ศูนย พัฒนามาตรฐานระบบข อมูลสุขภาพไทย · Interoperability Benson T: Principles of Health Interoperability HL7 and

ศนยพฒนามาตรฐานระบบขอมลสขภาพไทย Thai Health Information Standards Development Center

PHARMACY INFORMATICS EDUCATIONAL SERIES

โครงการอบรมการพฒนาและจดการระบบขอมลเภสชกรรมในโรงพยาบาล

: การเตรยมขอมลยาเพอการเบกจาย

วนท 18 มถนายน 2557

คณะเภสชศาสตร จฬาลงกรณมหาวทยาลย

นพ.ดาวฤกษ สนธวณชย

นพ. บญชย กจสนาโยธน Ph.D.(Health Informatics)

BHI-ED-SIG

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IS) กรอบการนาเสนอ

แนวคดการแลกเปลยนขอมลสขภาพ (Health information

exchange) การทางานรวมกนของระบบขอมล(Interoperability)

และ มาตรฐานขอมลสขภาพ (Health information standards)

รหสยามาตรฐาน:

บญชขอมลยาและรหสยามาตรฐานไทย (Thai Medicines

Terminology) TMT

รหสยามาตรฐาน 24 หลก

รหสสนคาและบรการมาตรฐาน GS1

2

Meaningful Use of Health Information

Personal Health

(Provision of info to patient)

Public Health (Reports,

Surveillance)

Health care

Delivery (EHR use, HIE,

etc)

Presenter

Presentation Notes

If we start with how health information to be meaningfully used. We all agree that the information should be used meaningfully to serve healthcare delivery system, personal health and the health of the population. It should meet the requirement of health care services and public health functions. Such the information should be comprehensive , integrated and good quality. Patient health information should be able to exchange between providers, authorized agencies and should be available to the right person at the right time and the right place. To achieve this situation the different health information systems, both inside and outside of organization must be interoperable.

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Patient Data

Clinical Research

Quality Improvement

Management Financing Business

Intelligence

EMR, CPOE Lab, Pharm

Data Clinical Notes

Reimbursement Claim Data

(DRG)

Individual Data

Aggregated Data

Clinical Data Administrative Data

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Patient Data

Administrative data Clinical data Use for reimbursement,

administration and reports Diagnosis, Procedure codes Charge/cost data

Use for clinical care Laboratory data, Pharmacy data Clinical notes

Individual Data Aggregated data Operational, Transactional Report form

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6

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7

National Health Information Systems Blueprint (the Architecture)

A Health Information Exchange (HIE) makes the sharing of health data across information systems possible

1) who received health services

2) who provided those services,

3) where did they receive the services

4) what specific care did they receive.

From: http://ohie.org/architecture/

http://ohie.org/architecture/

Why Health Information Exchange(HIE) Interoperability and information standards?

Integration & Exchange of Health Information

Health Information Systems Interoperability

Health Information Standards

What is Interoperability?

is ability of two or more systems or components to exchange information

and to use the information that has been exchanged.

IEEE standard computer dictionary: a compilation of IEEE standard computer glossaries.1990.

Level of Interoperability • is realized through invocation of services accessed via standardized interfaces. Here, common business models are needed.

Process/Service Interoperability

• harmonised information models based on common references and agreed, ontology-based terminology

Semantic Interoperability

• harmonized messaging and document exchange Syntactic

Interoperability

• is based on the exchange of agreed data. Structure

Interoperability

• establishes harmonization at the plug and play, signal and protocol level

Technical Interoperability

Benson T: Principles of Health Interoperability HL7 and SNOMED. 2nd ed. 2012. Springer; 2012. Bobel B: Making Hospital IT Interoperable Hospital Information Technology Europe 2008

What is Standardization?

is the process of agreeing on standards represent the common language allows the exchange of data between disparate data

systems. Goals are to achieve comparability, compatibility, and

interoperability between independent systems to ensure compatibility of data to reduce duplication of effort and redundancies.

ISO

Presenter

Presentation Notes

The standardization is the process of agreeing on standards. It represents the common language that allows the exchange of data between disparate data systems. Goals of standardization are to achieve comparability compatibility and interoperability between independent systems. It reduces duplication of effort and redundancy.

What is a Standard?

is a definition, set of rules or guidelines, format, or document that establishes uniform engineering or technical specifications, criteria, methods, processes, or practices

approves by a recognized standard development organization (SDO), or have been accepted by the industry

From: Public Health data standards consortium http://www.phdsc.org/default.asp 2011

Presenter

Presentation Notes

Interoperability needs standards, so what is standards? Standards is a definition a set of rule/regulation or guidelines format or document that establish uniform specification criteria methods process or practices. Standards should be approved by a recognized standard development organization or, public authorities or have been accepted by the industry.

http://www.phdsc.org/default.asp


Why Standards is needed? The number of interfaces = 𝑁

2−𝑁2

Linking 6 nodes ->15 interfaces, Linking 100 nodes -> 4,950 interfaces.

Benson T: Principles of Health Interoperability HL7 and SNOMED. 2nd ed. 2012. Springer; 2012.

Interoperability and Standards

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Landscape ของมาตรฐานขอมลสขภาพ

From: Standards – Yesterday, Today and Tomorrow: Integrating the Standards for Healthcare presentation , Ken Lunn, 17 October 2011

Categories of Health Information Standards

Health data Standards Category

Content Exchange Standards - Core data sets Health Data Dictionary: eg. Referral letter, Billing Data Set Patient summary data set Continuity Care Document (CCD) - HL7 CDA

Standard Vocabularies Standards - Semantic Patient, Providers identifiers Classification : ICDs Terminology: SNOMED-CT, LOINC

Presenter

Presentation Notes

A public-key infrastructure (PKI) is a system for the creation, storage, and distribution of digital certificates which are used to verify that a particular public key belongs to a certain entity.

Apple What is Semantic? มาตรฐานความหมาย

Messaging Standards - Syntactic : HL7 V2, HL7 V3 messaging standards

Security and Privacy standards Rules & Regulations

PKI (Public Key Infrastructure)

Health Information Standards

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Standards (มาตรฐานขอมล) National

1. Core data set standards (ชดขอมล) 12 & 18 files standards 2. Semantic standards (คาจากดความ

ความหมาย) ICD 10 TM, ICD 9 CM Citizen IDs, Facility IDs

3. Syntactic standards (รปแบบการสงขอมล) X 4. Security and privacy standards (ความเปนสวนตว และความมนคงของขอมล)

X

Thai Health Data Standards: Current

Thai Health Information Standards Development

Standards (มาตรฐานขอมล) National

1. Core data set standards (ชดขอมล) Referral, Chronic Diseases

2. Semantic standards (คาจากดความ

ความหมาย)

Drug Terminology (TMT), Lab. Code (LOINC)

Providers ID

3. Syntactic standards (รปแบบการสงขอมล) HL7 messaging,HL7-CDA

4. Security and privacy standards (ความเปนสวนตว และความมนคงของขอมล)

X

What is Standardization?

is the process of agreeing on standards represent the common language allows the exchange of data between disparate data

systems. Goals are to achieve comparability, compatibility, and

interoperability between independent systems to ensure compatibility of data to reduce duplication of effort and redundancies.

ISO

Presenter

Presentation Notes

The standardization is the process of agreeing on standards. It represents the common language that allows the exchange of data between disparate data systems. Goals of standardization are to achieve comparability compatibility and interoperability between independent systems. It reduces duplication of effort and redundancy.

What is a Standard?

is a definition, set of rules or guidelines, format, or document that establishes uniform engineering or technical specifications, criteria, methods, processes, or practices

approves by a recognized standard development organization (SDO), or have been accepted by the industry

From: Public Health data standards consortium http://www.phdsc.org/default.asp 2011

Presenter

Presentation Notes

Interoperability needs standards, so what is standards? Standards is a definition a set of rule/regulation or guidelines format or document that establish uniform specification criteria methods process or practices. Standards should be approved by a recognized standard development organization or, public authorities or have been accepted by the industry.


OBX|1|CE|ABO ABO GROUP||O Type O| OBX|1|CE|BLDTYP ABO GROUP||TYPEO Type O| OBX|1|CE|ABOTYPE ABO GROUP||OPOS Type O|

Presenter

Presentation Notes

Here is the sample of HL7 v2 messaging standard.

Presenter

Presentation Notes

There are several coding systems that represent the meaning in several aspect in medicine. They have different objectives and they are all important to health information exchange. The ICD system mains objective is for disease statistical report and epidemiological purpose and for administrative reimbursement. Case max system such as the Diagnosis related group (DRG) is used for reimbursement. SNOMED-CT, and LOINC are detail coding system of clinical terms suitable for clinical and direct care of patient.

Groupers

Continuum of Health Semantic Standards

Nomenclature-Highly detail descriptions (SNOMED-CT)

Classification-organized aggregation of descriptions into rubric (ICDs)

Groupings-High level categories of rubrics (DRGs)

Nomenclatures Classification Groups

Aggregation

Details Grouped SNOMED-CT ICD DRG

World Health Assembly Resolution WHA66.24 May 2013

Urges member state to 1. Draw up a road map for implementation of ehealth and health

data standards at national and subnational levels. 2. Develop policies and legislative mechanisms linked to an

overall national eHealth strategy, in order to ensure compliance in the adoption of ehealth and health data standards.

http://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_R24-en.pdf

Dr Margaret Chan, Director-General of WHO

Documents

ศูนย พัฒนามาตรฐานระบบข อมูลสุขภาพไทย · Interoperability Benson T: Principles of Health Interoperability HL7 and