2. GCPR Near-Term Solution System Design Review John Leslie PRC Health Informatics Systems & Services Chief Architect GCPR Project

3. Purpose/Scope The purpose is to pass certain medical records on a select group of Department of Defense (DoD) patients through the GCPR Framework to the Veterans Affairs (VA) to be used by the VA's clinicians who will read the records using the VA's CPRS. This will achieve partial fulfillment of Presidential Review Directive 5 (PRD 5). The scope is to provide a bridging network between Agency Systems. The information, which is to be exchanged, is defined in a number of “Partitions” which are defined by the Information Model.

4. Real Scope NTS Discharged/Retired only Batch messaging HL7 v2.2 Limited set of information

5. Information View RIM/RTM –Initial delivery as GFI December ‘00 –UML Clinical Records in “Templates” –Describe structure of data exposed by Framework –Represented internally as Graphs –NTS Templates Laboratory (Chem, Micro, AP, BB) Radiology Reports Outpatient Medications Person Identity –Positively Identify Persons –Locate Clinical Record

6. GCPR NTS Datatypes

7. NTS Lab Template

8. NTS Rad Template

9. NTS Meds Template

10. Graph Generic structure based on meta-classes ‘Normalized’ representation inside Framework Based on RIM Each Graph represents records

11. Graph

12. GCPR NTS Architecture

13. NTS HL7 Add/Update New Patient ADT (A28, A30, A31)

14. NTS VA Add/Update New Patient

15. NTS HL7 Add/Update New Patient Records ORU

16. NTS HL7 Add/Update Existing Patient Records ORU

17. NTS Deliver Patient Records

18. transformer Adapters/Connectors –Connectors provide support protocol (ie ftp, IIOP) –Adapters components translate from one representation to another (ie HL7 to RIM) Graphs/GraphCollections/GraphCollectionMgr –‘Generic’ internal representation of RIM –Independent of underlying persistence –IGraphcollection (CacheGraphCollection, PersonGraphCollection)

19. Normalized RIM, Reference Terminology and Privacy Controls (ADI) HL7 2.3 Adapter HL7 v3 XML (future) PIDS Adapter COAS Adapter SQL Adapter HL7 v2.2 Adapter IIOPODBC CHCS ftp IIOP/ CORBA MLLP/ HL7 IIOP/ CORBA HTTP (future) MPI COAS Server DoD VA IHS Connectors Adapters Transformer COAS Adapter IIOP PIDS Adapter

20. Graph

21. GraphCollections

22. GraphCollectionMgr (local)

23. GraphCollectionMgr (remote)

24. Current Status Loading files Beta testing –San Diego –Alaska –El Paso –Washington DC Support/minor enhancements

25. Future More robust set of info –Adverse Reactions –Discharge Summaries –Etc...

26. Questions?