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© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. HL7 Education Summit St. Louis, MO July 17-19, 2012 Calvin E. Beebe Introduction To HL7

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Page 1: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

HL7 Education Summit

St. Louis, MO July 17-19, 2012

Calvin E. Beebe

Introduction To HL7

Page 2: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

n Calvin E. Beebe Ø  Technical Specialist, Mayo Information Services Ø  31 Years experience at Mayo Clinic in Rochester MN Ø  Co-editor, CDA R1, CDA R2 Ø  Chair of HL7 Finance Committee Ø  Co-chair HL7 Structured Documents Working Group Ø  Chair Structure & Semantic Design Steering Division

n  Significant contributors to this tutorial: Ø  Liora Alschuler, Lantana Consulting Group Ø  Bob Dolin MD, Lantana Consulting Group Ø  Keith W. Boone, GE Healthcare IT Ø  CiC materials provided by David Markwell [email protected] Ø  Additional contributors: Virginia Lorenzi; Dan Russler, MD; Kai Heitmann MD,

Michio Kimura, and some slides from Tim Benson's tutorial 'Standards for Interoperability'

Presenter:

Page 3: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Presentation Outline

n  Intro to HL7 n  What is CDA? n  CDA Data Types n  CDA Structure: Header and Body n  CDA Structure: Entries

Page 4: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Intro to HL7 Outline

n Core concepts –  Interoperability – Standards – Type/Scope of Communication – Paradigms – HL7 as SDO

n Messaging Standards Ø  HL7 V2 and V3

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Page 5: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Core Concepts

n  Interoperability Ø  Definition Ø  Types

n Standards Ø  Definition Ø  SDOs

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Page 6: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Interoperability Definition

n  Interoperability is the ability of two or more systems or components to exchange information and to use the information that has been exchanged Ø  IEEE 1990

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© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. 12/28/10

The goal of SAIF is to enable Working Interoperability (WI); where, the biggest impediment to WI is implicit assumptions. As such, SAIF provides a set of grammars that enable developers and users of “components” involved in WI scenarios to explicitly define and govern those aspects of the component’s structure and behavior that affect its ability to seamlessly engage in a WI scenario.

HL7 SAIF Project

Page 8: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Types of interoperability

n  Technical n Semantic n Process

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Page 9: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Technical Interoperability

n Move data from A to B (wire?) n Domain-independent n  Information theory n Now commodity

12/28/10 9

Page 10: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Semantic Interoperability

n A and B understand data in the same way n Domain specific n What HL7 mainly does n Use of codes and identifiers

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Page 11: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Process Interoperability

n Business systems at A and B interoperate n Business process-specific n Requires re-engineering n Generates most benefit

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Page 12: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Standards Definition

n  A standard is a document, established by consensus and approved by a recognised body, that provides, for common and repeated use, rules, guidelines, or characteristics for activities or their results, aimed at the optimum degree of order in a given context Ø  ISO 2004

12/28/10 12

Page 13: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Consensus

n  General agreement, characterized by the absence of sustained opposition to substantial issues by any important part of the concerned interests and by a process that involves seeking to take into account the views of all parties concerned and to reconcile any conflicting arguments. Consensus need not imply unanimity. Ø  ISO 2004

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Page 14: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Recognised body

n  Internationally recognised standards development organization (SDO)

n  ISO Ø  Regional SDOs

n  CEN Ø  National SDOs

n  ANSI •  Affiliates (e,g, HL7)

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Page 15: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Health Informatics SDOs

n  ISO TC215 n  CEN TC251 n  HL7 n  IHTSDO n  CDISC n  DICOM n  ASTM n  GS1

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© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Industry Consortia

n  S&I Framework n  HITSP n  IHE

Ø  Integrating the Health Enterprise n  Continua n  Open Health Tools n  OpenEHR

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© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Benefits of Standards

n  Users n  Health Informatics

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Page 18: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

User Benefits

n  Right information n  Right place n  Right time n  Right person

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Page 19: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Health Informatics Benefits

!

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Page 20: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Interoperability Standards

n  Types of Communication Scope:

– Intradepartamental – Interdepartamental – Interorganizational – Regional (province, city, etc.) – Global (healthvault, epSOS)

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Page 21: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Types of Communication

n  Within workgroup n  Between departments n  Between providers n  Provider to payer n  Regional n  Global

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© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Within workgroup

n  Scheduling Ø  Appointments

n  EHR Ø  Problems Ø  Medication Ø  History and physical Ø  Procedures

n  Medical devices Ø  Vital signs

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Page 23: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Between departments

n  Orders Ø  CPOE Ø  Reports

n  Medication Ø  Prescribe Ø  Dispense Ø  Administer

n  Finance

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Page 24: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Between Providers

n  Referral n  Discharge summary n  PMR

Ø  GP2GP

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© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Provider to payer

n  Invoices n  Authorization n  Accountability

Ø  Statistical returns n  Managed care

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Page 26: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Complex Patterns

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© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

It takes time

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Page 28: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Why interoperability is hard

n  Translation Ø  A to HL7; HL7 to B

n  Bit-perfect Ø  Computers are digital L

n  User language Ø  Each specialty has its own context-specific dialect

n  Developer language n  Each vendor has its own computer-specific dialect

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Page 29: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

What is Health Level 7? Health Level Seven or (HL7) is a volunteer, not-for-profit,

standards development organization (SDO). Focusing on the development and advancement of clinical and administrative standards for healthcare.

It’s name is taken from the OSI model which represents the 7 layers of a communication stack. Level 7 represents the application layer or the healthcare domain.

ISO Model ISO Model Health Level Seven

Page 30: Introduction To HL7 - this.or.th · 2013. 4. 17. · © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health

© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

What is Health Level 7? •  Health Level Seven or (HL7) is a volunteer, not-for-profit,

standards development organization (SDO). Focusing on the development and advancement of clinical and administrative standards for healthcare.

•  With over 80 ANSI approved standards, its most successful standard is the HL7 2.X messaging standard: –  Patient Administration, Order Entry, Query, Financial

Management, Observation Reporting, Master Files, Medical Records/Information Management, Scheduling, Patient Referral, Patient Care, Laboratory Automation, Application Management, Personnel Management http://www.hl7.org/implement/standards/ansiapproved.cfm?ref=nav

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• Argentina • Australia • Brazil • Canada • China • Croatia • Czech Republic • Denmark • Finland • Germany • Greece • India • Ireland • Italy • Japan • Korea (Sth.) • Lithuania • France • Mexico • New Zealand • Uruguay • Poland • Southern Africa • Spain • Switzerland • Taiwan • Turkey • Netherlands • United Kingdom • Sweden • USA

HL7 is International!

HL7 International Affiliates

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© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

HL7 Work Group Meetings

Next Working Group Meeting: 26th Annual Plenary & WGM September 9 - 14, 2012 Baltimore, MD

Each year we hold 3 WG meetings: Ø  January Ø  May Ø  September

Developing Standards

Teaching Standards

USS Constellation, Photo by Chuck Szmurlo

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© 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office.

Thank you! Contact Information:

E-Mail: [email protected] Blog: www.cbwise.com