hl7 april meeting - toronto 1999

HL7

HL7 April Meeting, Toronto, 1999 1

HL7 April Meeting - Toronto 1999

HL7 Standards Development

in

Australia / New Zealand

- an Update

Dick Harding / Klaus Veil

HL7

HL7 Meeting - Orlando 1999 2

Who’s here?

Dick Harding Orders/Observations

David Rowed MnM

Patient Care / Comm. Health

Klaus Veil PAFM V2.3.2

Data Warehousing

Publishing

HL7


Background Information

In Australia, standards are created by “STANDARDS AUSTRALIA (SAA)” - a government-supported organisation representing all stakeholders.

The Australian Federal and State Govts. often elevate Standards created by SAA to legislation level.

These standards have achieved widespread acceptance in Australia & New Zealand.

HL7


SAA HL7 Working Groups

C lin. Pa thologyO rders & R eports

"AS4700.2"

D rug Prescriptions

"AS4700.3"

R eferra l Messa ges

tbd

Pa tient Adm inistra tion(IT /14/6/3)

"AS4700.1"

HL7


Patient Administration

Standard is based on HL7 Chapter 3 (AS4700).Currently being revised to match HL7 V2.3.1.

• This standard has become the accepted way of implementing Patient Administration messaging in Australia/New Zealand.

• Fully endorsed by Australian Government.

HL7


Clinical Pathology

Pathology Orders and Results (AS4700.2):• Covers parts of HL7 Ch. 4 & 7.

Currently being revised to match HL7 V2.3.1.Need for an extended Order Message (ORM)

for referrals has been identified.Proposal has been submitted to the Orders/Ob-

servation TC for consideration at this Meeting.

HL7


The proposed Expanded ORM

ORM^O01 General Order Message ChapterMSH Message Header 2… [{NTE}] Notes and Comments (for Header) 2… PID Patient Identification 3 [PD1] Additional Demographics 3

… [PV1 Patient Visit 3 [PV2]] Patient Visit- Additional Info 3… [{AL1}] Allergy Information 3… ORC Common Order 4 ... Order Detail Segment OBR, etc. 4 [PID Patient Identification - previous result 3

[PD1]Additional Demographics - previous result 3

[PV1

Patient Visit - previous result 3

[PV2]]Patient Visit – Add. Info - previous result 3

[AL1]]Allergy Information - previous result 3

… [ORC] Common Order - previous result 4 OBR Order Detail - previous result… OBX Observation/Result 7…[BLG] Billing Segment 4

HL7


Drug Prescriptions

Australian Standard for Drug Prescriptions (AS4700.3) is ready for publication:• formal modelling approach.• 8 data entities• 76 transaction types• collapsed into 19 HL7 messages

New Zealand has adopted AS4700.3 as an NZ Standard.

HL7


Referral Messages

Currently being re-established:• Chair: David Rowed• New scope being defined.

HL7


Govt. Standards Policy

Comprehensive broad-based study on national requirements (Andersen Cons.) focusing on:• Health eCommerce.• Digitisation & Consolidation of Patient Inf.• Aggregation and feedback of information into

the Health System,• Privacy, security and access

Steering Committee to issue recommendations later this year.

HL7


Australian HL7 Participation

PAFM V2.3.2 Naming Work Group:• Moderator: K. Veil• Scope: To internationalise the V2.3.2 ("XPN").• Brief fulfilled.• Proposal prepared for PAFM 2.3.2 Meeting this

week.

Expanded Order MessageRIM Harmonisation Meeting as observer.… normal HL7 Meeting attendance.

HL7


RAPID Specification

Redevelopment ofAcute and Psychiatric Information Directions

Covers entire Australian state of Victoria

HL7


RAPID Components

Three main components• Mental Health Operational Data Store (ODS)• Mental Health Patient Management feeder

system• Data Warehouse

HL7


RAPID Coverage - Data Warehouse

Acute admitted episodes Elective Surgery (waiting / booking list) EmergencyAged CareAmbulance

HL7


RAPID Messaging

HL7 based• ADT/ACK

– A01, A02, A03, A04, A08, A11, A12, A13, A21, A22, A24, A31, A37, A45

• ORU/ACK– R01

• QRY/ADR– A19

• MFN/MFK– M02, M05

HL7


RAPID Issues with HL7

AliasesAddress (suburb is coded in “other

designation” subcomponent) Financial information (implemented as a Z-

segment) Legal status (implemented as a Z-segment) “Leave of absence”

HL7


RAPID Doctor Master File

RAPID relies on a centrally-maintained doctor master file!

• That is, thousands of instances of a single Doctor master file for the whole State of Victoria.

• Synchronisation by MFN messages

HL7


Central Registries

Notifiable diseases and conditionsVaccinationBreast Screening Pap smearDangerous Drugs etc etc . . .

HL7


Central Registries - Early Stages

Support from all StatesRecently commenced Limited HL7 planning to date

HL7


Central Registries - Issues with HL7

Defining Doctors (particularly Doctors in private clinical practice)

• Address• Nature of role of various Doctors involved• We notice similar limitations in Australian

Pharmacy and USA Center for Disease Control• RAPID avoided problem with Doctor master

file

Consistent definitions of what data is required

HL7


Other Australian Developments

Community Health (CHIME, CHIS, etc.)Aust. Government has commited support for

attendance at all HL7 Meetings in 1999!

HL7


New Zealand Developments - 1

Currently re-establishing its position as International Affiliate.

May send a delegate to next HL7 Mtg. HL7 well-established in NZ:

• Central PMI accessed via HL7.• >60% of clinical pathology results are sent

electronically using HL7.

NZ has adopted the Australian Drug Prescrip-tion standard as a NZ standard.

HL7


New Zealand Developments - 2

New Zealand sent 2 delegates to TC215 Meeting in Berlin two weeks ago:

• Modelling WG• Messaging WG

NZ International involvement will be via:• ISO TC 215• Standards Australia

Funding currently being investigated.No activity on NZ Z-segment register.

HL7


Find out more about HL7 Australia at:

http://OurWorld.CompuServe.com/Homepages/KVeil

Thank You!

hl7 april meeting - toronto 1999

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