August 24-25, 2006, Cologne, Germany
| International HL7 Interoperability Conference IHIC 2006
August 24-25, 2006, Cologne, Germany |
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To the IHIC 2006 conference program committee
Email: williamtfgoossen@cs.com
dr. William TF Goossen
Acquest research, development and consulting
Dorpsstraat 50
2396 HC Koudekerk aan den Rijn,
Netherlands
acquest@acquest.nl
phone +31715419594
fax + 31715418202
dr Goossen is researcher and consultant at Acquest research, development and consulting in the Netherlands. In addition he is assistant professor at the college of nursing in Iowa, USA. His primary tasks at Acquest this moment include standardization work in area's of messages, EHR and health vocabulary. Currently, he is carrying out several projects based on HL7 v3 and SNOMED CT. Examples include the birth data message that are HL7 v3 messages to exchange data about mother and child from perinatology to youth health care. This is part of the national ICT infrastructure for healthcare. He has published many papers about R&D in nursing and health informatics. Some recent examples are shown below:
• van Beek L, Goossen WT, van der Kloot WA, (2005). Linking nursing care to medical diagnoses: Heterogeneity of patient groups. Int J Med Inform, 74, 926-936.
• Goossen WTF, Delaney C, Hovenga E, Marin H, Saba V, (2005). Lessons Learned for the international Nursing Minimum Data Set (i-NMDS). In: Oud N, Sermeus W, Ehnfors M, (2005). Proceedings 5th ACENDIO conference 2005. Bern etc, Verlag Hans Huber, pp 31-35.
• Goossen W, Ozbolt J, Coenen A, Park HA, Mead C, Ehnfors M, Marin H. (2004). Development of a provisional domain model for the nursing process for use within the Health Level 7 RIM. J Am Med Inform Assoc., 11 (3): 186-194.
• Goossen WTF. (2004). Model once, use multiple times: reusing HL7 domain models from one domain to the other. In: Fieschi M, Coiera E & Jack Li, YC: (Eds). Proceedings of the 11th World Congress on Medical Informatics Medinfo 2004. Amsterdam etc. IOS Press, 366-370.
• Goossen WT, Jonker MJ, Heitmann KU, Jongeneel-de Haas IC, de Jong T, van der Slikke JW, Kabbes BL. (2003). Electronic patient records: domain message information model perinatology. Int J Med Inf. 2003: 70(2-3):265-76.
Applying the HL7 v3 care provision messages in practice: first experiences
research
short or long
This presentation will cover the development, the contents and structures of the HL7 v3 artifacts and the practice applications and some experiences with the Care Provision domain in HL7 v3, which has recently received the DSTU status.
Applying the HL7 v3 care provision messages in practice: first experiences
Dr. William Goossen
Introduction
The HL7 domain care provision has achieved DSTU (Draft Standard for Trial Use) status since the May 2006 ballot of the HL7 v3 standard , which is part of health and clinical chapter (the status in the ballot will be identified between brackets):
1. D-MIM Care Provision (DSTU). This is the generic domain message information model that facilitates development of many care provision messages. This model goes back about 9 years in HL7 v3 history when the Unified Action Service Model was introduces, and since then input from projects has evolved to the current contents and structure of the D-MIM.
2. Care Structures topic (DSTU). This topic includes the Care Statement structure that allows a diversity of patient related findings to be defined and exchanged. The choice box structure guarantees that a clinician can pick and choose what he wants to use. In addition variability in professionals’ acts, such as procedures and encounters can be selected and defined. Further structures include the Observation Assessment model for representation of clinical scales and indexes, the Vital Signs Structure and the Care Plan Structure. All serves to further specify and define clinical statements about the patient and his care.
3. Care Record structure (DSTU). This REPC_RM004000 message model can be used to exchange (parts of) the patient record. This can be used either in referral messages, patient transfers or as the answer to a query.
4. Care Record query (DSTU). Three queries allow the user to (1) find a specific patient record candidate when no unique identifier is known, (2) retrieve a care profile derived from patient health record matching the criteria parameters. The third Care Record Query request RMIM provides the list of query parameters needed to retrieve a specific Care Record determined by its unique identifier.
5. Care Transfer topic (DSTU). This is to refer or transfer a patient in the chain of care (request), and to accept the referral / transfer (Promise). Once the referral takes place the Care Record (event) message is send to complete the cycle.
In addition, several draft items are currently included, but ongoing work is needed to further complete the standard. E.g. allergies and adverse reactions, conditions and condition trackers, basic observations and other items will follow in the near future.
Use of HL7 v3 Care Provision in practice
The domain Care Provision covers for example the following use cases / storyboards at this stage: the request for a patient record by a medical specialist to the general practitioner after the general practitioner has referred the patient with an initial referral question and some supporting data. The transfer of a stroke patient to a nursing home is another use case covered. The models are such that they can be used in many domains, provided that the domain data are mapped one to one to the D-MIM and R-MIM artifacts, classes and attributes. At this stage an excel spreadsheet is used for such mapping.
These Care Provision D-MIM and R-MIMs have been developed based on clinical domain analysis and standards application projects in different countries. Examples include the national EHR strategy (UK), the aged care analysis and modeling work in Australia, the chronic disease management work and Canada Infoway in Canada and the renal transplant project in Germany. In addition in the Netherlands several projects are ongoing such as perinatology referrals , general practitioner to general practitioner messages, general practitioner to psychological care referral .
Goossen WT, Jonker MJ, Heitmann KU, Jongeneel-de Haas IC, de Jong T, van der Slikke JW, Kabbes BL. (2003). Electronic patient records: domain message information model perinatology. Int J Med Inf. 2003: 70(2-3):265-76.
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