Health Level 7 (HL7) - QUIZ 1

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Health Level Seven (HL7), is a non-profit organization involved in the development of international healthcare informatics interoperability standards. HL7 and its members provide a framework (and related standards) for the exchange, integration, sharing, and retrieval of electronic health information.
What is HL7?
A01 Admit a Patient
A02 Transfer a Patient
A03 Discharge a Patient
A04 Register a Patient
A05 Pre-admit a Patient
A06 Transfer Outpatient to Inpatient
A07 Transfer Inpatient to Outpatient
HL7 Event Types
A08 Update Patient Information
A09 Patient Departing
A10 Patient Arriving
A11 Cancel Admit
A12 Cancel Transfer
A13 Cancel Discharge Cancel
HL7 Event Types
A01 Admit a Patient
A04 Register a Patient
A05 Pre-admit a Patient
A06 Transfer Outpatient to Inpatient
Standard Message Configuratio
MSH is the header record
PID is the Patient ID
ADT is the event trigger
Components of HL7
Typically, a hospital registration database will have the master of the patient data and information.

Each time patient information is updated, the updates will be pushed out in the form of an ADT message to the appropriate applications in facilities such as labs or clinics.


ADT feeds are usually received through either an interface engine or direct (point-to-point) interface.
ADT Feeds and Updates
Patient event identifiers are generated at the start of each registration event for each visit or hospitalization.

Each event establishes:
-If first time visit; the MRN
-What insurance will cover this stay
-Who the guarantor will be
-The diagnoses that will justify downstream treatments

The patient specific identifiers such as the MRN, name, & diagnoses are then sent to the LIS, RIS, PACS systems for order and result matching.
The Importance of ID
configuration in each segment
Point-to-point messaging is adopted when there is a one-to-one relationship between sender and receiver.

Common usage scenarios include submitting an order or registration request to a processing application, effecting an account inquiry or update, and exchanging data between two systems that are being synchronized.

Dependencies are added on an impromptu basis, resulting in a complex structure that is difficult to maintain.
The number of connections needed to have fully meshed point-to-point connections, with n points, is given by

n(n-1)/2 .
What is Point-to-Point
?
A HL7 interface engine is an interface or integration engine built specifically for the healthcare industry. It connects legacy systems by using a standard messaging protocol.

HL7 interface engines are software which work as a go-between for different systems. They monitor different types of interfaces and communication points and perform actions according t
Interface Engines?
Eclipsys eLink
Intersystems Ensemble
Oracle SOA Suite
Orion Health Rhapsody
Quovadx Cloverleaf
Siemens OPENLink
Sun eGate
Sun eGate 5-ICAN Suite
Sybase e-Biz Impact
TC Software ConnectMate
Iguana
Most commonly used industry HL7 interface engines?
HL7's Version 2.x (V2) messaging standard is the workhorse of electronic data exchange in the clinical domain and arguably the most widely implemented standard for healthcare in the world. This messaging standard allows the exchange of clinical data between systems. It is designed to support a central patient care system as well as a more distributed environment where data resides in departmental systems.
What is HL7 Version 2?
The Health Level Seven Version 3 (V3) Normative Edition—a suite of specifications based on HL7's Reference Information Model (RIM)—provides a single source that allows implementers of V3 specifications to work with the full set of messages, data types, and terminologies needed to build a complete implementation.

It is a foundational part of the technologies needed to meet the global challenge of integrating healthcare information, in areas such as patient care and public health.

The Version 3 Normative Edition represents a new approach to clinical information exchange based on a model driven methodology that produces messages and electronic documents expressed in XML syntax.
What is HL7 Version 3
The HL7 Version 3 Clinical Document Architecture (CDA®) is a document markup standard that specifies the structure and semantics of "clinical documents" for the purpose of exchange between healthcare providers and patients. It defines a clinical document as having the following six characteristics: 1) Persistence, 2) Stewardship, 3) Potential for authentication, 4) Context, 5) Wholeness and 6) Human readability.

A CDA can contain any type of clinical content -- typical CDA documents would be a Discharge Summary, Imaging Report, Admission & Physical, Pathology Report and more. The most popular use is for inter-enterprise information exchange, such as is envisioned for a US Health Information Exchange (HIE).
What is CDA Release 2?
Persistance, Stewardship, Potential for Authentication, Context, Wholeness, Human Readability
CDA Standards?
The Continuity of Care Document (CCD) is a joint effort of HL7 International and ASTM. CCD fosters interoperability of clinical data by allowing physicians to send electronic medical information to other providers without loss of meaning and enabling improvement of patient care.

CCD is an implementation guide for sharing Continuity of Care Record (CCR) patient summary data using the HL7 Version 3 Clinical Document Architecture (CDA), Release 2.

CCD establishes a rich set of templates representing the typical sections of a summary record, and expresses these templates as constraints on CDA. These same templates for vital signs, family history, plan of care, and so on can then be reused in other CDA document types, establishing interoperability across a wide range of clinical use cases.
HL7/ASTM Implementation Guide for CDA® R2 -Continuity of Care Document (CCD®)