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Adapting Vendor Clinical Systems for Real-Time Registry Participation Using HL7

Adapting Vendor Clinical Systems for Real-Time Registry Participation Using HL7. By Kevin Davidson, MS QS Technologies National Immunization Registry Conference Atlanta, GA, October 28,2003. Stakeholders Meeting. Gather requirements and expectations Select standards and protocols

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Adapting Vendor Clinical Systems for Real-Time Registry Participation Using HL7

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  1. Adapting Vendor Clinical Systems for Real-Time Registry Participation Using HL7 By Kevin Davidson, MS QS Technologies National Immunization Registry Conference Atlanta, GA, October 28,2003

  2. Stakeholders Meeting • Gather requirements and expectations • Select standards and protocols • Assign responsibilities • Set project timetable

  3. VXU HTTPS VXR VXQ Trading Partner Agreement • HL7 messages • HL7 data fields • Transport protocol • Business rules VXX QCK ACK

  4. Design Goals • Transparent to the user • No double entry • Don’t make the user wait • Control costs • Deliver on time

  5. Adapting the Software

  6. Registry Interface User User Interface • Trigger events • User decision points • Integration with medical record • Problems and exceptions

  7. Trigger Events • Registering a new patient • Changing Demographic Info • Resolving Multiple Matches • Changing the Immunization Record • Retrieving Demographic Info

  8. User Decision Points • Is it the same child? • Is it the same child? • Is it the same child?

  9. Resolving Multiple Matches

  10. Integrate with Medical Record • Vaccine • Lot Number and Manufacturer • “Opt In” / “Opt Out” • Distinguish between immunizations the provider gave and history from the registry.

  11. Integrate with User Interface

  12. Problems and Exceptions Request retransmission What went wrong?

  13. Technical Design Principles • Minimize changes to vendor software • Isolate HL7 and communications • Control, monitoring, debugging and logging functions

  14. Database Interface The clinical software just reads and writes database tables • Off-the-shelf technology • Isolates HL7 and communications • Works with both n-tier and host-based systems. • Supports mixed platforms • Asynchronous

  15. Control, Monitoring, Debugging

  16. VXU HTTPS VXR VXQ Testing • HTTPS protocol • HL7 messages • Round-trip data quality • Performance

  17. The Registry Side Registry business logic has a significant impact on its ability to participate in automated HL7 interfaces. Interoperability

  18. Registry Business Logic • Search algorithm • Exact Vs inexact • Browsing • Unique Identifiers • Code assignment

  19. Watch Out! • Just because it doesn’t blow up, doesn’t mean it’s working right! • Don’t store an immunization when none was given! • Deletes • Vaccinations Refused • Contraindications • Opt-out • Deceased patients

  20. Findings • A vendor system with robust Immunization capability can be adapted to use HL7 without extensive re-engineering. • User’s don’t have to be burdened by the interface. • A thorough understanding of the Registry’s business logic is necessary at the outset.

  21. End of Presentation For additional information email info@immregistry.com No actual patients were harmed during the development of this interface.

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