1 an hl7-centric immunization registry presented by kevin davidson qs technologies
TRANSCRIPT
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Enter HL7
An international standard for the exchange of health information
Designed for unlike systems to communicate through a standard format
"HL7”, "Health Level Seven," and the puzzle design are registered trademarks, and the HL7 design is a trademark of Health Level Seven, Inc.
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Implementation Guide for Immunization Data Transactions using Version 2.3.1 of the
Health Level Seven (HL7) Protocol
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MSH|^~\&||MA0000||GA0000|199705221610||VXR^V03^V03|19970522MA53|T|2.3.1|||NE|AL|<CR>MSA|AA|19970522GA40|<CR> …PID|||1234^^^^SR^~1234-12^^^^LR^~3872^^^^MR~221345671^^^^SS^ ~430078856^^^^MA^||KENNEDY^JOHN^FITZGERALD^ JR^^^L|BOUVIER ^^^^^ ^M|19900607|M|KENNEDY^BABY BOY^^^^^^B|2106-3^WHITE^HL 70005|123 MAIN ST^APT 3B^LEXINGTON^MA^00210^ ^M^MSACODE^MA 034~345 ELM ST^^BOSTON^MA^00314^^BDL~^^^^^^BR^^MA002||(617) 555-1212^PRN^PH^^^617^5551212 …
Actual HL7 Message
HL7 messages are not designed for humans, but machines like them Segmen
t
Field
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HL7 Message Types for Immunizations
VXQ – Query for Vaccination Record VXX – Response with Multiple Matches VXR – Response with Vaccination Record VXU – Unsolicited Vaccination Update QCK/ACK – Acknowledgments ORU – Unsolicited Transmission of an
Observation (used for VAERS) ADT – Admit / Discharge / Transfer
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VXX – Response with multiple matches
JimmySmith 1
JimmySmith 2
JimmySmith 3
JimmySmith 4
JimmySmith 5
JimmySmith 6
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VXR – Response with Vaccination Record
Patient demographics
Identifiers
Vaccination history
Adverse events
Contraindications
Recommendations for shots due
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VXU – Unsolicited Vaccination Update
Use to add new individual immunizations to the registry
Use for mass loading from other systems
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ADT – Admit / Discharge / Transfer
ADT Messages can be used with legacy hospital and billing systems
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Database
Problems with Legacy Databases
Do not provide ways to store all the possible information in an HL7 message
Data fields have to be used in ways not originally intended
Database
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Problems with Legacy Code Sets
Legacy Code Sets may not capture HL7 Coded Data completely.
Translation tables are hard to maintain.
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The Need for Speed
Relational Database Server
One or Many HL7 Application Servers
Web Server &Traffic Manager
HTTPSHL7 LLP
ADO
•Multi-tasking
•Scalable
•Lightweight Protocols
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External Interfaces
HL7 Pipe
WebApp
Server
SSL
HTTPSInterface
Email?ebXML?
Batch(FTP)
InternalSystem
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Good designs are easier to implement
Standards encourage completeness
Standards encourage modular design
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Good designs are easier to implement
Standards encourage completeness
Standards encourage modular design
Standards reduce false starts
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High-Level Design Decisions
Decide what HL7 Messages to Support VXQ, VXR, VXX, VXU, ACK, QCK plus ORU
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High-Level Design Decisions
Decide what HL7 Messages to Support VXQ, VXR, VXX, VXU, ACK, QCK plus ORU
Select HL7 Mapping Tool (or write one) iNTERFACEWARE Chameleon
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High-Level Design Decisions
Decide what HL7 Messages to Support VXQ, VXR, VXX, VXU, ACK, QCK plus ORU
Select HL7 Mapping Tool (or write one) iNTERFACEWARE Chameleon
Select Development Tools
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High-Level Design Decisions
Decide what HL7 Messages to Support VXQ, VXR, VXX, VXU, ACK, QCK plus ORU
Select HL7 Mapping Tool (or write one) iNTERFACEWARE Chameleon
Select Development Tools
Select Client Technology 100% HTML for widest acceptance
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Open Issues
Transport Mechanisms
Digital Signatures (PKI)
Deduplication Interface
Query Improvement
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Open Issues
Transport Mechanisms
Digital Signatures (PKI)
Deduplication Interface
Query Improvement
Coordinating Business Rules between Registries – Minimal Data Quality
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Conclusions
You can do everything you need to do using HL7
It performs well
It is scalable
Developers are productive
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Start With HL7
The project goes much better if you start with HL7 rather than trying to add it on at the end.
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Resources National Immunization Program Registry Page
http://www.cdc.gov/nip/registry
Health Level Seven http://www.hl7.org
Committee on Immunization Standards and Electronic Transactions (CIRSET) http://www.cirset.org
QS Technologies Immunization Registry information http://www.immregistry.com