May 2011 Newsletter
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MAY 2011 greenCDA™ Implementation Guide Liora Alschuler Now Available By Liora Alschuler, Co-Chair, HL7 Structured Documents Work Group and Co-Editor, greenCDA The HL7 greenCDA Implementation Guide has been published by the HL7 Structured Documents Work Group. The HL7 Clinical Document Architecture (CDA®) is at the core of the requirements for Meaningful Use of Electronic Health Records. It supports continuity of care and re-use of clinical data for public health reporting, quality monitoring, patient safety and clinical trials. greenCDA maintains the utility of CDA while making it easier to implement. It is a simplified XML for CDA templates. “Any developer with basic XML knowledge and a tool that can process simple XML sche- mas can create green instances. We flattened the hierarchy, focused on variable data ver- sus fixed structural markup, and removed complexities like xsi:type. The result is simple and intuitive,” said Rick Geimer, Lantana Group CTO and co-editor of the greenCDA Implementation Guide. greenCDA features include: • XML schema validation • Simple business names • Tagged data elements in extensible library • Rapid path to Meaningful Use compliance • Modular XML with business names generate JAVA, .NET • Single style sheet display, as for all CDA • Extensible to physician documentation requirements and quality The enthusiastic response to the development of greenCDA is driving rapid experimenta- tion and has raised the question of how greenCDA fits into the larger ecosystem of clini- cal information systems. This trial use and experimentation will help us understand how going green affects ease of use for data capture; management and analysis; when it might be an appropriate wire format for CDA; if there are significant limits on expressivity; and where the cost and benefits may lie. continued on next page ® Health Level Seven and HL7 are registered trademarks of Health Level Seven International, registered in the US Trademark Office In This Issue... greenCDA™ Implementation Guide, continued greenCDA™ Implementation Guide..... 1-2 CDA®: Spirometry Test The CDC is planning a pilot project with vendors interested in using greenCDA to Standardization....................................3-4 enable use of their systems for submitting Central Line Insertion Practices (CLIP) Software Implementation of CDA......... 5, 9 data to the National Healthcare Safety Network (NHSN). Update From Headquarters.................. 6-7 Report from the HL7 International Council Meeting in Sydney................... 8-9 Post Sydney WGM Survey and First Time Attendee Survey.................... 10 News from the PMO and Project Services Work Group............................. 11 Healthcare Information Standards for Active Aging: State of Play for Patient Summaries............................................ 12 eHealth Week: “eHealth: Investing in Health Systems of the Future”............... 13 New Chair for the Joint Initiative Council.......................... 14 EFMI Special Topic Conference 2011: eHealth across Borders without Boundaries ............................ 15 greenCDA: Transforming the Essential into the Interoperable TSC Newsletter Update.................... 16-17 Upcoming International Events............. 17 “Use of greenCDA and supporting transformation tools show great promise as an SAIF Architecture Program.............. 18-19 approach for reducing the effort required to implement fully normative CDA,” said Daniel A. Pollock, MD, Surveillance Branch, Division of Healthcare Quality Promo- 4th Annual SOA in Healthcare Conference........................................... 20 tion, Centers for Disease Control and Prevention. Certification Exam Congratulations..... 21 HL7 looks forward to a robust and informative discussion with all stakeholders leading HL7 Benefactors................................... 22 to acceleration of the development and adoption of interoperable clinical information Welcome HL7 Luxembourg................... 22 systems. We encourage a broad range of experimentation across different use cases Affiliate Contacts................................... 23 and environments and welcome the trial use and the opportunity to review the oppor- tunities, costs and benefits of going green across the spectrum of implementation. Organizational Members.................. 24-26 2011 Technical Steering For more information on the greenCDA, visit the greenCDA wiki at Committee Members ............................ 27 http://wiki.hl7.org/index.php?title=GreenCDA_Project. Steering Divisions................................. 27 HL7 Work Group Co-Chairs.............. 28-30 HL7 Facilitators............................... 31-32 HL7 Staff Members................................ 33 2011 Board of Directors....................... 34 Educational Summits.............................35 Upcoming Working Group is the official publication of: Health Level Seven International Meetings................................................36 3300 Washtenaw Avenue, Suite 227, Ann Arbor, MI • 48104-4261 USA Phone: +1 (734) 677-7777 • Fax: +1 (734) 677-6622 • www.HL7.org 2 Mark McDougall, Publisher • Andrea Ribick, Managing Editor • Karen Van Hentenryck, Technical Editor Clinical Document Architechture: Manuel Domingo Spirometry Test Standardization By M. DOMINGO and M. LIZANA, Centre de Competències d’Integració. Parc de la ciència i la innovació Tecnocampus de Mataró. 08304-Mataró. Espanya C.GALLEGO, Oficina d’Estàndards i Interoperabilitat – Fundació TicSalut. Departament de Salut de la Generalitat de Catalunya – Chair Of HL7 Spain Matias Lizana Respiratory diseases, especially lated with the spirometry test, but also all the data chronic obstructive pulmonary from the test request, patient identification, and disease (COPD), lung cancer and tuberculosis, spirometer. This set of data compiled from differ- are main causes of mortality that will continue to ent sources requires applying a CDA R2 structure, increase in the coming decades. A spirometer is the oriented to ease the integration between medical medical device mandated to measure the pulmo- device and the health information system (HIS), nary volume and capacity, identifying possible and a higher interoperability among hospital infor- alterations. Commonly, all devices have a propri- mation systems. etary data format output. This is a setback for their integration in different environments because when The data model1 has been developed by a multidis- data is stored on a shared repository, it is not in- ciplinary scientific team, consisting of pulmonolo- teroperable since all of the data does not share the gists, health-tech experts and spirometer manufac- same format nor does it contain structured data. turers, thus providing different perspectives about this model. The model is thus enriched by the Driven by “Oficina d’Estàndards i Interoperabilitat diversity and vast knowledge of the team. de TICSalut” and “Pla de Digitalització de la Imatge Mèdica del Departament de Salut de la Generalitat Two versions of this data model1 exist. The first de Catalunya,” a standard has been created based version is more detailed and is clearly oriented to a on the HL7 Clinical Document Architecture, Release subsequent execution of a data mining system. The 2 (CDA® R2). The goal of the standard is to normal- second version is more basic and takes into account ize a complete data set, including both data received that not all the centers or hospitals can provide the from spirometers as well as those that come from information required by the detailed version. the test citation provided by the electronic clinical history from a hospital or medical center. After the data model was developed, a set of nor- mative and technological articfacts was generated Consequently, this standard creates a spirometry to facilitate the standard implementation: report that contains not only the information re- continued on next page This standard creates a spirometry report that contains not only the information related with the spirometry test, but also all the data from the test request, patient identification, and spirometer. MAY 2011 3 Spirometry Test Standardization continued from page 3 Figure 1. Visualization of spirometry report CDA R2 • CDA R2 Spirometry Implementation Guide2: The first implementation of the CDA R2 spirometry This guide contains the norms to follow to standard was through an open-source integration implement CDA R2 correctly, including manda- framework called EI2Med, based on Mirth Connect, tory fields and their content. Two versions of in which many tools have been developed to ease this implementation guide have been created— generation and integration between standard files and one for each version of the data model. HIS. Manufacturers and spirometry models have been • CDA R2 XML Formatted Templates: A set of integrated with the integration framework EI2Med. CDA R2 spirometry templates has been cre- ated. Templates exist for both versions, basic Public hospitals in Catalonia are currently collabo- and detailed. rating on pilot projects to validate the normaliza- • XSL Style Sheet: This is a file needed to tion and integration technology of the spirometry visualize spirometry CDA R2, which follows a tests. There are plans to start the implementation standard style sheet for CDA-HL7 presentation. in all health facilities in Catalonia. Using spirometry CDA R2 allows for the resulting References reports to be shared through different hospital health 1 T. Salas, M. Domingo, y F. Burgos. Data model