Information Architecture It’s utility with the NHS landscape · NPfIT/ITK : HL7 Messaging...
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• Information Architecture • It’s utility with the NHS landscape • Presented by Richard Kavanagh, Head of Data Standards, HSCIC
Transcript of Information Architecture It’s utility with the NHS landscape · NPfIT/ITK : HL7 Messaging...
• Information Architecture
• It’s utility with the NHS landscape
• Presented by Richard Kavanagh, Head of Data Standards, HSCIC
Information Architecture for Interoperability
An insight into current work to support a more capable Information Architecture within the HSCIC.
§ The challenge
§ Where we are on the solution
§ Work yet to be undertaken
§ How you can help? 2
The challenge…
The availability of usable information definitions to aid Interoperability does not support the current landscape.
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The Complexity of Transforms
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§ Interoperability assumes compatibility on sending & receiving systems
§ This applies to both the information content and the semantics
§ Transforms are often hard, take excessive development time and are
prone to errors
Messaging Standards
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NHS Data Dictionary
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• Predominantly used for central data collections• Largely focussed on administrative and activity concepts• Increasingly being asked to support more clinical concepts• >2M Page views per year
NPfIT/ITK : HL7 Messaging Specifications
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• Introduced by NPfIT for national messaging• Based on HL7v3 standard• Complicated to create, publish and use• Difficult to understand the “information” content• Utilisation is increasing though undoubtedly more difficult that it need be
Supporting a mixed technical landscape
§ The variety of technical standards is
expanding not contracting (HL7 FHIR)
§ Existing systems will be in place for many
years yet (Spine2)
§ The local/national interface can not be
ignored
§ The real world is heterogeneous8
Increased demands for consistency
§ Increased demand for coded clinical
information flows
§ SNOMED CT usage is increasing
§ Professional standards for content are
arriving (e.g. CDGRS record headings)
§ Exchanges between “Health” and “Social
Care” are increasing9
Back to basics
§ Behind any information exchange is the
definition of the information to be exchanged
§ Make the definitions easier to create and
share
§ Lower the barriers for understanding
§ Have a common way to define information
content independent from the technical
transport
§ A standard for content definitions…
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Standards for Information Content
“The nice thing about standards
is that you have so
many to choose from”Andrew S. Tanenbaum
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CEN/ISO 13606
• An existing standard used both in Europe and the USA
• Allows the creation of “Archetypes”, constrained information models that can be created and understood by a wide set of stakeholders
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Example : Blood Pressure (UML)
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dm Blood Pressure
Blood Pressure Observ ation
- type: Coded- obs_time: DATETIME
Korotkoff Sounds
- phase: Coded = 4,5
Systolic pressure
- value: mmHg
Diastolic Pressure
- value: mmHg
Dev ice
- type: Coded = sphygmomanometer
Body Position
- position: Coded = supine, si tting...
Cuff Size
- type: Coded = smal l, large, s...
Laterality
- side: Coded
Body location
- site: Coded
Method
- type: Coded = Auscultation, P...
Mean Arterial Pressure
- /value: mmHg
Patient State
- factors: Coded [1..*]
Blood Pressure Finding
- interpretation: Coded
Reference Range
Blood Pressure Ev ent
Pulse Pressure
- /value: mmHg0..1
1..*
+hasInterpretation
0..1
0..*
0..1
0..1
0..1
0..1
0..1
0..1
0..1
1
1
+phaseIdentifier
0..1
Example : Blood Pressure (Mind Map)
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The Mind Map format chosen is fully compatible with free open source Mind Mapping tools.
Archetype Editor (LinkEHR)
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Each “item” of information can be constrained for§ Data Types (Integers, Quantities, Codes, Dates )§ Cardinality ( Mandatory, Optional, Multiplicity etc. )§ Terminology Binding (SNOMED CT or other)§ Default Values or Fixed Values
Model Publication & Governance
§ The publication format and method is yet to be determined, hopeful for a 2015 delivery
§ Governance process yet to be defined, though expect significant clinical input and federated structure
§ Alignment to existing “NHS Data Dictionary” and Message Specifications will be built in where required
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Using the Archetypes in HSCIC
The “Archetypes” represent a “logical” view of the data and can be mapped to “physical” structures for messaging.
For messaging the “archetypes” will need to be mapped to physical structures (e.g. HL7 CDA Templates or HL7 FHIR Profiles).
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Phase 1 – Pilot (Underway)
§ Within HSCIC a “Proof of Concept” project
underway for Child Screening Models.
§ Newborn Physical Examination
§ Newborn Birth Details
§ Newborn Blood Spot Screening
§ Archetypes available in October together with
CDA and FHIR Mappings
§ Basis for consultation with technical/clinical
stakeholders
§ Assessment Q1 2015
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Relevance to Renal Care Domain?
§ Child Screening not of direct relevance here
§ Require input into utility of:
– archetypes
– terminology bindings
– mappings to messaging forms
– publication formats19
A suitable carrot?
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UKRDC – Information Model
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§ Create Archetypes for part of Information model§ Create terminology bindings and other
constraints§ If useful, exemplar message fragments.§ Timeline Dec’13/Jan’14
Phase 2 – Pilot (Proposal)
Phase 2 – Pilot (Proposal)
§ Interested in participating?
§ Further details will be circulated via UKRDC
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