HL7 capabilities for working with GS1 Andrew Hinchley Board Member HL7 UK Integration Strategist Cerner Corporation
Agreements/MOUs * Accredited Standards Committee X12 ASC-X12 * American Dental Association ADA o ADA Joint Project Statement * American Society for Testing Materials ASTM * CEN/TC 251 * Clinical Data Interchange Standards Consortium CDISC * Digital Imaging and Communication In Medicine DICOM * ehealth Initiative ehi * Institute for Electrical and Electronic Engineers IEEE * Integrating the Healthcare Enterprise IHE * Medbiquitous * National Council for Prescription Drug Program NCPDP * OASIS * Object Management Group OMG * University of Nevada Las Vegas UNLV * College of American Pathologists - SNOMED International Division SNOMED
Committees & Special Interest Groups WWW.HL7.ORG Anatomic Pathology Anesthesia Architecture Review Board** Arden Syntax Attachments Cardiology Common Message Element Types*** CCOW* Clinical Decision Support* Clinical Genomics Clinical Guidelines Community Based Health Services Conformance Infrastructure & Messaging* Education** Electronic Health Records* Electronic Services** Emergency Dept. Financial Management* Government Projects (US) Imaging Integration Implementation** International Affiliates** Java Laboratory Health Care Devices Marketing** Medical Records/ Information Management* Modeling & Methodology* Orders & Observations* Organization Review** Outreach for Clinical Research* Patient Administration* Patient Care* Patient Safety * Technical Committees, ** Board Committees, ***Task Force Pediatric Data Standards Personnel Management* Pharmacy Process Improvement** Public Health & Emergency Response Publishing** Regulated Clinical Research Information Management (RCRIM)* (formerly Clinical Trials) Scheduling & Logistics* Security* Service Oriented Arch. Structured Documents* Technical Steering Committee** Templates Tooling** Vocabulary* XML
HL7 messaging - now only one dimension of what HL7 does Messaging Documents EHR/PHR
CDA: A Document Exchange Specification This is a CDA and this and this and this and this and this and this
CDA Body: Human-readable report Any type of clinical document WWW.HL7.ORG H&P Consult Op note Discharge Summary... Format: tif,, PDF, HTML, XML: Paragraph List Table Caption Link Content Presentation required
CDA Body: Machine Processible WWW.HL7.ORG Model-based computable semantics: Observation Procedure Organizer Supply Encounter Substance Administration Observation Media Region Of Interest Act Optional
PHR US National initiative WWW.HL7.ORG
HL7 beyond the hospital interface WWW.HL7.ORG Enterprise Region Facility Network National
HL7 a rapidly widening integration challenge Point-to-point Messaging SOA Services oriented architecture Repositories National hubs
XDS Affinity Domain (NHIN sub-network) WWW.HL7.ORG XDS Scenario Showcased at HIMSS PDQ Query to Acquire Affinity Domain Patient ID M8354673993 2006 Patient Identity XRef Mgr M8354673993 L-716 A87631 M8354673993 L-716 14355 A87631 Patient Identity Feed Patient Identity Feed EHR System Physician Office Patient Identity Feed Affinity Domain Patient Identity Source M8354673993 Patient Identity Feed ED Application PACS PACS L-716 Community Clinic Lab Info. System XDS Document Repository PIX Query Query Document (using Pt Id) ATNA Audit record repository Retrieve Document Document Registry PIX Query XDS Document Repository Register (using Pt ID) CT Time server PACS A87631 EHR System Provide & Register Docs Teaching Hospital
Scope for NHS Connecting for Health chooseandbook WWW.HL7.ORG Patient Choice Secondary Uses Service Analysing National Health Trends Picture Archiving & Communications Service West North East East London South Largest civil IT project in the world 40,000 GPs 80,000 other doctors 350,000 nurses 300+ hospitals 10 year programme 50m+ patients 1.344m healthcare workers Electronic Prescriptions Service N3 New National Network National & Local Care Record Services Healthspace Web Access for Patients NHSmail Secure E-mail for all NHS workers
In a typical NHS week WWW.HL7.ORG 6 million people visit their GP Over 800,000 outpatients are treated Over 10,000 babies are delivered by the NHS Over 50,000 emergency journeys in NHS ambulances In other words, 3 million critical transactions each day! District nurses make over 600,000 home visits Pharmacists dispense ~8.5 million items NHS surgeons performing ~1,200 hip operations, 3,000 heart operations and 1,050 kidney operations Labs and associated services provide millions of tests results
Architecture Overview WWW.HL7.ORG
NHS spine Part of 1 billion pound national shared services to support clinical communications Only accessed by accredited systems Each system has agreed set of HL7 V3 message profiles/versions it is allowed to send and receive
NHS spine 60 million patient central demographic service built on HL7 V3 Queries Central clinical summaries and key in- patient/out-patient events built on HL7 CDA National Choose&Book system for hospital in-patient and out-patient booking based on HL7 V3
Coding and identification WWW.HL7.ORG challenges Unique NHS Number for each of 60 million patients SNOMED as clinical terminology 850,000 terms DM&D Extensive drugs dictionary 19 attributes for each drug Professional staff directory 250,000 moving up to 750,000
Hl7 - Transition to meet the WWW.HL7.ORG new challenges! Board of Directors met August 2006 Developed transition strategy Start to identify transition team(s) Assigned major task areas: Structure/Organization/Governance Product Life Cycle/Project Management Product & Services Strategy Communication/Branding Funding/Revenue Sources Volunteer Resources
HL7-Re Re-organise and update! Optimize the effectiveness of our core resource: the volunteers Maintain culture of volunteerism Global participation Document institutional process Identify new sources of volunteers Support: Comprehensive toolkit Support: Professional/HQ staff Support: e-workinge Support: Organization/Governance
Product-oriented oriented Project Management Approach
Both CEO and CTO now in place
Establish Harmonization Processes WWW.HL7.ORG Clarify Governance Provide Project Support Modeling & Methodology Services Oriented Architecture RIM Java Foundation & Technologies Infrastructure & Messaging Conformance CCOW XML Vocabulary Tools Security Electronic Services Publishing Implementation TermInfo Early Adopters Arden Syntax Templates Structured Documents Orders and Observations Personnel Management Structure & Semantic Design Attachments Scheduling & Logistics Patient Administration Clinical Decision Support RCRIM Financial Management Healthcare Devices Patient Care Pharmacy Clinical Guidelines EHR Cardiology Government Projects Clinical Genomics Lab Patient Safety Domain Experts Image Integration Community Based Health Public Health/Emergency Response Anatomic Pathology Pediatrics Data Standards Emergency Care Anesthesiology
Contact Web sites www.hl7.org www.hl7.org.uk CEO Charles.jaffe@hl7.org Andrew.hinchley@cerner.com