1. Dr Kevin O’Carroll, Standards & Technology Manager, Health Information and Quality Authority Health Information Standards and the Health Information and Quality Authority
11. GPMS - Segments ERR (message error) OBX (observation result) MSA (message acknowledgement) OBR (observation request) SAC (specimen container detail) NTE (notes and comments) RF1 (referral information) DG1 (diagnosis) ORC (common order segment) PRD (provider data) AIL (appointment information – location resource) PV2 (event type additional information) SCH (scheduling activity information ) PV1 (event type/ patient visit) AIP (appointment information – personnel resources) EVN (event RGS (resource group) PID (patient identification) PDA (patient death and autopsy) MSH (message header)
12. GPMS – Clinical Scenarios Use Case: A laboratory receives a specimen and analyses the specimen. When a result is available this is communicated to the healthcare practitioner responsible for ordering the investigation or to the healthcare practitioner to whom a copy has been requested to be sent. Describes the use case, messaging interaction , minimum abstract message definitions and constraints
13. GPMS – clinical scenarios Describes the use case, messaging interaction, minimum abstract message definitions and constraints
14. GPMS – Message flows Corrected result Unsolicited radiology result Unsolicited laboratory result Laboratory order Death notification Referral and response Administrative discharge Waiting list notification Clinical discharge summary Outpatient department summary Admission notification Cooperative discharge summary Emergency department attendance
22. Laboratory Orders The National Laboratory Medicine Catalogue (NLMC): Editorial Principles
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24. Other projects inventory of all health and social care data sources semi structured interviews to identify themes to develop standards Draft standards for consultation (immanent) Final standards for health information source Health Information Sources Information Governance toolkit Information Governance Guidance Information Governance SNOMED CT, HL7, IHE Workshops ISO 27527 Healthcare practitioner and healthcare organisation identifiers ASTM-E1714, ISO 22220 Individual Health Identifier Standards Projects
27. HPI & HOI International Standards Organization Technical Standard 27525
28. Workshops Dublin 30 June 2009 Health Information Standards Dublin 18 November 2009 An introduction to SNOMED CT Cork 27 January 2010 An introduction to SNOMED CT Dublin 17 November 2010 Health Level Seven (HL7) v2 and v3 Cork 9 March 2011 Health Level Seven (HL7) v2 and v3 Dublin 16 Nov 2011 Overview of Healthcare Interoperability Standards Location Date Workshop Title
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Editor's Notes
Not just a regulator for when things go wrong but promote health and social services excellence by delivering a structured programme aimed at identifying and sharing good practice, building capacity and capability
Paper and Electronic formats In paper – common language exists, information usually transferred as letters/prescriptions, structure may be defined and agreed – UK In electronic world – different languages within organisations and across care settings. GP practices there are 4 different practice management systems and in hospitals greater number considering laboratories, Radiology departments, out patients, wards want to communicate Need to define the structure before messaging starts
The GPMS standard specifies the structure and content of electronic messages transmitted to and from GP practices . defines a set of building blocks for messages; know as message segments, which may be reused when constructing messages. A total of 20 segments are detailed and are listed below. The patient identification segment , which is used to carry patient demographic and identification information, consists of 38 fields . The fields have been taken directly from the HL7 v2.4 standard. Each individual field in a building block must adhere to certain rules as defined in the GPMS.
Segments are used to construct messages specific to clinical scenarios e.g. Emergency Department attendance, Laboratory results. Clinical scenarios use different combinations of the building blocks to create the required message. The Authority’s GPMS details the messages required for 13 clinical scenarios, also known as message flows. For each of these scenarios it identifies the actors , triggers and the structure and content of the message used to transmit relevant clinical information using a use case, messaging interaction diagram, minimum abstract message definitions and constraints
Draft dataset developed after consultation Public consultation process 86 responses Qualitiative Quantative – 330+ alterations Process Study in Denmark has shown that electronic GP referrals can lead to a) a faster referral process b) reduction in the loss of referrals c) can be more cost effective for both GPs and hospitals
Requirements to develop a national code set for tests currently being ordered by GPs using Healthlink online Assessed suitability of LOINC & SNOMED
Requirements to develop a national code set for tests currently being ordered by GPs using Healthlink online Assessed suitability of LOINC & SNOMED
A formal, distinct, and unique 6-part name is given to each term for test or observation identity.1 The database currently has over 58,000 observation terms that can be accessed and understood universally. Each database record includes six fields for the unique specification of each identified single test, observation, or measurement: Component- what is measured Glucose post 100g oral bolus dose Kind of property- characteristics of what is measured , such as length , mass , volume, time stamp and so on Time aspect- interval of time over which the observation or measurement was made System- context or specimen type within which the observation was made (example: blood, urine,...) Type of scale- the scale of measure. The scale may be quantitative, ordinal, nominal or narrative Type of method- procedure used to make the measurement or observation
A central directory, which becomes a single up to date authoratitive source of information regarding healthcare professionals and healthcare organisatation offering services in the health and social care sector. The sources are professional regulatory authorities and other ICT systems which maintain data on professionals and organisations. The consumers of the central directory include those who require an element of the UHI for Healthcare Practitioners or Organisations data for identification, publication, research or other such purposes. These include National Health Information sources, ICT projects, Service planners ISO 27527 International standard, progress from a draft to a full standard over the lifetime of this project, have fed back our requirements into the development project. At its simpiest it is a document which details the pieces of information which should be collected regarding practitioners and organistion to safely and uniquely identify them We took this standard and thru a survey and working with our advisory group members assessed the impact of adopting the standard. In the report we are recommending adopting the standard with three national adaptations. in the case of healthcare practitioners the field of practice section as mentioned above, the regulatory bodies do not collect this information. The Authority suggests adapting the standard and instead track the data that is currently collected which is the date on which the healthcare practitioner registers with their professional regulatory authority not the date on which they began to practice in a certain field. individual biometric identifiers are ‘required’ for the ISO/TS 27527. Biometric identification is only in its infancy in Ireland, the standard will be adapted to by changing the biometric identification data field as optional. looking at healthcare organisations, the Irish adaptation will include an additional directory record, which will include the services and functions that healthcare organisation provide.
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