Introduction to HL7 Version 3 May 2010 - HL7 E Learning ... · May 2010 Introduction to HL7 Version 3 Ambassador Briefing Presented by Kai U. Heitmann An HL7 V3 Ambassador Heitmann

May 2010

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May 2010

Introduction to HL7 Version 3

Ambassador Briefing

Presented by Kai U. Heitmann

An HL7 V3 Ambassador

Heitmann Consulting and Services

(Germany)

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May 2010




Agenda

Why V3

The V3 Family of Standards

Additional benefits

Frequently Asked Questions

The Future

Summary

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May 2010




HL7 Version 2

Widely accepted healthcare interoperability

standard since the 90’s.

A messaging standard.

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May 2010




Why a new Version?

Version 2

...was developed to meet the immediate needs

in the health care IT community in the 1980’s

and 1990’s.

...was designed using an ad hoc method that

was difficult to coordinate and control

...does not have a common information model

...is not a barrier to interoperability for small

numbers of systems sharing data, as in a single

institution

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May 2010




Why a new Version?

Shortfalls of Version 2

Site specific negotiation is needed to determine

semantics and to implement V2 interfaces

When the number of systems grows large, as in

multiple-institution and/or regional and/or

jurisdictional systems, HL7 V2.x become a

barrier to interoperability

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May 2010




V3 Enables Semantic Interoperability

Functionalinteroperability

Semanticinteroperability

interoperability:

ability of two or more systems or

components to exchange information

and to use the information that has been

exchanged.

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May 2010




Dog!

As the number of systems grows, so does the need for standard information models

Semantic variation:

Different meanings,

different models

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May 2010




V3 is Model Based

The central Healthcare information model

for HL7 Version 3 is called the

Reference Information Model (RIM)

All V3 products are based on this model

ANSI standard since 2003

ISO standard since 2006

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May 2010




HL7 V3 Uses Object Oriented Design

Not ad hoc design

V3 = Object Oriented software methodology

and information architecture

Object Oriented means that HL7 V3 can be

extended incrementally whenever new healthcare information domains

need to be added

doesn’t require changing what already exists

Scalable, flexible

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May 2010




Version 3 is a Family of standards

ALL based on a shared information model and terminology

Version 3 RIM (ISO/HL7 21731:2006 RIM)

V3 Messaging

Documents Clinical Document Architecture (CDA – release 2)

Service Oriented Architecture: Entity Identification Services (EIS)

Common Terminology Services (CTS)

Resource Location and Update Services (RLUS)

Decision Support Services (DSS)

RIM Based Application Architectures (RIMBAA) Java APIs

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May 2010




Version 3 Domains

Accounting and Billing

Blood, Tissue, and Organ

Care Provision

Clinical Genomics

Claims and Reimbursement

Clinical Document Architecture

Clinical Decision Support

Clinical Statement

Common Message Element Types

Imaging Integration

Immunization

Laboratory

Medication

Materials Management

Medical Records

Observations

Orders

Patient Administration

Personnel Management

Pharmacy

Public Health

Registries

Regulated Products

Regulated Studies (Clinical Trials)

Scheduling

Shared Messages

Specimen Domain

Therapeutic Devices

…some in ballot phase

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May 2010




HL7 V3: built to support

inter-organizational care processes

Gen. Pract.

Patient

Specialists

Hospital O.R.

X-ray

Lab

Research, clinical trials,

administrative, utilization,

financial, public health, drug

certification, genomics…

Healthcare System

Information flow

Aftercare

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May 2010




Version 3 Enables the inter-organizational sharing of healthcare information

For example a lab result ordered in an outpatient clinic and

obtained from the local laboratory could be:

a part of a patient summary

(V3 CDA document) retrieved

using a Resource Location and

Updating Service (HL7 RLUS SOA)

the reason to order a specific

medicine using a computerized

physician order entry system (CPOE)

(V3 Rx Order message)

an indication of a particular disease

to a decision support system

…input to a RIM Based Application

Architecture (RIMBAA) decision support system

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May 2010




Additional V3 features

Formal vocabulary binding

Extensive tools library

Implementation Guides

Identifiers Globally Unique

Explicit Semantics (model based) makes automatic

conformance testing possible

Incorporates Web technology

XML (Extended Markup Language) as primary

implementation technology

Use of Web Services protocols for transport

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May 2010




Snippets of V3…

<observationEvent classCode="OBS" moodCode="EVN">

<id root="1.9.99.999.99.10.3" extension="APH65597960" />

<code codeSystem="2.16.840.1.113883.2.1.6.2" code="4K1D."

displayName="Histology laboratory test" />

<statusCode code="completed" />

<effectiveTime value="20100514" />

<value xsi:type="ED">MACRO: Ellipse of skin 25 x 8 x 12mm, centrally there

is an area of Pigmented tissue approximately 4mm diameter. On section there is a

2mm diameter area of dark material in the lower dermis. MICRO: Histology

confirms a small nodule of malignant melanoma extending to in deep

dermis/subcutis. Total volume 4.2 x 3.8 x 2.1mm Excision is complete on all

margins. Mitotic activity is low. Breslow level 2.1 Clark level IV Lymphatic

invasion not seen Adjacent superficial spreading component not present</value>

</observationEvent>

Class

Instance

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May 2010




Where is V3 in use today?

CDA is used in many countries, including

Australia, Canada, UK, Germany, the US,

the Netherlands, Greece, Japan...

V3 messaging is used in Canada, UK, the

Netherlands…

V3 SOA (service oriented architecture): in

the US, the NCI and the VHA have

significant projects…

V3 RIMBAA in Japan, Austria, Italy…

!

?

!

!

!

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May 2010




V3 implementations

Registries (Patient, Provider, Organization)

Transfer of care (Patient Care domain)

Clinical Documents (CDA)

Medication (Pharmacy domain)

Billing (Charges, insurance)

“Niche” clinical areas (immunization, clinical genomics, implantable theraputic devices, blood and organ banks...)

Research (clinical trials)

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May 2010




Do I need to be a modelling/ informatics expert to use V3?

No, V3 implementation guides are usable without a

detailed theoretical background. Many HL7

affiliates have also created detailed V3

implementation guides

HL7 offers a variety of tutorials to jump start

implementation

If an IT staffer knows XML, and the system is using

V3 messages or CDA documents or services, all

you need is an implementation guide

Start “small scale” – CDA Quick Start Guide

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?

!

!

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May 2010




How can I learn more about V3?

Tutorials

At Working Group Meetings

Affiliate meetings

Educational Summits

On site

Distance learning class

CDA Quick Start Guide and V3 Primer

RIM and CDA Certification

!

?

!

!

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May 2010




Looking Ahead:Recent Developments and Plans

Collaborations with ISO TC 215

and CEN TC 251 and

WHO (planned) and other

global & national organizations

Global adoption and implementation of EHR and

PHR

Healthcare Information integration in the

developing world

Public health, Research, Decision Support,

Practice Patterns, Quality

Implementation Guides for Version 3

Joint Initiative Council (JIC)

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May 2010




Messaging, documents, SOA, RIM

based application development

Free form CDA documents,

implementation guides, extensive

tooling, educational opportunities

XML and Web Services, for

universal application

For a higher level of semantic

interoperability

The V3 Familysolving the BIGGER problems of healthcare interoperability

Not just

messaging!

Easy to get

started

Employs Web

technologies

Model based:

the RIM

May 2010




Introduction to HL7 Version 3

Q & A