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iEHR Standards Project
HL7 PC Presentation
HL7 WGM Boca Raton
September 2006
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© 2006, Canada Health Infoway, Inc.
• To introduce the Canadian iEHR Project • To introduce the Canadian iEHR Care Objects• To demonstrate that our work fits with the PC Committee• To discuss how we can work together
Presentation Objectives
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© 2006, Canada Health Infoway, Inc.
Presentation Overview
• Background• iEHR Components• iEHR Messages• EHR Infostructure• Requirements• Canadian mini-D-MIMs derived from PC Care Statement
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© 2006, Canada Health Infoway, Inc.
Background
Canada Health Infoway (Infoway) has initiated the Interoperable Electronic Health Record (iEHR) project to set the foundation for establishing the messaging standards by which the EHR community in Canada will interoperate. These specifications will form the basis of the interoperable messaging platform within the EHR Infostructure as detailed in Infoway’s blueprint document.
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© 2006, Canada Health Infoway, Inc.
iEHR Components
• The iEHR specifications will address the requirement by the healthcare community (Point of Service or PoS) to interact with two specific components of the EHR Infostructure; 1. The Shared Health Record (SHR)2. The EHR Index.
• The SHR is primarily responsible for housing healthcare information related to encounters, events and episodes which spans multiple business domains; that is, information specifically identified as not belonging to an already existing business area (e.g. Drug Information, Laboratory, and Diagnostic Imaging)
• The EHR Index will contain meta information about healthcare events, episodes and encounters stored in the SHR and in domain-specific repositories (Drug, Lab, DI). This meta data will effectively catalogue the information to allow for easier storage to, and retrieval from the SHR and the domain-specific repositories.
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© 2006, Canada Health Infoway, Inc.
EHR Infostructure: Conceptual ArchitectureJURISDICTIONAL INFOSTRUCTURE
Ancillary Data& Services
Registries Data& Services
EHR Data& Services
DataWarehouse
OutbreakManagement
PHSReporting
SharedHealth Record
DrugInformation
DiagnosticImaging
LaboratoryHealth
Information
POINT OF SERVICE
Hospital, LTC,CCC, EPR
PhysicianOffice EMR
EHR Viewer
Physician/Provider
BusinessRules
EHRIndex
MessageStructures
NormalizationRules
Security MgmtData
Privacy Data Configuration
Physician/Provider
Physician/Provider
Lab System(LIS)
Lab Clinician
RadiologyCenter
PACS/RIS
Radiologist
PharmacySystem
Pharmacist
Public HealthServices
Public Health Provider
Longitudinal Record Services
HIALCommunication Bus
Common Services
ClientRegistry
ProviderRegistry
LocationRegistry
TerminologyRegistry
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© 2006, Canada Health Infoway, Inc.
iEHR HL7 v3 Messages
• The iEHR Standards Project has develop HL7 V3 messaging and associated terminology standards
– to support PoS recording/retrieval of clinical information to/from the SHR for high priority clinical needs.
– to support the capture of EHR Index Metadata.
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© 2006, Canada Health Infoway, Inc.
Requirements
• Common Observations– Record/List/Get Common Observation (Coded/Measured)
• Procedure– Record/List/Get Procedure (Physical/Non-Physical)
• Care Composition– Record/List/Get/Update Encounter/Episode/Generic Care Event
• EHR Index– Retrieve a list of events described at a high level for a particular patient
based on various search criteria– Notify a Point of Service application that an event previously captured in
the index is being revised (e.g. status change)
• Patient Clinical Profile– Obtain Patient clinical profile from SHR & Domain-specific Repositories
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© 2006, Canada Health Infoway, Inc.
Canadian mini-D-MIMs derived from PC Care Statements
Observation
SubstanceAdmin
Supply
Procedure
Encounter
Organizer
Act Reference
CommonObservation
PharmacySupply
OtherSupply
Procedure
Care Composition
EHR Index
Lab
DI
-Coded Observation-Measured Observation
-Cognitive Service-Physical/Surgical Service
-Encounters-Episodes-Generic Care Events
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