The Evolution of Pharmacy Messages HL7 UK Conference 2 November 2004 Hugh Glover, BSc, PhD Partner, Blue Wave Informatics LLP

Basics Information for Health proposes using IT to better share patient record Must interface different systems together How many interfaces do we need? –2 Systems = 1 Interface –3 Systems = 3 Interfaces –4 Systems = 6 Interfaces –n Systems = n*(n-1)/2 Interfaces –15 GP Pharmacy Systems = 105 Interfaces –250 Trusts = 31,125 Interfaces Something has to be done!

HL7 v3 as a “standard” NHS made a judgement that HL7 v3 was the way to go No domains had passed ballot BUT The RIM was on the point of passing ballot

Do Domains Matter? dotORG Ballot Basic Refinement & Localisation RIM Vocabulary Data Types: Abstract XML ITS UML ITS Transport Specifications –ebXML –MLLP –Web Services Gello Common Terminology Services Common Domains –Shared Messages –CMETS Infrastructure Management –Transmission –Message Control Act –Query –Master File UK MIM Basic Infrastructure CMETs Data Types Vocabulary Business Process Specific LRs PDS PSIS Query

Do Domains Matter? dotORG Ballot Admin Management –Account Billing –Claims & Reimbursement –Patient Administration –Personnel Management –Scheduling Health & Clinical Management –CDA –Blood Bank –Laboratory –Clinical Genomics –Medical Records –Care Provision –Pharmacy –Public Health reporting –Informative Public Health Specs –Regulated Studies –Therapeutic Devices UK MIM Mainstream Accident & Emergency Diagnostic Imaging eBooking Emergency Admissions GP2GP Medication Management Mental Health NHS Direct OOP Appointments Out of Hours Provision of Care Single Assessment

Pharmacy is a Domain Exemplar Giving a patient medicine is understood by all It is the first example that springs to mind –RIM Definitions are frequently in terms of drug administration … What has happened?

Pharmacy DMIM 2002

Pharmacy DMIM 2003

Pharmacy Combined Order RMIM 2004

NPfIT MIM – Parent Prescription

NPfIT MIM – Parent Prescription

Development & Harmonisation Pharmacy DMIM 2002 Pharmacy DMIM 2003 Pharmacy DMIM 2005 UK Development Dutch Development Canadian Development Pharmacy RMIM 2004 Toronto Harmonisation Meeting

Do Domains Matter? dotORG Ballot Admin Management –Account Billing –Claims & Reimbursement –Patient Administration –Personnel Management –Scheduling Health & Clinical Management –CDA –Blood Bank –Laboratory –Clinical Genomics –Medical Records –Care Provision –Pharmacy –Public Health reporting –Informative Public Health Specs –Regulated Studies –Therapeutic Devices UK MIM Mainstream Accident & Emergency Diagnostic Imaging eBooking Emergency Admissions GP2GP Medication Management Mental Health NHS Direct OOP Appointments Out of Hours Provision of Care Single Assessment

Challenges for HL7 Absorbing new domains Making ballot processes work Defining conformance