HL7 教育訓練課程教材 資料交換入門介紹

1. HL7教育訓練課程教材資料交換入門介紹 教育訓練委員會 Education Technical Committees 秘書長 范士展 編撰

2. 講員背景 • HL7 Taiwan 第二屆理事 • HL7 Taiwan 第三屆秘書長 • HL7 Taiwan 長期照護技術委員會召集人 • HL7 Taiwan 轉診檢技術委員會副召集人 • HL7 國際認證分析師 - V2.5 • HL7 Taiwan 教育訓練講師 • 東元電機智慧系統事業部 顧問 • 東海大學、亞洲大學 兼任講師 • 東海大學工業工程與經營資訊研究所 博士生

3. 講授大綱 • 資訊交換緣起 • 資料交換架構 • HL7總會介紹

4. 資訊交換緣起

5. 位元世界 1/2 • 一個位元(bit)可以代表一個事實的兩個狀態，例如，電燈的“開”或“關”、性別的”男”或”女”（只有這樣子嗎？）。 • 兩個位元可四種狀態，有下列組合：00、01、10、11。方向，00代表往前、01代表往後，10代表往右，11代表往左。

6. 位元世界 2/2 • n個字元就具備有2n個狀態。 • N=8時，稱之為位元組(Byte)。共256個狀態。 • 這0~255個數字分別給予指定的文數字或符號，稱之為ASCII碼。American Standard Code for Information Interchange，美國訊息交換標準代碼。 交換標準始焉！！

7. 但！資料(訊)交換在哪一層級 從人的角度 從電腦的角度 資訊的層級 • 事實 fact • 所關心的某一事件。描述方向、性別。 • 資料 data • 此事件可以攜帶的資料。 00代表往前、01代表往後，10代表往右，11代表往左。 • 資訊 information • 資料經過有目的處理。某人從原點(0,0)出發，收集{00, 00, 10, 00}資料，得知離開原點至座標(1,3) • 知識 knowledge • 學習所得，前往該點有哪些路徑。{00,10,00,00}也可到座標(1,3)。資訊重現。 • 智慧 wisdom • 可以產生新的路徑 資訊創新

8. Data – medical datum 120 80 120/80 mmHg 120/80 Blood-pressure (Systolic/Diastolic) 130/90 But, it’s hard to be recognized by computer So, We need Context and Content

9. 資訊涵義 • 句法方面 (Syntactic Aspect) • 描述語法、儲存或訊息傳輸的文法或語法有關。 • 語意方面 (Semantic Aspect) • 資訊所呈現的意義 • 實用方面 (Pragmatic Aspect) • 意圖或將被達成的目標 台灣大勝日本 V.S. 台灣大敗日本 但！電腦傳遞的資訊是？

10. 真實世界觀點 電腦世界觀點 Logical Model 抽象觀念 實做觀念 Physical Model 真實 電腦 需求 使用 世界 世界 問題 操作 需求書 規格書 程式碼 資訊系統抽象過程

11. 相同資料、不同思考 資料來源： Niilo Saranummi , PICNIC ARCHITECTURE

12. Requirement: Create a means to transport a single individual from home to place of work. Management I T User Interpretation Interpretation Interpretation 相同語意、不同見解 我們需要一個訊息參考架構 資料來源： Bentley Dittman， SYSTEMS ANALYSIS AND DESIGN METHODS， 5th Edition

13. Example Transaction 住院病人 范士展 男性 生於 10/31/1965 於 8/5/2000 12:30 PM 住進了WARD NO 8B 真實世界 HL7 訊息參考結構 HL7 國際認證分析師 MSH|^~\&|REGAMT|MCM|NURCAR||200005081232||ADT^A01|00001|P|2.3<CR> EVN|A01|200005081230||01||200005081230<CR> PID|||191919^^^GENHOSP|253763|范^士展||19651031|M|||407^台中港路^ ISHPEMING^台中市^49849^””^||(900)4855344|(900)4855344||S|C|10199925<CR> PV1||I|8B^06^01^某醫院||||0200^JONES,GEORGE|0148^ADDISON,JAMES||8B ||||||||0148^ANDERSON,CARL|||<CR> 電腦世界

14. 資料交換架構

15. The purpose… INTEROPERABILITY

16. INTEROPERABILITY The ability of two or more systems or components to exchange information and to use the information that has been exchanged.” [IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries, IEEE, 1990] Functionalinteroperability Semanticinteroperability

17. Healthcare Today

18. Materials Management Clinical System Billing, claims reimbursement X12N HL7 Retail Pharmacy Orders & Reimbursement X12N / HL7 (Non-US only) Healthcare Information System NCPDP HL7 Immunization Database Waveforms HL7 HL7, X12N Images, pictures Agency Reporting DICOM HL7 HL7, X12N IEEE MIB,ASTM Provider Repository Adverse Events Reporting Bedside Instruments

19. 以往軟體整合方式 EAI 連結方式 點對點 以資訊中心點(Information Hub) 作串連 連結界面數 N(N-1) / 2 N 連結介面程式 侵入式(Invasive) 程式撰寫 l非侵入式(Non-Invasive) 程式撰寫 l對世界知名系統開發了現成的連結器(Adaptor) 整合層面 資料層、連結層 資料層、連結層、流程層 因應未來變動 低 高 適合對象 l內部系統數少、對即時性需求不高 l內部系統數多、對即時性需求高 系統整合、資訊交換模式 資料來源： 資訊與電腦 2001.12

20. 點對點的架構 • 連結點增加到某一層度時，Session的量、交換實作點會大增...

21. 介面引擎架構 • 以Interface Engine為中心，可減少Session的量，並且增加穩定度及延展性

22. HL7總會介紹 http://www.hl7.org/

23. What’s HL7 • Health Level Seven is one of several American National Standards Institute (ANSI) -accredited Standards Developing Organizations (SDOs) operating in the healthcare arena. • Members of Health Level Seven are known collectively as the Working Group, which is organized into technical committees and special interest groups. • The technical committees are directly responsible for the content of the Standards. • Special interest groups serve as a test bed for exploring new areas that may need coverage in HL7’s published standards. More information

24. TC

25. SIG

26. HL7's Mission • HL7 is an international community of healthcare subject matter experts and information scientists collaborating to createstandards for the exchange, management and integration of electronic healthcare information. • HL7 promotes the use of such standards within and among healthcare organizations to increase the effectiveness and efficiency of healthcare delivery for the benefit of all.

28. What Does the Name HL7 Mean • "Level Seven" refers to the highest level of the International Organization for Standardization (ISO) communications model for Open Systems Interconnection (OSI) - the application level. • The application level addresses definition of the data to be exchanged, the timing of the interchange, and the communication of certain errors to the application. • The seventh level supports such functions as security checks, participant identification, availability checks, exchange mechanism negotiations and, most importantly, data exchange structuring.

29. Function Communication HL7 (Health Level Seven) HL7 7 Application 6 Presentation 5 Session 4 Transport 3 Network 2 Data Link 1 Physical ISO-OSI Communication Architecture Model

30. Meetings – When? • Plenary • 1 per year • Fall (Northern Hemisphere) • What is it • Working Group • 2 per year • Winter & Spring (Northern Hemisphere) • What are they • International Meetings - IHIC • Educational Meetings • Off Schedule Meetings

31. Meeting - What • Tutorials • Committee Meetings • Administrative Meetings • Technical Steering Committee • Board of Directors • Education Committee • Publications Committee • Process Improvement Committee • Electronic Services Committee • Marketing Committee Ribbons: Board Staff Committee Chair Benefactor Mentor International Student Supporter Guest Facilitator Speakers Press 10 yr. Organization Member 10 yr. Benefactor Member

33. 2007 HL7 Publishing Calendar

34. Ballots • The end product of a ballot process is a document. • The document could stand on its own. However, most balloted documents are a part of a published Standards Document (e.g., HL7 2.6, HL7 3.0, etc.)

35. Ballots • Documents can be: • Reference：Content is harmonized during HL7 meetings or approved by the HL7 Board. It is not subject to ballot acceptance. • Informative：Content is balloted by the general membership. However, it is not considered to be a structural part of the Standard but only supporting information. • Normative：Content is balloted by the general membership and is considered a structural component of the HL7 Standard. Negative ballots must be resolved. • Draft Standards for Trial Use (DSTU)：Content is balloted by the general membership as the draft of a future standard which will, following a pre-specified period of evaluation and comment (usually 2 years), be expeditiously incorporated into normative standard.

37. Other Resources • HL7 Standards：HL7各項標準書清單 • Plenary Meeting Materials：每年會員大會之簡報下載區 • HIMSS Presentations：HL7人員參加HIMSS之簡報 • HER Technical Committee‘s Home Page：HER官方首頁 • Opt-in Document Center：文件下載區 • List Services Welcome Center：TC/SIG的文件自動通知伺服器

38. HL7 Standards

39. Plenary Meeting Materials

40. HIMSS Presentations

41. HER Homepage

42. Opt-inDocumentCenter

43. List Services Welcome Center

44. 感謝聆聽HL7教育訓練課程教材─入門介紹 下一場：訊息結構與規則說明