dr. sungkee lee dr. il-kon kim todd cooper daegu connectathon daegu connectathon 2011.07.11 – 15...

Dr. Sungkee LeeDr. Sungkee LeeDr. Il-kon KimDr. Il-kon KimTodd CooperTodd Cooper

Daegu ConnectathonDaegu Connectathon

2011.07.11 – 15

Report to Report to IHE InternationalIHE International

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IHE-Korea @ DaeguConnectathon 2011

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Event @ Computer

Science Lab @

KyungpookNational

University!

Overview: Managers / Monitors:

Dr. Sunkgkee Lee Dr. Il Kon Kim Todd Cooper

Dates: 2011.07.11 – 2011.07.15 (5 full days) Companies & Systems

9 Participating Companies 17 Different Systems / Software Applications 2010: 4 Companies & 7 Systems - > 100% increase!

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IHE-Korea Daegu 2011General Review

PHD Devices

PHD Manager u-Health Serveru-Health Server

EMR/HISEMR/HIS

ISO/IEEE 11073 PHD

PCD-01

PHMR

Home/Mobile WAN

(DEC)

WAN(XDS.b)

XDS-MS

Note: Out-of-Scope for Testing


Overview: Profiles:

2nd Year: CT, DEC “WAN” 1st Year: XDS-MS & XDS.b (R’s only) –

Very High Mountain to Climb! Additional CDA documents:

Personal Health Monitoring Report (PHRM) – not an IHE profile … yet

Planned but … next year! ATNA

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General IHE-K 2011 Connectathon Info @ftp://ftp.ihe.net/International/Korea/2011_Connectathon/

Test results @…/2011_Connectathon/Connectathon/TestResults

Validated CDA Documents @…/2011_Connectathon/Connectathon/CDA_Samples _Validated

Validated message exchanges @…/2011_Connectathon/Connectathon/DEC or /XDS.b

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IHE-Korea Daegu 2011PCD “DEC” / WAN

Samsung ElectronicsINFINITTUCareSoft

Samsung ElectronicsSKTelecomSoftNet

PHD Specializations:

• Blood Pressure• Glucose Monitor• Weighing Scale

Data Observation

Consumer (DOC)

Device Observation

Consumer (DOC)

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IHE-Korea Daegu 2011PCD “DEC” / WAN

Testing overview: NIST Tools:

Static message validation for all exchangeshttp://xreg2.nist.gov:8080/PCD-HL7WebCon/

Incorporated IHE-K OIDs & Patient Demographics Incorporated support for Personal Health Device (PHD)

specializations Added support for SOAP envelope “stripping” & XML

escape sequence translation in HL7 v2 messages Note: Disconnect test not used for WAN testing

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IHE-Korea Daegu 2011DEC PCD-01 Results

PCD DEC profile testing

… 100% successful!

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Serious “meeting of

the minds” …

Dr. Lee

Hyoungho Do

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Happy group upon

completion of PCD DEC

testing!

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IHE-Korea Daegu 2011PCD “DEC” / WAN Testing overview:

Issue – WS-Addressing: Used xdstools2 “Message Validator” to check SOAP envelope

(http://ihexds.nist.gov:9080/xdstools2/) Showed that WS-Addressing soapenv:Header missing Participants said that this is a difference between IHE ITI &

PCD Web Services specification & Continua Health Alliance’s specification … under investigation

Problem said to be primarily in implementation platform differences between Java EE / Linux & Microsoft .NET

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IHE-Korea Daegu 2011CDA: XDS-MS & PHMR

Testing overview: Participating Companies:

Content Creators: 5 Content Consumers: 5 (View option only)

CDA Profiles XDS-MS (Discharge): Cross-Enterprise Document

Sharing – Medical Summary – Discharge Summary Option Document

PHMR: Personal Health Monitoring Report Document

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IHE-Korea Daegu 2011CDA: XDS-MS & PHMR Testing overview:

NIST Tools: Used “CDA Guideline Validation” tool @

http://xreg2.nist.gov/cda-validation/validation.html Supports CDA R2 + IHE XDS-MS profile validation Added support for Personal Health Monitoring Report

(PHMR) validation – not currently an IHE profile Content Validation

Content specified by IHE Korea & Validated by Inspection

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IHE-Korea Daegu 2011XDS.b Testing

UCareSoft[NIST Korea]

ezCaretechGNSKINFINITTInsungMedical Standard

Only Integrated Repository

ezCaretechGNSKINFINITTInsungMedical Standard

2012

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Testing overview: Overview

Actors: Consumer, Registry & Integrated Repository TLS used for all transactions (ITI-18, -42 & -43) PIX/PDQ Manager for 2012

NIST Tools: Used special configuration of xdstools2 for Korea @

http://ihexds.nist.gov:9080/xdstools2k/ NIST Registry used as 2nd actor instance NIST PIDs generated using “xdstools” allocate service

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Testing overview: Testing process:

All systems passed static Message Validator testing All systems showed TLS link (via logs) Transactions tested: ITI-42, ITI-18 & ITI-43 Validated CDAs registered & retrieved

Tests not performed: homeCommunityID not supported (2012) Error handling tests not performed (also only partial could be

supported given Integregated Repository)

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XDS.b group

… after working

through the night,

smiles well deserved!

Drs. Kim & Lee

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IHE-Korea Daegu 2011XDS.b Results

　Repository

Registry ezCareTech GNSK Infinitt InsungInfo MedicalStandard

NIST Registry TLS TLS TLS TLS TLS

UCareSoft TLS TLS TLS TLS TLS

　 Repository

　 GNSK Infinitt MedicalStandard

ConsumerNIST

Registry UCareSoftNIST

Registry UCareSoftNIST

Registry UCareSoft

ezCareTech TLS TLS TLS TLS TLS TLS

GNSK 　　 TLS TLS TLS TLS

Infinitt TLS TLS 　　 TLS TLS

InsungInfo TLS TLS TLS TLS TLS TLS

MedicalStandard TLS TLS TLS TLS 　　

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Testing overview: TLS Certificate issues

Generating & installing to enable NIST TLS links Converting for use on both Java EE & Microsoft .NET Conversion tool: OpenSSL (from www.OpenSSL.org)

Patient Identifier issues: UCareSoft Registry used same PIDs as CDA & PCD DEC NIST PIDs had to be generated using xdstools service No PIX/PDQ Manager support made initial NIST Registry

configuration difficult

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Testing overview: Profile Validation Test Requirements Issue:

Test requirements embedded in Gazelle Connectathon tool – Not used in Korea due to small size & training

Tool hard to use – e.g., interaction is slow, printing test definitions works sometimes … not other times

Process for validating validation test suite not well defined Tool troubleshooting issues:

Should have set up remote tool (xdstools) access – would have saved time that could have been used for testing!

IHE-Korea Daegu 2011Showcase Plan

IHE Korea Showcase opportunities … KOSMI (Korean Society of Medical Informatics)

Fall Conference Oct. 2011

Korea Health Congress 2011 KHA (Korean Hospital Association) Nov. 2011

KITHA (Korean Information Technology of Hospital Association) Fall Conference Nov. 2011

IHE-Korea Daegu 2011Use Case Scenarios

Target Use Case Scenarios Meets needs of end users + participants

National u-Health Project Personal Health Focus

u-Health <Chronic Health> Services: Diabetes (primary target for 2011)

PHM glucose monitor reading to u-Health ServerReport sent to primary care physicianPhysician creates and publishes health summary (a.k.a. CCD)

COPD (anticipated 2012 or later) Cancer (anticipated 2012 or later)

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IHE-Korea 2012 Connectathon? Under Consideration for 2012 Connectathon:

Enhanced tools: Open source implementations (e.g., from Open Health

Tools, Microsoft, etc) Local copies & implementation of NIST XDS tools Possible use of Gazelle for Connectathon management

CDA Documents: Add Referral Option? Add Korea-Specific Documents? Support for more Consumer Actor “Import” Options

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IHE-Korea 2012 Connectathon?

Under Consideration for 2012 Connectathon: XDS.b & Related Services:

ATNA (Audit Trail / Node Authentication) Security Profile Document Repository & Consumer options to support full Registry

validation (e.g., document replacement and folder management)

Document Source – as a separate actor? Patient Identity Source (e.g., PIX/PDQ Manager)?

Imaging Support Profiles (e.g., XDS-I) Patient privacy, Cross Community Access + Discovery

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IHE-Korea Daegu 2011Special Thanks

Special thanks to those who made the 2012 IHE Korea Connectathon a success! U.S. Expert Support:

John Garguilo & Julian Deshayes (NIST) – PCD tooling Bill Majurski (NIST) – XDS.b testing support (incl. xdstools2K –

Public version for Korea!) Andrew McCaffrey (NIST) – CDA PHMR Test Tools Steve Moore (WUSTL) - Testing req’s + CA certificates

Daegu Support: Hyoungho Do (KNU) – Worked through the night!

Let’s get started!Let’s get started!

Find out more at www.ihe.netFind out more at www.ihe.net

dr. sungkee lee dr. il-kon kim todd cooper daegu connectathon daegu connectathon 2011.07.11 – 15...

Documents

ihe korea

ihe international

testingihekorea daegu

pcdhl7webconincorporated

general reviewgeneral

ihe profile yetplanned

xdsms xds

wan testing overview