applications of xml in the nhs
DESCRIPTION
Applications of XML in the NHS. Paul Woolman Standards Program Manager ISD. Contents. XML for: Patient Records Publishing Communications. Patient records. Store clinical information as XML Structured documents Case notes Discharges Referrals Summary documents Structured data - PowerPoint PPT PresentationTRANSCRIPT
Applications of XML in the NHS
Paul WoolmanStandards Program ManagerISD
Contents
XML for:Patient RecordsPublishingCommunications
Patient records
Store clinical information as XMLStructured documents
Case notesDischargesReferralsSummary documents
Structured dataXML data model
Information storage
XML as the format for authoring and storage of documentsRather than Word .Doc, Rich Text Format,
TextClinical documentsMetadata (description of documents)Latest Office applications (MS, SUN, Open)
Examples
Graphnet CSW OfficeAnaesthetic records…Next 4 slides…
Office applications
MS office, Sun, OpenOffice
store & use XML documentsInfopath forms client
Supports web services & XMLBuild forms from xml schema
Replacing Paper Forms
pre-opinstructions
Patient info
Case typepre-op
assessment
post-op instructions
labtest
results
Pasting a Theatre List
Client Behaviour
XML SAX Writer
XSLT Transform
(Optional)
XML Signature & Encryption
SOAP
Message
XML SAX Handler
XSLT Transform
(Optional)
XML Signature & Encryption
SOAP
Message
server
Web Server(IIS)
RequestHandlers
SCI Store
DatabaseObjectsASP
PagesBrowser(IE5.5)
.NetFramework
RequestHandlersRequest
HandlersWebService
3rd PartyApplication
LogLog
Handler
Contents
XML for:Patient RecordsPublishingCommunications
Publishing
Document Metadata
Data about data…descriptions eg keywords
Descriptive headings about documentsUseful for filing, searching and
cataloguingE-Government metadata standardHL7 Clinical Document Architectureneed NHS Scotland standards
SHOW & NELH
Main NHS portalsHTML pages need manual updatingXML data storageXML -> HTML in active server pagesAdvantages:
Many views of single dataSupport clinical networksSupport automated query tools
NHS Data Dictionary
Data definitions on webXML export selected definitionsUML models designing XML schema &
refer to data definitions.
New dictionary to tie all three together
Contents
XML for:Patient RecordsPublishingCommunications
Communications
Electronic Data Interchange
Moving data from one computer to another
Eg Patient referral from GP to hospitalReplace older formats eg EDIFACTNew forms of EDI with user interactionXML allows Graceful Degradation
View messages if required
GP records exchange
Patient moves house or changes GPRecords follow 4+ weeks laterElectronic exchange is quickerGPASS early implementations ongoing
NHSScotland GPEX
GPASS specific messageGP exports XML document to PSDPSD send off to new GP & update CHINew GP selectively imports record into
new GPASSCurrently in early implementation sites
Scottish Birth Record
Replaced SMR for birthsAdded clinical informationMake useful to clinical care Rolled out to all maternity units
Concept
Single web site in NHSnetBrowser input from maternity unitsLink to PAS’sLink to new maternity systems
Reduce data duplicationLink to CHI
Give baby new CHI number at birth
Scottish Child Health Information Development (SCHID) Project
Want more information? www.show.scot.nhs.uk/sbr alternatively tel: 0131 551 8046
Example of Hospital Data-flows
Patient ID and demographics
Clinical data
PAS
SBR
CHI/UPI
Paper
Other Child Systems
Clinical System
INTERNAL
EXTERNAL
INTERNAL AND EXTERNAL
Use of XML
CHI linkMaternity systemOngoing development
Community Health Index (CHI)
Mainframe application Green screen terminal inputNeed machine EDI input & query
Concept
Casablanca XML to VMS transform application
NHS Standard XML SchemaWeb serverHTTPS and XML input to active server
pages
XML messages
Register new patientFind patientResponses
SCI integration
SCI Store – every health boardLabs systems – feed into Store E-Biz 2000 middleware & XML
XRay Labs PAS otherGPASS
practicenon-GPASS
practicecommunity/MH system
Id XRay Lab1..xx OK 3.2OK 3.2
SCI Store
OK 3.2
communitypharmacy
Test requests and results reportingTo achieve this SCI first has to integrate
existing hospital systems and re-assemble the patient’s information in a
new system called SCI Store
SCIIntegration
SCI web services
Electronic Transmission of PrescriptionsReferrals to outpatientsSCI Gateway
David Brazier this afternoon
E-Care
Shared care records between health, social services, education and others
Eg Shared AssessmentsElderlyMental healthchildren
Single Shared Assessments
Lots of work on data and definitionsBased on paper versionsInitiated by any partyInvolves patient/client and
relatives/carersInvolves independent sector
Eg churches, voluntary orgs.
Concept
Server in demilitarized zoneXML integration to health systemXML integration to social work systemBrowser input
E-care store
Central data storeMultiple identifiers – CHI, Hospital nos.,
social work numbersXML Web Services for data exchange
Virtual EHR portal
Pull data from distributed systemsRearrangePresent to viewer
NHSnet
Education??Education??
LA net
parent/child+ smartcard
parent/child+ smartcard
GP SBR SIRS School SNS
NHS systemsNHS systems
Internet
Integrated Children’s Services RecordHealth Care Personal Record
Name: Alerts:
Demographics:
Carer: Allergies:
GP:
Teacher: Health Problems:
Social Worker:
Child Protection Status:
Medications:
Section of register:
Special Needs Status: I mmunisations outstanding:
Health Care Personal Record
Name: Alerts:
Demographics:
Carer: Allergies:
GP:
Teacher: Health Problems:
Social Worker:
Child Protection Status:
Medications:
Section of register:
Special Needs Status: I mmunisations outstanding:
Health Care Personal Record
Name: Alerts:
Demographics:
Carer: Allergies:
GP:
Teacher: Health Problems:
Social Worker:
Child Protection Status:
Medications:
Section of register:
Special Needs Status: I mmunisations outstanding:
Health Care Personal Record
I nterventions:
Health:
Social Work:
School:
Health Care Personal Record
I nterventions:
Health:
Social Work:
School:
Health Care Personal Record
Name:
Who lives with me:
I nterests:
Treatments used outwith health service:
Special I nf ormation you may want to know about me:
Health Care Personal Record
Name:
Who lives with me:
I nterests:
Treatments used outwith health service:
Special I nf ormation you may want to know about me:
CH System
Social CareSocial Care
Health Care Personal Record
Name: Alerts:
Demographics:
Carer: Allergies:
GP:
Teacher: Health Problems:
Social Worker:
Child Protection Status:
Medications:
Section of register:
Special Needs Status: Immunisations outstanding:
Health Care Personal Record
Interventions:
Health:
Social Work:
School:
Health Care Personal Record
Name:
Who lives with me:
Interests:
Treatments used outwith health service:
Special Information you may want to know about me:
‘Virtual’ EHR Model
EPR
Acute
EPR
Commun
EPR
MH
‘EPR’
GP
A&E OoH NHS24GP
Patients
XML web views of systems
Portal
NHSnet - a fully distributed Data Web
End-user client
DataPublishers/owners
The Semantic NHS Web
Web Browser
EHR Store Mk 1.xDemographicsAccess rightsPointers
EHR Gateway
SCI Gateway Discharge
Local systems
e-Care Stores
SCI Stores via web services
CHI and child health systems r
SCI-DC
SHOW2Web service
Terminology; Definitions; Schema; Services
- NHS Dictionary and Grammar
