HL7 Clinical Document Architecture,Release 2

Clinical Document Architecture, Release One (CDA R1), became an American National Standards Institute (ANSI)–approved HL7 Standard in November 2000, representing the first specification derived from the Health Level 7 (HL7) Reference Information Model (RIM). CDA, Release Two (CDA R2), became an ANSI-approved HL7 Standard in May 2005 and is the subject of this article, where the focus is primarily on how the standard has evolved since CDA R1, particularly in the area of semantic representation of clinical events. CDA is a document markup standard that specifies the structure and semantics of a clinical document (such as a discharge summary or progress note) for the purpose of exchange. A CDA document is a defined and complete information object that can include text, images, sounds, and other multimedia content. It can be transferred within a message and can exist independently, outside the transferring message. CDA documents are encoded in Extensible Markup Language (XML), and they derive their machine processable meaning from the RIM, coupled with terminology. The CDA R2 model is richly expressive, enabling the formal representation of clinical statements (such as observations, medication administrations, and adverse events) such that they can be interpreted and acted upon by a computer. On the other hand, CDA R2 offers a low bar for adoption, providing a mechanism for simply wrapping a non-XML document with the CDA header or for creating a document with a structured header and sections containing only narrative content. The intent is to facilitate widespread adoption, while providing a mechanism for incremental semantic interoperability.     

HL7组织与HL7标准简介

HL7标准在国内的普及应用需要各方面力量的共同努力,组建HL7中国委员会将起到凝聚的作用.HL7标准是不断发展的,我们在追赶最新潮流的同时,更应该扎扎实实地学习和借鉴已经成熟并广泛应用的版本.     

基于HL7 CDA的中草药处方文档规范构建

目的：参照HL7 CDA文档规范的表示方法,对中医处方中中草药处方的数据进行建模,并建立中草药处方的CDA文档规范,使其能够完整地表示中草药处方的信息。方法：通过研究中医电子病历处方信息特征及组成结构,将中医电子处方信息抽象提取相应的信息元素,参照HL7 CDA模板构建中草药处方文档规范,使其能够充分表达中草药处方信息的概念与属性。结果：通过将中草药处方数据元素与CDA模板进行映射来完成中草药处方的数据表达具有可行性,为中医处方信息规范化研究提供了新的指导方法。     

基于HL7和IHE的中国卫生信息文档共享规范深入研究

中国区域卫生信息共享依赖的标准体系中,语义层次必须的《卫生信息文档共享规范》具有关键作用。它在HL7CDAR2的基础上,利用IHEPCC、HL7CCD模板库作为基础参考库制定中国本地化文档模板。目前处于征求意见稿阶段,通过对其深入研究,发现关于一致性、完整性等几方面存在的问题,并进行相关阐述和建议。     

HL7在英国

虽然HL7是源自美国的医疗信息交换标准,但随着国际成员的不断加入,其发展方向、决策制定已经成为一个多国参与的活动,除美国以外,包括加拿大,澳大利亚,日本,新西兰,德国,荷兰以及英国,芬兰,南非,阿根廷和印度等,这些国家均为HL7的国际成员,因此HL7也成为一个名副其实的国际性标准组织。HL7标准之所以如此迅速的由美国走向世界,还要归功于跨国医疗IT     

HL7在台湾

HL7在台湾迅速发展 台湾在HL7的应用上发展比较迅速,主要得益于以下几个方面: 1.官方政策支持 台湾卫生署、经济部、行政院等机构积极引进医学信息标准-HL7,DICOM,ICD,SNOMED等。并且依照引进标准积极参与本地化工作,增修为岛内适用之标准。 鼓励医疗院所与产业界投入——由     

The Clinical Document Architecture and the Continuity of Care Record: A Critical Analysis

Health care provides many opportunities in which the sharing of data between independent sites is highly desirable. Several standards are required to produce the functional and semantic interoperability necessary to support the exchange of such data: a common reference information model, a common set of data elements, a common terminology, common data structures, and a common transport standard. This paper addresses one component of that set of standards: the ability to create a document that supports the exchange of structured data components. Unfortunately, two different standards development organizations have produced similar standards for that purpose based on different information models: Health Level 7 (HL7)'s Clinical Document Architecture (CDA) and The American Society for Testing and Materials (ASTM International) Continuity of Care Record (CCR). The coexistence of both standards might require mapping from one standard to the other, which could be accompanied by a loss of information and functionality. This paper examines and compares the two standards, emphasizes the strengths and weaknesses of each, and proposes a strategy of harmonization to enhance future progress. While some of the authors are members of HL7 and/or ASTM International, the authors stress that the viewpoints represented in this paper are those of the authors and do not represent the official viewpoints of either HL7 or of ASTM International.     

基于HL7V3建立临床数据中心

参照HL7标准，结合医院的实际情况，探讨了基于HL7标准建立临床信息模型。并采用全新的J2EE平台开发出了部分临床信息系统。     

The Development of MML (Medical Markup Language) Version 3.0 as a Medical Document Exchange Format for HL7 Messages

Medical Markup Language (MML), as a set of standards, has been developed over the last 8 years to allow the exchange of medical data between different medical information providers. MML Version 2.21 used XML as a metalanguage and was announced in 1999. In 2001, MML was updated to Version 2.3, which contained 12 modules. The latest version—Version 3.0—is based on the HL7 Clinical Document Architecture (CDA). During the development of this new version, the structure of MML Version 2.3 was analyzed, subdivided into several categories, and redefined so the information defined in MML could be described in HL7 CDA Level One. As a result of this development, it has become possible to exchange MML Version 3.0 medical documents via HL7 messages.     

HL7标准概述

经过20年的发展,HL7标准研究和应用的领域不断扩展,开发技术和过程不断发展,标准的各个部分也在不断完善和相互融合.3.0版是HL7标准集大成的体现.但同时,发展都是有延续性的,而且3.0版自顶向下的开发方式与国内缺乏实际项目经验之间的巨大差距,使得当前学习研究2.X版仍然有十分重要的意义.     

医院信息化建设中推行 HL7标准的迫切性

本文简要介绍了当前国家医疗制度改革、社会医疗保险的全面推行面临的医院信息化建设中缺乏统一标准带来的问题,提出了推行 HL7标准的迫切性.     

浅谈我国医院信息化的发展及HL7标准

随着计算机及网络技术的飞速发展,信息技术在医院得到了日益广泛的应用.本文简要介绍了我国医院信息系统的发展状况及发展趋势, HL7作为医疗信息交换标准对医院信息系统发展具有重要意义.     

中医药行业应用HL7体系的意义

HL7（Health Level 7）是西方医学电子数据传输与交换的标准,西方医疗机构在此基础上实现了数据共享。据此探讨如何建立符合中国国情的医学数据传输标准、如何实现电子病历和建立医学数据中心,以及HL7对医药行业发展的意义。     

HL7在HIS系统中的应用研究

医院信息系统(HIS)间的"异构"问题由来已久,而业务的发展要求实现医疗信息的交换和共享.本课题引入了HL7标准作为医院信息系统间共同遵循的数据交换协议,以实现异构系统间数据的交换.文章以HL7消息作为主要研究对象,设计一个HL7消息的构建、解析演示系统.中间件包括两个功能模块:HL7消息的构建/解析模块和消息传输模块.消息的格式基于XML技术.系统的演示表明,在对现有系统不作更改的前提之下,采用外挂中间件的模式,能在系统间正常地处理传输基于XML格式的HL7消息,很好地解决了异构系统间数据的交换,符合当前的需要.本课题所作的探讨也为将来深入的研究工作提供了帮助.     

HL7标准2.4版概述

卫生部医院管理研究所组织翻译出版THL7标准2.4中文版,本文针对消息应用的12个领域分别作一个概要说明,以帮助对于HL7标准所涉及到的业务范围有一个初步的了解.     

基于HL7多层体系工作流的LIS系统的研究

目的 结合医院的实际情况,探讨适用于我院信息化建设相适应的实验室信息系统(LIS).方法 LIS信息系统使用多层体系工作流实施的方案,遵循Health Level 7(HL7)医疗信息交换标准实现异构系统信息交互.结果 基于HL7多层体系工作流的LIS系统,能够很好地解决异构系统的互操作问题,实现各部门数据资源安全的互通互连.结论 基于HL7多层体系工作流的LIS系统,能为提高临床研究的效率、保证数据质量、加强数据安全、促进数据共享等方面起到积极的作用.     

The HL7-OMG Healthcare Services Specification Project: Motivation, Methodology, and Deliverables for Enabling a Semantically Interoperable Service-oriented Architecture for Healthcare

Context

The healthcare industry could achieve significant benefits through the adoption of a service-oriented architecture (SOA). The specification and adoption of standard software service interfaces will be critical to achieving these benefits.

Objective

To develop a replicable, collaborative framework for standardizing the interfaces of software services important to healthcare.

Design

Iterative, peer-reviewed development of a framework for generating interoperable service specifications that build on existing and ongoing standardization efforts. The framework was created under the auspices of the Healthcare Services Specification Project (HSSP), which was initiated in 2005 as a joint initiative between Health Level7 (HL7) and the Object Management Group (OMG). In this framework, known as the HSSP Service Specification Framework, HL7 identifies candidates for service standardization and defines normative Service Functional Models (SFMs) that specify the capabilities and conformance criteria for these services. OMG then uses these SFMs to generate technical service specifications as well as reference implementations.

Measurements

The ability of the framework to support the creation of multiple, interoperable service specifications useful for healthcare.

Results

Functional specifications have been defined through HL7 for four services: the Decision Support Service; the Entity Identification Service; the Clinical Research Filtered Query Service; and the Retrieve, Locate, and Update Service. Technical specifications and commercial implementations have been developed for two of these services within OMG. Furthermore, three additional functional specifications are being developed through HL7.

Conclusions

The HSSP Service Specification Framework provides a replicable and collaborative approach to defining standardized service specifications for healthcare.     

LIS中HL7接口设计与实现

将检验仪器或仪器系统与LIS系统以TCP通讯方式连接,交换的数据采用HL7标准,实现仪器系统与LIS间检验医嘱信息和检验结果信息的交互,提高实验室工作效率.利用.Net的C#开发平台,借助开源NHapi模块生成标准HL7消息,在处理接收消息处理中采用实时处理与缓存文件相结合方式,保证了传输的效率.实际使用中,接口程序LISHL7Srv最终以windows服务形式部署运行,使其在计算机开机后无需登录,服务即可启动.接口服务程序的功能和性能,满足医院实验室工作要求,信息交互顺畅、实时.采用HL7标准降低了信息交互整合的难度,提出的接口设计方案有效地解决了LIS与仪器、仪器系统连接问题,同时,该方案还可扩展到其他医疗信息系统间数据交换的应用场景中.     

HL7标准下的医疗信息系统融合

简要介绍HL7标准,分析HL7的消息结构、消息构造与解析、HL7引擎的服务器与客户端体系模块,并从中间件的角度研究HL7应用的实现技术及其可以利用的资源,包括TinyXML,Chameleon,SOCKET套接字接口,Iguana。为分布式的异构医疗信息系统整合提出一个基于中间件技术的解决方案。