Presentation is loading. Please wait.

Presentation is loading. Please wait.

Unit 7 System Interfaces and Integration Component 8 Installation and Maintenance of Health IT Systems This material was developed by Duke University,

Published byMyron Horn Modified over 9 years ago

Similar presentations

Presentation on theme: "Unit 7 System Interfaces and Integration Component 8 Installation and Maintenance of Health IT Systems This material was developed by Duke University,"— Presentation transcript:

1 Unit 7 System Interfaces and Integration Component 8 Installation and Maintenance of Health IT Systems This material was developed by Duke University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000024.

2 What We’ll Cover Definitions of interface and integration Why are integration capabilities important? What is an interface? Types of protocols Interoperability standards, e.g. HL7 –How HL7 works Integration & EHR systems Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 2

3 What are Interface and Integration? Interface –Point of interaction between components –Mappings, translation tables –Example: Practice management system shares data with EHR via software interface. –Must be managed as systems get updated Integration –Process of combining various subsystems into larger system, ensuring that subsystems function together as a whole –IT: linking computing systems and software applications, physically or functionally Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 3

4 Why are Integration Capabilities Important? Healthcare often involves many isolated systems that increasingly need to be interfaced with EHR systems. –Too expensive to replace: cost of purchase + manpower + training + lost productivity –Tailored to meet specific departmental needs Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 4

5 Pre-Existing Systems to Consider with an EHR Clinical information –Vital sign measurements –Results reporting –Clinical documentation –Order management, computerized provider order entry (CPOE) –Consults tracking –Clinical rules engine, alerts, reminders –Patient education Patient management –Patient registration –Admission/discharge/transfer (ADT) –Scheduling Labs –Chemistry –Microbiology –Anatomic pathology Pharmacy/Medications –Inpatient, outpatient –Barcoding, electronic medication administration record (MAR) –Adverse drug reactions (ADRs) Radiology –General radiology –Nuclear medicine –Clinical image viewing (PACS) Nutrition and food service –Food service management –Clinical nutrition Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 5

6 Common Interface Methods Point-to-point –Direct connection between each component Interface engine –Connected via centralized location Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 6

7 Interface Method: Point-to-Point Traditional method Requires that each component have direct connection points to other components Disadvantages: Labor-intensive to set up and maintain; can require a large number of connections Advantage: direct, secure linkage Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 7

8 Point-to-Point Illustration Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 8 Lab PACS DatabaseRegistry

9 Interface Method: Interface Engine Routes data through centralized location, reduces number of separate connectivity points Advantages: flexible, scalable, easier to install and maintain, data consolidation, centralized management –Good option if unable to purchase full-featured EHR. Older-generation interface engines had disadvantage of high cost: long time to build, extensive programming, scripting skills. Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 9

10 Interface Engine Illustration Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 10 Interface Engine Lab PACS Database Registry

11 Types of Interface Protocols eXtensible Markup Language (XML) Fixed-length formats Variable-length delimited formats Java HL7 (Health Level 7) –Widely used for interfacing between healthcare systems Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 11

12 HL7 as a Protocol Name “Health Level 7” refers to 7 th layer of ISO OSI reference model: “application” layer. HL7 represents ANSI (American National Standards Institute) at ISO (International Org. for Standardization) for health data. HL7 messages –Based on messaging protocol. –Body comprised of many purposed segments, each on own line. –Segments denoted by 3-letter notation indicating purpose. Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 12

13 Why is HL7 Important? First standard protocol for communication between EHR components. Allows for open system architecture (rather than closed/proprietary) –Interfacing between systems –Independent of vendor –New systems can be added without modifying original source code. Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 13

14 What is the HL7 Standard? Method for moving clinical data between independent medical applications in near-real time Structured, message-oriented framework for communicating between healthcare applications Acknowledged healthcare industry standard Not “plug and play”, but designed to be customizable Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 14

15 How do HL7 Messages Work? Sent & received by various EHR applications as requests and updates are made. 3-letter acronym at beginning of first line denotes message type. Single segment (line) contains many different fields/sub fields separated by delimiters, e.g.: | Pipe Field delimiter ^ Carrot Sub-field delimiter ~ Tilde Repeating field delimiter \ Backslash Escape character & Ampersand Sub-sub-field delimiter Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 15

16 HL7 Examples What can we tell from this segment? NK1||Smith^John^^^^|SPO||(919)5 55-5555||EC|||||||||||||||||||| –“NK1” = “Next of Kin” segment –“John” = subfield in third field of segment. –5 of first 8 fields of this segment contain data. Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 16

17 HL7 Examples (cont’d) Sample full HL7 message: MSH|^~\&||GA0000||MA0000|199705221605||VX Q^V01|19970522GA40|T|2.3.1|||AL QRD|199705221605|R|I|19970522GA05|||25^RD |^SMITH^JOHN^FITZGERALD^JR|VXI^VACCINE INFORMATION^HL70048|^SIIS QRF|MA0000||||256946789~19900607~MA~MA999 99999~88888888~SMITH^JACQUELINE^LEE~BOUVI ER~898666725~SMITH^JOHN^FITZGERALD~822546 618 –A lot can be gleaned from the first line. Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 17

18 HL7 Examples (cont’d) First line of message: MSH|^~\&||GA0000||MA0000|19970522 1605||VXQ^V01|19970522GA40|T|2.3. 1|||AL –“MSH” denotes “New Message”. –9 th field always tells what the message will be, with 2 subsets. “VXQ^V01” = vaccination history query. Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 18

19 HL7 Examples (cont’d) Rest of message: QRD|199705221605|R|I|19970522GA05|||25^RD|^SMITH^JOHN^F ITZGERALD^JR|VXI^VACCINE INFORMATION^HL70048|^SIIS QRF|MA0000||||256946789~19900607~MA~MA99999999~88888888 ~SMITH^JACQUELINE^LEE~BOUVIER~898666725~SMITH^JOHN^FITZ GERALD~822546618 QRD|199705221605|R|I|19970522GA05|||25^RD|^SMITH^JOHN^F ITZGERALD^JR|VXI^VACCINE INFORMATION^HL70048|^SIIS QRF|MA0000||||256946789~19900607~MA~MA99999999~88888888 ~SMITH^JACQUELINE^LEE~BOUVIER~898666725~SMITH^JOHN^FITZ GERALD~822546618 –“QRD” = Query definition segment. –“QFR” = Segment query filter. –Dozens of segment headers. Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 19

20 HL7 Interface Engine Helpful for incorporating EHR into legacy environment. Different standards: conceptual, document, application, messaging Flexible, customizable Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 20 HL7 Interface Engine Lab PACS Database Registry

21 Integration Between EHRs EHR integration is growing trend. –“Interoperability”: enabling healthcare entities to share patient information –Enhancing billing/payment & reform initiatives –Streamlining workflows between hospitals & clinics –Meeting HITECH “meaningful use” criteria Integration is still maturing. More standards and practices are being developed. Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 21

22 Integration Between EHRs (cont’d) To demonstrate “meaningful use”, EHRs must be able to exchange information with other certified EHR systems beyond their own environments. –Also need to link hospital EHR to ambulatory EHRs. Two methods for interfacing: –Point-to-point –Health Information Exchange (HIE) Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 22

23 Point-to-Point EHR Interface Traditional connection method Connect via variety of media Drawbacks: cost, customization, high maintenance Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 23 Hospital EHR Enterprise Ambul. EHR Enterprise EHR/ integration

24 Point-to-Point vs. HIE Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 24 Hospital EHR Regional Information Exchange Hospital or private HIE Enterprise EHR MDs without EHRs MDs using hospital enterprise EHR HIE PORTALS MDs using VHR or Lite EHR REGIONAL HIE PRIVATE HIE EHR POINT-to-POINT MDs using other owned EHRs

25 Summary Interface – A point of interaction between components. Integration – Combining various subsystems into one larger system and ensuring subsystems function together as a whole. Disparate systems require some way to connect to newer EHR systems to ensure interoperability. Point-to-point connectivity – Traditional method requiring that each component have direct connection points to other components. Interface Engines – Allow disparate systems to connect to each other more efficiently via interface that deciphers info from each component. Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 25

26 Summary (cont’d) HL7 messaging –Standard of choice for communication between different EHR components. –Based on messaging standard, uses groupings of segments to relay information throughout EHR system in near-real time. –Promotes “open architecture”, which allows anyone to interface systems using appropriate protocols, independent of vendor. Health Information Exchanges act as interface engines for healthcare institutions for an entire region. Component 8/Unit 7Health IT Workforce Curriculum Version 2.0 Spring 2011 26

27 Reference Integrating EHRs: Hospital Trends and Strategies for Initiating Integrated EHRs within their communities –http://assets1.csc.com/health_services/downloads/CSC_In tegrating_EHRs.pdfhttp://assets1.csc.com/health_services/downloads/CSC_In tegrating_EHRs.pdf HL7 Standards – What is Cardinality in HL7? –http://www.hl7standards.com/blog/2006/11/02/what-is-hl7- cardinality/http://www.hl7standards.com/blog/2006/11/02/what-is-hl7- cardinality/ “How to Select an Electronic Health Record System,” by Kenneth G. Adler, MD, MMM. Family Practice Management. 2005 Feb;12(2):55-62. Retrieved May 9, 2011. –http://www.aafp.org/fpm/2005/0200/p55.htmlhttp://www.aafp.org/fpm/2005/0200/p55.html Component 8/Unit 8aHealth IT Workforce Curriculum Version 2.0 Spring 2011 27

Download ppt "Unit 7 System Interfaces and Integration Component 8 Installation and Maintenance of Health IT Systems This material was developed by Duke University,"

Similar presentations

Meaningful Use and Health Information Exchange

Meaningful Use and Health Information Exchange
A Primer on Healthcare Information Exchange John D. Halamka MD CIO, Harvard Medical School and Beth Israel Deaconess Medical Center.

A Primer on Healthcare Information Exchange John D. Halamka MD CIO, Harvard Medical School and Beth Israel Deaconess Medical Center.
Meaningful Use, Standards and Certification Under HITECH—Implications for Public Health InfoLinks Community of Practice January 14, 2010 Bill Brand, MPH,

Meaningful Use, Standards and Certification Under HITECH—Implications for Public Health InfoLinks Community of Practice January 14, 2010 Bill Brand, MPH,
Chapter 2 Electronic Health Records

Chapter 2 Electronic Health Records
Series 1: Meaningful Use for Behavioral Health Providers From the CIHS Video Series “Ten Minutes at a Time” Module 2: The Role of the Certified Complete.

Series 1: Meaningful Use for Behavioral Health Providers From the CIHS Video Series “Ten Minutes at a Time” Module 2: The Role of the Certified Complete.
MEANINGFUL USE UPDATE 2014 Mark Huang, M.D. Chief Medical Information Officer Rehabilitation Institute of Chicago Associate Professor Department of PM.

MEANINGFUL USE UPDATE 2014 Mark Huang, M.D. Chief Medical Information Officer Rehabilitation Institute of Chicago Associate Professor Department of PM.
Medicare & Medicaid EHR Incentive Programs

Medicare & Medicaid EHR Incentive Programs
August 12, 20151 Meaningful Use *** UDOH Informatics Brown Bag Robert T Rolfs, MD, MPH.

August 12, Meaningful Use *** UDOH Informatics Brown Bag Robert T Rolfs, MD, MPH.
Introduction to Information and Computer Science Networks Lecture e This material (Comp4_Unit7e) was developed by Oregon Health and Science University,

Introduction to Information and Computer Science Networks Lecture e This material (Comp4_Unit7e) was developed by Oregon Health and Science University,
A First Look at Meaningful Use Stage 2 John D. Halamka MD.

A First Look at Meaningful Use Stage 2 John D. Halamka MD.
Meaningful Use Measures. Reporting Time Periods Reporting Period for 1 st year of MU (Stage 1) 90 consecutive days within the calendar year Reporting.

Meaningful Use Measures. Reporting Time Periods Reporting Period for 1 st year of MU (Stage 1) 90 consecutive days within the calendar year Reporting.
Decision Support for Quality Improvement

Decision Support for Quality Improvement
Component 10 – Fundamentals of Workflow Process Analysis and Redesign

Component 10 – Fundamentals of Workflow Process Analysis and Redesign
Installation and Maintenance of Health IT Systems Unit 8-2 System Selection- Software and Certification Component 8/Unit 2 1 Health IT Workforce Curriculum.

Installation and Maintenance of Health IT Systems Unit 8-2 System Selection- Software and Certification Component 8/Unit 2 1 Health IT Workforce Curriculum.
Series 1: Meaningful Use for Behavioral Health Providers From the CIHS Video Series “Ten Minutes at a Time” Module 2: The Role of the Certified Complete.

Series 1: Meaningful Use for Behavioral Health Providers From the CIHS Video Series “Ten Minutes at a Time” Module 2: The Role of the Certified Complete.
A First Look at Meaningful Use Stage 2 John D. Halamka MD.

A First Look at Meaningful Use Stage 2 John D. Halamka MD.
HL7 HL7  Health Level Seven (HL7) is a non-profit organization involved in the development of international healthcare.

HL7 HL7  Health Level Seven (HL7) is a non-profit organization involved in the development of international healthcare.
What Did I Work on in Washington? John Glaser April 16, 2010.

What Did I Work on in Washington? John Glaser April 16, 2010.
Copyright © 2009 by The McGraw-Hill Companies, Inc. All Rights Reserved. McGraw-Hill Chapter 4 Electronic Health Records in the Hospital Electronic Health.

Copyright © 2009 by The McGraw-Hill Companies, Inc. All Rights Reserved. McGraw-Hill Chapter 4 Electronic Health Records in the Hospital Electronic Health.
This material was developed by Duke University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information.

This material was developed by Duke University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information.

Similar presentations

Ads by Google