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MOHH – Models Submission

MOHH – Models Submission. Dr Linda Bird 9 th August 2012. Singapore’s Future Healthcare Landscape. Strategic vision of patients moving seamlessly across the healthcare system, receiving coordinated patient-centric care at the most appropriate settings.

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MOHH – Models Submission

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  1. MOHH – Models Submission Dr Linda Bird 9th August 2012

  2. Singapore’s Future Healthcare Landscape Strategic vision of patients moving seamlessly across the healthcare system, receiving coordinated patient-centric care at the most appropriate settings. Enabled by the National Electronic Health Record(EHR)

  3. Standards Products • Diagnosis - SNOMED CT and Singapore Extension (SE) • Drugs - Singapore Drug Dictionary (SDD) • Allergic Reactions– SNOMED CT + SE • Allergens - SNOMED CT + SDD • Laboratory Results – LOINC • Data Dictionary – MOHH Data Dictionary • Procedures - TBD • Reason for visit - SNOMED CT • Symptoms and Problems - SNOMED CT and Singapore Extension • Laboratory Reports – Smart SNOMED CT • Laboratory Orders – SNOMED CT • Radiology Orders - SNOMED CT

  4. LIM Development Process

  5. Clinical Modelling Framework Clinical Modelling Language (LOM) Clinician Verification Lim Repository Graphical Represent-ations Instance of References Store representation Generate Clinician Input Singapore Logical Information Model Computable Implementation Specification Requirements Generate Input Constrain References Bind semantics Bind values Logical Reference Model (ISO13606+21090) Terminology Ontology Terminology Server Store

  6. Clinician Validation of the LIM

  7. WYSIWYG NDDS snippet NXDS LXML XSD NXDS LXML Instance

  8. IsoSemantic Models – Example of Problem e.g. “Suspected Lung Cancer”

  9. IsoSemantic Models – Example Instances e.g. “Suspected Lung Cancer”

  10. IsoSemantic Models – Compositional Grammar • Problem Diagnosis = $ProblemDiagnosisName: • 246090004|associated_finding|= • (404684003|clinical_finding|: • 63698007|finding_site|=($BodySite: • 272741003|laterality|=$Laterality), • 246112005|severity|=$Severity), • 408729009|finding_context|=$FindingContext

  11. IsoSemantic Models – Equivalence Testing • Problem Diagnosis = $ProblemDiagnosisName: • 246090004 |associated finding| = (404684003|Clinical Finding|: • 363698007 | finding site | = ($BodySite: • 272741003|laterality| = $Laterality), • 246112005 | severity| = $Severity), • 408729009 | finding context | = $FindingContext • GP Problem Diagnosis= 86049000|Cancer| : • 246090004 |associated finding| = (404684003|Clinical Finding|: • 363698007 | finding site | = 39607008|Lung|), • 408729009 | finding context | = 415684004|Suspected| • Polyclinic Problem Diagnosis= 162572001 |Suspected cancer|: • 246090004 |associated finding| = (404684003|Clinical Finding|: • 363698007 | finding site | = 39607008|Lung|) • RH Problem Diagnosis= 86049000|Suspected lung cancer|

  12. Bi-directional Semantic Interoperability Source Data Maps In NEHR Design Patterns - Diagnosis Research Semantics DP-based GP - Source Data National Term GP - Source Data Maps out Transformed GP - Source Data in RH format Transformed GP - Source Data in Polyclinic format

  13. Submission Overview • ENTRY • Observation Entry (Observable Name/Value) • Heart Rate/ Blood Pressure / Blood Glucose • Clinical Finding • Problem Diagnosis Entry • Adverse Reaction Entry • Alert Entry • Activity • Pharmacy Activity Entry • Pharmacy Order Entry • Pharmacy Dispense Entry • Pharmacy Administration Entry • Investigation Activity Entry • Investigation Order Entry • Investigation Result Entry • Procedure Entry (Reference Pattern) • CLUSTER • Pharmacy Item / Investigation Test Item

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