PROCESS DEVELOPMENT GROUP Steering Committee Meeting (Summer ‘99) Toronto, July 9, 1999.
HL7 April Meeting - Toronto 1999
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Transcript of HL7 April Meeting - Toronto 1999
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HL7 April Meeting - Toronto 1999
HL7 Standards Development
in
Australia / New Zealand
- an Update
Dick Harding / Klaus Veil
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Who’s here?
Dick Harding Orders/Observations
David Rowed MnM
Patient Care / Comm. Health
Klaus Veil PAFM V2.3.2
Data Warehousing
Publishing
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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.
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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"
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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.
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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.
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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
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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.
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Referral Messages
Currently being re-established:• Chair: David Rowed• New scope being defined.
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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.
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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.
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RAPID Specification
Redevelopment ofAcute and Psychiatric Information Directions
Covers entire Australian state of Victoria
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RAPID Components
Three main components• Mental Health Operational Data Store (ODS)• Mental Health Patient Management feeder
system• Data Warehouse
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RAPID Coverage - Data Warehouse
Acute admitted episodes Elective Surgery (waiting / booking list) EmergencyAged CareAmbulance
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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
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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”
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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
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Central Registries
Notifiable diseases and conditionsVaccinationBreast Screening Pap smearDangerous Drugs etc etc . . .
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Central Registries - Early Stages
Support from all StatesRecently commenced Limited HL7 planning to date
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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
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Other Australian Developments
Community Health (CHIME, CHIS, etc.)Aust. Government has commited support for
attendance at all HL7 Meetings in 1999!
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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.
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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.
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Find out more about HL7 Australia at:
http://OurWorld.CompuServe.com/Homepages/KVeil
Thank You!