysis and comparison of an agreed upon set of such implementations to inform the progress of the NLM-EHR project.

12 27 January 2005Copyright 2005, HL712 Phase II: Review Contract Tasks –Summarize the use case for each model. –Identify the level of negotiation and or built-in assumptions required for successful information transfer between participants to occur. –Compare process, tools, and methods used to create each model. –Compare handling of unstructured documents. –Compare higher level constructs in each model such as episode-of-care. –Compare interactions in the model such as patient roles, order & observations roles. –Compare ability of each model to handle the range of data elements specified by the ASTM Continuity of Care Record (CCR). –Compare model maturity – Is it currently in production? How long? Current tooling level supporting model? –Compare implementations where they exist. –Gather Implementation guides for each project. –Explore issues encountered in comparison. –Summarize disagreements between proponents of each model.

13 27 January 2005Copyright 2005, HL713 Phase II: Message Set Develop Phase II EHR Query-Response Message Set –Using the model-based HL7 Development Framework (HDF), ensure that the information exchanged enables as much semantic interoperability as possible. –Design a message set that can carry full semantic information of as much clinical information as possible and produce an implementation guide and tool set complete enough to enable reliable implementation by a broad range of vendors.

14 27 January 2005Copyright 2005, HL714 Phase II: Message Set Tasks –Identify issues beyond the raw data transactions that need to be addressed for implementation (e.g., patient ID, document ID, ensuring data integrity, ensuring system security, documenting origin of info, etc.). –Explore the query-response capabilities of existing HL7 messages to determine modifications to allow the Phase II query-response messages to be more complete as to the kinds of patient data that can be requested and delivered. –Generate specifications for Phase II query-response messages. –Review results of contract for Current Implementation Review and incorporate into a specification for the Phase II delivery mechanism. –Design a standard HL7 Version 3 payload message to deliver an arbitrary number of clinical statements, each of which is able to handle a variable level of semantic interoperability from plain text to fully structured and coded clinical information, based on the capabilities of the record holder. –Draft an implementation guide for transmitting all the data and documents comprising an entire electronic health record (EHR) between systems using these messages, independent of source and destination architectures. –Using the implementation guide, create a test implementation to provide Proof of Concept of the Phase II model by transferring a subset of meaningful clinical data, which demonstrates the feasibility of variable semantic interoperability between independent systems and refines the implementation guide and tool set. –Submit any additional or changed standards through the HL7 standards approval process.

15 27 January 2005Copyright 2005, HL715 Phase II: Message Set Looking for best way to break this contract up into 2-3 smaller parts each of which would extend the previous part but produce complete deliverables on its own. Goal is to make rapid progress, limit risk to the project and subcontractors, and reuse and build on existing development. Comment period of three weeks, then formulate and post the next EHR Query- Response Message Set RFQ(s).

16 27 January 2005Copyright 2005, HL716 Phase II: Message Set Possible ideas include: –First implement subset of data, e.g., medications, labs, and active problem list. –Consider frameworks other than CDA release 2. –Incorporate examples of use of services (e.g., terminology, patient identification) into message set. –Expand the phase I query-response message set to be more complete as to the kinds of patient data that can be requested and delivered. –Expand phase I query-response message set as necessary to deal with indexed information/documents. –Separately identify issues beyond the raw data transactions that need to be addressed for implementation (e.g., patient ID, document ID, ensuring data integrity, ensuring system security, documenting origin of info, etc.).

17 27 January 2005Copyright 2005, HL717 More Information … For more information/to declare interest: –Subscribe to –Refer to contains a description of the projects and the sub-tasks to be subcontracted to experts. Contacts Phil Barr Bill Braithwaite Ed Hammond


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