page 1 implementing hcfas esrd e-reporting with hl7 v3 xml cleveland, may 22-26, 2000 © 1997-2000...
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
End Stage Renal Disease (ESRD)http://www.hcfa.gov/medicare/esrdpage.htmhttp://www.hcfa.gov/quality/qlty%2D5d.htm
Standard Information Management System (SIMS)http://www.simsproject.com
http://www.esrdnetwork6.org
Vital Information Systemto Improve Outcomes in Nephrology (VISION)
HCFA / ESRD E-Reporting based on HL7 v3 XML Technology
XML based Data Collection / ETL Toolsoon http://www.metaintegration.net/HCFA
Contacts @ HCFA Contacts @ Meta IntegrationCyrus Karimian [email protected] Bill Le Clair [email protected] Stricker [email protected] Christian Bremeau [email protected]
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HCFA ESRD Network SOWBackground
HCFA ESRD Network SOWBackground
• The Statement of Work (SOW) delineates the activities to be conducted by each End Stage Renal Disease (ESRD) Network Organization (Network) to meet the requirements of section 1881(c) of the Social Security Act; the Health Care Financing Administration's (HCA's) Health Care Quality Improvement Program (HCQIP); and other directives related to improving the quality of care of patients with ESRD.
• The statute, regulations, the ESRD Network Organizations manual, and other HCFA instructions provide additional detail concerning Network functions, activities, and responsibilities.
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HCFA ESRD Network SOWGoals
HCFA ESRD Network SOWGoals
• Improve the quality of health care services and quality of life for ESRD beneficiaries;
• Improve data reliability, validity, and reporting among ESRD providers/facilities, Networks and HCFA (or other appropriate agency);
• Establish and improve partnerships and cooperative activities among and between the ESRD Networks, Peer Review Organizations (PROs), State Survey Agencies, ESRD providers/facilities, ESRD facility owners, and professional groups.
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HCFA ESRD Network SOWInformation ManagementHCFA ESRD Network SOWInformation Management
• The Network shall be required to utilize theStandard Information Management System (SIMS)to support Network data processing, information management and reporting contractual requirements to HCFA.
• HCFA is redesigning the current Renal Beneficiary and Utilization System (REBUS).
• The new system will be named the Renal Management Information System (REMIS).
• The Network shall be required to utilize REBUS or REMIS as directed by HCFA.
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HCFA / ESRD / SIMSResponsibilities
HCFA / ESRD / SIMSResponsibilities
• The Network's responsibilities for data processing, information management and reporting are: – To have sufficient system capacity with the appropriate computer
hardware and software to carry out its contractual responsibilities;
– To effectively manage the collection, validation, storage and use of data, including data provided by HCFA, for review, profiling, pattern analysis, and sharing with the HCFA RO and State Survey Agency for use in its ESRD Medicare survey and certification activities;
– To ensure timely and accurate reporting by the providers/facilities;
– To maintain an ESRD patient and facility database and ensure the integrity and accuracy of the databases; and
– To ensure the quality and accuracy of the data submitted to HCFA for inclusion in the ESRD Program Management and Medical Information System (PMMIS) and the United States Renal Data System (USRDS).
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HCFA / ESRD / SIMS System Capacity
HCFA / ESRD / SIMS System Capacity
• The Network shall maintain a system that provides the capacity to meet its contractual responsibilities for data collection, validation, entry, retrieval, profiling, analysis, and reporting, and for electronic data interchange. The system, at a minimum, shall utilize and consist of the following: – SIMS software, and program documentation, for the entry and transmission of the
HCFA ESRD forms described in section C.5.E.; – HCFA approved software for the entry and transmission of clinical performance
measures described in section C.2.C.; – Internet enabled electronic mail capability compatible with HCFA, including the
ability to send and receive attachments; – Dial-in capability for connection to REBUS and HCFA compatible web browser
access for connection to REMIS; – Office automation software compatible with the HCFA standard;– HCFA supplied or other statistical software for data analysis and profile analysis
including profiling patients and facilities by county to facilitate disaster planning and other studies;
– Provisions for disaster recovery of the databases and data system; and– Sufficient hardware to run the above software applications.
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HCFA / ESRD / SIMSDatabase Management
HCFA / ESRD / SIMSDatabase Management
• The Network shall maintain a patient database containing the minimum/ critical data elements listed in the Draft ESRD Network Organizations Manual instructions. The Network shall perform the following tasks related to its patient database:
– The Networks shall consistently update the SIMS central repository based on data received from the providers/facilities. HCFA will receive a data feed from the SIMS central repository on a regularly scheduled basis to obtain an update of the Networks‘ patient data for REBUS/REMIS.
– Upon notification from HCFA either by hardcopy or electronically through REBUS/REMIS, update the Network's patient database with valid changes to important data elements (e.g., beneficiary name, date of birth, Health Insurance Claim Number (HICN) and Beneficiary Identification Code (BIC)).
• Through SIMS, the Network shall also maintain a facility database containing the minimum data elements listed in the Draft ESRD Network Organizations Manual instructions. HCFA has the capacity to create data files and labels, and to verify data for the national listing, directly from the SIMS system. HCFA will give the Networks two weeks notice prior to taking these actions so that Networks can properly schedule their system updates for the date the file is created.
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HCFA / ESRD / SIMSCollection, Validation & Maintenance of HCFA ESRD
Forms (Introduction)
HCFA / ESRD / SIMSCollection, Validation & Maintenance of HCFA ESRD
Forms (Introduction)
• The Network shall obtain completed HCFA ESRD forms from each ESRD provider/facility in the Network area. The Network will also include all voluntarily submitted forms from the non-Medicare Department of Veterans Affairs (DVA) facilities, and other institutions such as prisons and nursing homes. These forms contain patient specific information necessary for the operation of the national ESRD program. The HCFA ESRD forms and their facility computer generated equivalents include the following:– HCFA-2728-U4 - ESRD Medical Evidence Report Medicare Entitlement and/or
Patient Registration (completed on each incident ESRD patient);
– HCFA-2744 - ESRD Facility Survey (completed annually);
– HCFA-2746 - ESRD Death Notification (or computerized facility generated Death Notification form) (completed within 30 days of the date of death);
– HCFA-820 - In-Center Hemodialysis (HD) Clinical Performance Measures Data Collection Form; and
– HCFA-821 - Peritoneal Dialysis (PD) Clinical Performance Measures Data Collection Form.
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HCFA / ESRD / SIMSCollection, Validation & Maintenance of HCFA ESRD
Forms (VISION)
HCFA / ESRD / SIMSCollection, Validation & Maintenance of HCFA ESRD
Forms (VISION)
• It is anticipated the:Vital Information System to Improve Outcomes in Nephrology (VISION) project will be rolled out during this contract period, with National Implementation slated for the first quarter of calendar year 2001. However, until such time as the HCFA requires electronic reporting from all dialysis facilities for all patients, it will be on a voluntary basis. At that time, the Networks will be responsible for validating the data from the facilities.
• Monitoring the accuracy and completeness of reports, and the validation of facility-level patient data are critical roles in assuring the integrity of the patient tracking system. Similarly, capturing data forms on all incident cases requires a mechanism for cross-checking so facilities can query and detect unreported forms. As VISION is implemented, the activities specified below will need to be retained in a format that is consistent with migration from hardcopy to electronic reporting.
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HCFA / ESRD / SIMSCollection, Validation & Maintenance of HCFA
ESRD Forms (Activities)
HCFA / ESRD / SIMSCollection, Validation & Maintenance of HCFA
ESRD Forms (Activities)
• The Network shall conduct activities to ensure that the data required on the forms are collected, completed, and validated in accordance with Draft ESRD Network Organizations Manual instructions, and the ESRD Program Instruction Manual for Renal Providers. These activities include the following: – Review forms received for accuracy and completeness and return to the
provider/facility (or otherwise query the provider/facility) for correction or completion of those forms with missing or inaccurate data.
– Receive and process the ESRD Medical Evidence Report, Medicare Entitlement and/or Patient Registration form (HCFA-2728-U4).
– Process and transmit the information on HCFA-2728 and HCFA-2746 forms directly to the HCFA Data Center via SIMS.
– Process and transmit the information on the HCFA-2744 form directly to the HCFA Data Center via SIMS by the fifth working day in April.
– Transmit corrections on the HCFA-2744 form by hard copy or through SIMS by the third Friday in May.
– Maintain a file of all HCFA ESRD hardcopy forms that are processed for at least two years.
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HCFA / ESRD Data FlowThe big picture…
HCFA / ESRD Data FlowThe big picture…
In-Center Hemodialysis (HD)Clinical Performance Measures Data
CollectionForm 2000, Form HCFA-820
Peritoneal Dialysis (PD)Clinical Performance Measures Data
CollectionForm 2000 Form HCFA-821
ESRD Beneficiary Selection(Home Patients Only)
Form HCFA-382
ESRD Medical Information System
Facility SurveyPart One: Dialysis
Part Two: Kidney TransplantsForm HCFA-2744
ESRD Medical Evidence ReportMedicare Entitlement And/Or Patient
RegistrationForm HCFA-2728-U3
Dialysis Facility (DF)Clinical Performance Measures Data
CollectionForm 2000 Form HCFA-???
Patient DeathForm HCFA-2746
PatientSpecific Information
Form SIMS-???
FacilitySpecific Information
Form SIMS-???
Social SecurityAdministration
(SSA)
Health CareFinancing
Administration(HCFA)
End StageRenal Disease
(ESRD)Facility
End StageRenal Disease
(ESRD)Facility
End StageRenal Disease
(ESRD)Facility
Transforming the ESRD Reporting Process to HCFA
from Paper Forms to HL7 v3 XML based E-reporting
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
Network #20
…
HCFA / ESRD Data FlowThe SIMS front end
HCFA / ESRD Data FlowThe SIMS front end
HCFA-2744
HCFA-2728-U3
HCFA-2746
End StageRenal Disease
(ESRD)Facility
End StageRenal Disease
(ESRD)Facility
End StageRenal Disease
(ESRD)Facility
OvernightUpdates
…
Network #02
Network #01
Health Care Financing Administration (HCFA)
End StageRenal Disease
(ESRD)Facility
End StageRenal Disease
(ESRD)Facility
End StageRenal Disease
(ESRD)Facility
End StageRenal Disease
(ESRD)Facility
End StageRenal Disease
(ESRD)Facility
End StageRenal Disease
(ESRD)Facility
ReportingHCFA
(Paper)Forms
MS SQL Server Databases
Replication
SIMS Networks(geographically
distributed)
IBM Model 2.04 Databases
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HCFA / ESRD Data FlowInside HCFA Today…
HCFA / ESRD Data FlowInside HCFA Today…
Health Care Financing Administration (HCFA)
IBM Model 2.04
IBM Model 2.04
MS SQLServer
Social SecurityAdministration
(SSA)
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
Health Care Financing Administration (HCFA)
HCFA / ESRD Data FlowInside HCFA Tomorrow…HCFA / ESRD Data Flow
Inside HCFA Tomorrow…
IBM Model 2.04
IBM Model 2.04
Oracle 8i
Oracle Business Intelligence (BI) &
Knowledge Management (KM) Solutions:Data Warehousing
Data MiningOLAP
AuxiliaryESRDSpecializedDatabases
Very limited and primitive had-hocquery and reports on the IBM mainframe(no need for legacy software migration,
replaced by Oracle BI & KM tools: DW, DM, OLAP).
Legacy Migration ETL
UpdatesETL
Updates ETL
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HCFA / ESRD Data FlowLong Term Objective…HCFA / ESRD Data FlowLong Term Objective…
End StageRenal Disease
(ESRD)Facility
Health CareFinancing
Administration(HCFA)
MS SQL Server RDBMS ?Data Extraction, Transformation & Load (ETL)Electronic Data Interchange (EDI)
over Secure Internet (based on XML)
Do they havea database ?
Is HL7 v3XML Ready ?
Are they connectedon internet / dialups ?
How about the securityof the medical information ?
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HCFA / ESRD Data FlowThe VISION Data Collection Tool
(Vital Information System to Improve Outcomes in Nephrology)
HCFA / ESRD Data FlowThe VISION Data Collection Tool
(Vital Information System to Improve Outcomes in Nephrology)
End StageRenal Disease
(ESRD)Facility
VISION Data Collection Tool(Windows Standalone Utility)
HCFA-2744HCFA-2728-U3 HCFA-2746
Graphical User Interface(GUI)
(Windows Visual Basic)
Graphical User Interface(GUI)
(Windows Visual Basic)
Graphical User Interface(GUI)
(Windows MFC Visual Basic)
MS Access DB
•Manual Entries of HCFA Forms•Automatic Import (ETL from ESRD Facility Database)•Automatic Export (ETL to HCFA SIMS)•Form Editing, Browsing, Queries, Printing, etc.
Health CareFinancing
Administration(HCFA)
MS SQL Server RDBMS ?ETL ETL
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HCFA / ESRD Data FlowETL #1 & 2 : VISION Import/Export of
HL7 v3 XML “Based” HCFA Documents
HCFA / ESRD Data FlowETL #1 & 2 : VISION Import/Export of
HL7 v3 XML “Based” HCFA Documents
VISION Data Collection Tool(Windows Standalone Utility)
HL7 v3 XML based
HCFA -2744
HL7 v3 XML based
HCFA-2728-U3
HL7 v3 XML based
HCFA -2746
Graphical User Interface(GUI)
(Windows Visual Basic)Graphical User Interface
(GUI)(Windows Visual Basic)Graphical User Interface
(GUI)(Windows MFC Visual Basic)
MS Access DB
Data Movement Component
Data Movement Component
Data Movement Component
Meta Integration Works Data Extraction,Transformation
|& Load (ETL)
Generation & Maintenance of theData Movement Components
(C++ based, Windows Plug&Play)
Import
Export
Import
Export
XML Files
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
Health CareFinancing
Administration(HCFA)
HCFA / ESRD Data FlowETL #3 : HCFA / SIMS Import of
HL7 v3 XML “Based” HCFA Documents
HCFA / ESRD Data FlowETL #3 : HCFA / SIMS Import of
HL7 v3 XML “Based” HCFA Documents
HL7 v3 XML based
HCFA -2744
HL7 v3 XML based
HCFA-2728-U3
HL7 v3 XML based
HCFA -2746
MS SQLServer
Data Movement Component
Meta Integration Works Data Extraction,Transformation
|& Load (ETL)
Generation & Maintenance of theData Movement Components
(C++ based, Windows Plug&Play)
Import
Import
XML Files
Data Movement ComponentImport
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
End StageRenal Disease
(ESRD)Facility
HCFA / ESRD Data FlowETL #4, 5, … : ESRD Facility Export of
HL7 v3 XML “Based” HCFA Documents
HCFA / ESRD Data FlowETL #4, 5, … : ESRD Facility Export of
HL7 v3 XML “Based” HCFA Documents
HL7 v3 XML based
HCFA -2744
HL7 v3 XML based
HCFA-2728-U3
HL7 v3 XML based
HCFA -2746
Any RDBMSvia ODBC
Data Movement Component
Meta Integration Works Data Extraction,Transformation
|& Load (ETL)
Generation & Maintenance of theData Movement Components
(C++ based, Windows Plug&Play)
Export
Export
XML Files
Data Movement ComponentExport
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HCFA / ESRD Data FlowGenerating Data Movement Components HL7 v3 XML “based” HCFA Documents
HCFA / ESRD Data FlowGenerating Data Movement Components HL7 v3 XML “based” HCFA Documents
HL7 v3 XMLbased
HCFA-2728-U3
MS Access DB
Meta Integration Works Data Extraction,Transformation
|& Load (ETL)
HL7 v3 XML DTDbased
HCFA-2728-U3 (step 2) Model Mapper
(step 1) Model Converter (Import Bridges)
(step 3) Data Bridge Builder
HCFA-2728 HL7 v3 XML to VISIONData Movement Component
ME
TA
DA
TA
LE
VE
LD
AT
AL
EV
EL
Database SchemaLogical Model (ERwin, Rose, etc.)
Physical Model (DDL)
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
Network #20
Network #19
…
HCFA / ESRD Data FlowIntroducing VISION phase 1
HCFA / ESRD Data FlowIntroducing VISION phase 1
End StageRenal Disease
(ESRD)Facility
End StageRenal Disease
(ESRD)Facility
End StageRenal Disease
(ESRD)Facility
…
Network #02
Network #01Health Care Financing Administration (HCFA)
End StageRenal Disease
(ESRD)Facility
End StageRenal Disease
(ESRD)Facility
End StageRenal Disease
(ESRD)Facility
End StageRenal Disease
(ESRD)Facility
End StageRenal Disease
(ESRD)Facility
End StageRenal Disease
(ESRD)Facility
ConventionalReporting
HCFA(Paper)Forms
VISIONData Collection
Tool(Windows
StandaloneUtility)
HCFA-2744
HCFA-2728-U3
HCFA-2746
E-Reporting
“HyperShip”Secured
TransportU.S. Postal
OfficeCertified !
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
DomainInformation Models
(DIM)
HarmonizationProcess
ReferenceInformation Model
(RIM)
Refined MessageInformation Model
(R-MIM)
HL7 v2.x(Encoding-
Rules 7) ER7
HL7 v3.x(XML DTD)Messages
HL7 DevelopmentEnvironment
HL7 DevelopmentEnvironment
The HL7 Development Environment is composed of:•A repository called “RIM” implemented on Microsoft Access
•Represents the master copy of all HL7 metadata,•Contains RIM tables as well as R-MIM, HMD, more?•Can be populated from Rational Rose(with referential integrity, and version management))•But contains more information than in Rose?•Can export to Rose
•A toolset called “RoseTree” implemented with Visual Basic
HierarchicalMessage
Descriptions(HMD)
Message Object Diagram
Interaction Model
Message Object DiagramMessage Object Diagram
Interaction ModelInteraction Model
Unused?
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HL7 v3 XML “Based” HCFA DocumentsDocument/Message Construction
HL7 v3 XML “Based” HCFA DocumentsDocument/Message Construction
• Goal– Build HL7 XML documents/messages for HCFA forms
– Use Message Development Framework Version 3.2 April 1999
– Use RoseTree
– RIM095 with no modifications
– Use standard coding schemes• LOINC codes (Logical Observation Identifiers, Names and Codes ) for
identifying laboratory and clinical observations.
• ICD-9 (International Classification of Diseases)
– Fortunate that USAM 2.4 (Unified Service Action Model) existed
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HL7 v3 XML “Based” HCFA Documents Current Message Choices
HL7 v3 XML “Based” HCFA Documents Current Message Choices
• What about the current documents– Patient Record Architecture Framework
• Not enough RIM information
• Not all the information seems to be in the RIM (i.e.,Clinical_Document_Header with Patient relationship)
• Closest to what we need but timeliness is an issue
– Could not find other documents dealing with documents
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HL7 v3 XML “Based” HCFA Documents Classes Used
HL7 v3 XML “Based” HCFA Documents Classes Used
Clinical_document(1) Clinical_document_header(1) Authentication(0..1) Healthcare_document_authenticator(1) Person(1..n)
Person_name(1) Service(0..n) Target(0..n) Material(1)
Master_patient_service_location(1) Dependent_Service(1..n)
Service(1) Healthcare_provider_organization(1) Master_patient_service_location(1)
Patient(1) Person(1) Person_name(1) Employee(0..n)
Person_Employment(0..n) Administrative_patient_death(1)
Master_patient_service_location (from previous box) Patient(1)… Patient_Encounter(0..n) Service(0..n) Target(0..n) Material(0..1) Master_patient_service_location(0..1) Dependent_Service(0..n)
Service(1..n) Consent(1) Consent.Actor(1) Consent.Witness(0..1) Master_healthcare_benefit_product(0..1) Insurer(0..1)
Organization(1) Material(0..n) (Statistical) Target(0..n) Service(0..n) (statistical)
Service is an Observation, Procedure, Condition_node, Medication, or Supply
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Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Implementing HCFA’s ESRD E-Reporting with HL7 v3 XML Cleveland, May 22-26, 2000Cleveland, May 22-26, 2000
© 1997-2000 Meta Integration Technology, Inc.
www.metaintegration.comwww.hcfa.gov
HL7 v3 XML “Based” HCFA Documents Status
HL7 v3 XML “Based” HCFA Documents Status
• Lessons learned– The RIM is fairly complete – found no needs create new
relationships or to create new attributes
– It is sometimes hard to choose a path when several paths are possible and valid (Services for example)
– Yes/No questions require interpretation
– Members of HL7 are very cooperative
• Waiting on– Statistics – not yet defined
• Used Xeena tool from IBM (free validating XML editing tool)