Integrating the Healthcare Enterprise
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Integrating the Healthcare Enterprise and The National Institute of Standards and Technology Patient Care Devices Domain Test Effort April 2006. Outline. IHE and NIST Use Case Profiles Gateway 11073/HL7 High level diagram Year One Year Two+ NIST Conformance Test Tools Message Maker

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Outline 4693093

Integrating the Healthcare Enterprise andThe National Institute of Standards and TechnologyPatient Care Devices DomainTest EffortApril 2006


Outline

Outline

  • IHE and NIST

  • Use Case Profiles

  • Gateway 11073/HL7

  • High level diagram

    • Year One

    • Year Two+

  • NIST Conformance Test Tools

    • Message Maker

      • Input POC (HL7) XML message profiles

      • Data source (physiologic)

      • Output: HL7 test messages

        • Test framework

    • ICSGenerator

      • Implementation Conformance Statements

    • ValidatePDU

      • PDU syntax (and later semantics?)

  • 11073 DIM XSchema

  • Questions


Integrating the healthcare enterprise ihe and nist

Integrating the Healthcare Enterprise IHE and NIST

  • IHE defines a Technical Framework for the implementation of established messaging standards to achieve specific clinical goals.

  • NIST supports IHE fundamental objective:

    • To ensure that in the care of patients all required information for medical decisions is both correct and available to healthcare professionals.

  • NIST contributes to a rigorous testing process for the implementation of the Technical Framework.

    • Conformance claims by products must still be made in direct reference to specific standards.

    • Vendors implementing IHE integration capabilities shall use an IHE Integration Statement to describe the conformance of their product to the specifications in the IHE Technical Framework.


Ihe pcd year 1 use cases

IHE/PCD Year 1 Use Cases

  • The Patient Care Devices Domain is concerned with Use Cases in which at least one actor is a regulated patient care device.

  • Year One Profiles:

    • Profile 1:The Enterprise Communication of Patient Care Device Data Integration Profile

      Goal: Communicate PCD data to enterprise information systems.

    • Profile 2:The Patient Identification Integration Profile

      Goal:Bind enterprise unique patient identification to the PCD Data which is communicated to the enterprise


Iso ieee 11073 60101 hl7 v2 x ori ieee p1073 6 1 1 application gateway

1073 System

1073

System

1073

Device

1073

Device

1073

Device

ISO/IEEE 11073-60101 HL7(V2.x) ORI [IEEE P1073.6.1.1](Application Gateway)

1073/HL7

Gateway

1073

Device

1073

Network

HL7

Network

HL7

System

HL7

System

1073-based communications network where 1073 devices interact and

an HL7-based communications network, where HL7-based systems interact.

Problem: A communication gateway is needed between these two worlds!

Solution: ISO/IEEE 11073-60101 HL7(V2.x) ORI [IEEE P1073.6.1.1]


11073 application gateway ori

11073 Application GatewayORI

  • Can take non-complying data and translate it, permitting owners of legacy devices to transmit data to the enterprise in a consistent way.

  • Major partitions of the ISO/IEEE standards and “architectural” components are mapped:

    • Data types (VITAL vs. HL7)

    • Nomenclature Codes (VITAL vs. LOINC)

    • Information Model (Objects & attributes) to HL7 segments and fields.

    • Encoding Rules (VITAL ASN.1/MDER/XML(?) to HL7 ER, XML(v2.x/v3)

    • Correlate message types (1073 [profiles, GET/SET, CREATE/DELETE, Event Report, etc.] vs. HL7 [interrogatives, Imperatives & declaratives])


How message maker and ics generator could contribute to the ihe pcd year one initiative

-Attribute ID, Term codes, value ranges, qualifiers…-Object Containment Tree

ICS-Generator

ICS XML File

How Message Maker and ICS-Generator could contribute to the IHE/PCD year one Initiative…

1073

Standard

(DIM)

HL7 v2.x

Standard

IEEE 1073

Standard

IHE-ITI

Patient

Administration

n

(Year 2+ )

NIST

P1073.6.1.1

ORI

(Gateway)

(XSLT)

IHE/PCD Technical

Framework (Vol. II)

(Transactions)

Testing

Framework(Year 2+)

IHE

Profile

(Paper)

HL7 MessageProfile

Builder

(e.g., MWB)

*HL7 MessageProfilesXML

*HL7 v2.x Message Profile: Captures and describes a set of HL7v2.x messages used to solve a Use Case.


Conformance test tools

Conformance Test Tools

  • Message Maker

    • Message Maker dynamically constructs HL7 messages based on an HL7 message profile.

    • Data values for the primitive elements (i.e., Field, Component, and Subcomponent) defined in the profile are obtained from a number of data sources.

      • NIST developed database of HL7 primitive data items, HL7 tables, User tables, External tables, local tables, example values from the profiles and default values.

    • Test messages can be valid or invalid and contain variation from message to message.

      • Example of invalid message is a missing data item for a required field.

      • A number of test parameters control the variation in the construction of a message.

        • These may include segment and field cardinality, the usage of certain primitive fields, value sets, data content, and more.

        • Data content variation is achieved by randomly selecting items from the HL7 items database.

  • http://www.nist.gov/messagemaker


Conformance test tools continued based on 11073 dim schema

Conformance Test Tools (continued)(based on 11073 DIM Schema)

  • ICSGenerator

    • Facilitates creation of vendor conformance statements [as well as selection of tests that would be applicable to testing a particular device].

    • Provides Medical device data such as parameters or attributes with value ranges and restrictions. [This data is used as needed by MessageMaker (in addition to testing options, data source(s) and HL2 V2.x profile file) to build the test messages.]

  • http://www.nist.gov/medicaldevices


Conformance test tools continued based on 11073 dim schema1

Conformance Test Tools (continued)(based on 11073 DIM Schema)

  • ValidatePDU

    • Provides a basic syntax and structure check for a set of captured messages.

  • http://www.nist.gov/medicaldevices


1073 dim xml schema

1073 DIM XML Schema

  • XSchema

    • NIST can capitalize on use of the XSchema by having one schema for both tools (ICSGenerator and ValidatePDU).

      • Since the XSchema is growing substantially in size, NIST needs to verify it's utility before proceeding…

    • The (future) extension of the 1073 DIM model…

      • Verify that XSchema work is useful to capture the relationship among the objects.

    • Use by other efforts (e.g., IHE PCD tooling, IEEE 1073 standard development…)

      • Obtain feedback regarding the utility of the NIST DIM XSchema development work.


Questions

Questions

  • Is the flow presented in the diagram (slide 7) a valid interpretation of how an IHE Message profile is generated from the IHE Technical Framework (and 1073 representation)?

  • When will the IHE/PCD HL7 v2.x message profiles in XML format be created?

  • In addition to Message Maker source of data, what additional data sources (if any) are available to populate the test messages?

    • What data from ICS-Generator could be used to populate the test messages? Specifically for the year one initiative, if any?

  • The diagram presented represents a one way flow from device (1073) to HL7. Thoughts on flow in the direction from HL7 formatted messages into a 1073 representation?

    Related Longer Term Effort

  • A testing framework is needed to utilize these test messages to examine the behavior of the implementations.


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