1. iEHR Standards Project HL7 PC Presentation HL7 WGM Boca Raton September 2006

2. © 2006, Canada Health Infoway, Inc. 2 To introduce the Canadian iEHR Project To introduce the Canadian iEHR Care Objects To demonstrate that our work fits with the PC Committee To discuss how we can work together Presentation Objectives

3. © 2006, Canada Health Infoway, Inc. 3 Presentation Overview Background iEHR Components iEHR Messages EHR Infostructure Requirements Canadian mini-D-MIMs derived from PC Care Statement

4. © 2006, Canada Health Infoway, Inc. 4 Background Canada Health Infoway (Infoway) has initiated the Interoperable Electronic Health Record (iEHR) project to set the foundation for establishing the messaging standards by which the EHR community in Canada will interoperate. These specifications will form the basis of the interoperable messaging platform within the EHR Infostructure as detailed in Infoways blueprint document.

5. © 2006, Canada Health Infoway, Inc. 5 iEHR Components The iEHR specifications will address the requirement by the healthcare community (Point of Service or PoS) to interact with two specific components of the EHR Infostructure; 1.The Shared Health Record (SHR) 2.The EHR Index. The SHR is primarily responsible for housing healthcare information related to encounters, events and episodes which spans multiple business domains; that is, information specifically identified as not belonging to an already existing business area (e.g. Drug Information, Laboratory, and Diagnostic Imaging) The EHR Index will contain meta information about healthcare events, episodes and encounters stored in the SHR and in domain-specific repositories (Drug, Lab, DI). This meta data will effectively catalogue the information to allow for easier storage to, and retrieval from the SHR and the domain-specific repositories.

6. © 2006, Canada Health Infoway, Inc. 6 EHR Infostructure: Conceptual Architecture

7. © 2006, Canada Health Infoway, Inc. 7 iEHR HL7 v3 Messages The iEHR Standards Project has develop HL7 V3 messaging and associated terminology standards –to support PoS recording/retrieval of clinical information to/from the SHR for high priority clinical needs. –to support the capture of EHR Index Metadata.

8. © 2006, Canada Health Infoway, Inc. 8 Requirements Common Observations –Record/List/Get Common Observation (Coded/Measured) Procedure –Record/List/Get Procedure (Physical/Non-Physical) Care Composition –Record/List/Get/Update Encounter/Episode/Generic Care Event EHR Index –Retrieve a list of events described at a high level for a particular patient based on various search criteria –Notify a Point of Service application that an event previously captured in the index is being revised (e.g. status change) Patient Clinical Profile –Obtain Patient clinical profile from SHR & Domain-specific Repositories

9. © 2006, Canada Health Infoway, Inc. 9 Canadian mini-D-MIMs derived from PC Care Statements Observation Substance Admin Supply Procedure Encounter Organizer Act Reference Common Observation Pharmacy Supply Other Supply Procedure Care Composition EHR Index Lab DI -Coded Observation -Measured Observation -Cognitive Service -Physical/Surgical Service -Encounters -Episodes -Generic Care Events

10. © 2006, Canada Health Infoway, Inc. 10 For more information John Kufuor-Boakye kufuor@telusplanet.net Lloyd McKenzie lloyd@lmckenzie.com