Obsolete - overview of using CDA with GP systems for the PCEHR (My Health Record)

1. Connecting
GP Systems
with the PCEHR
Brett Esler
www.oridashi.com.au
brett.esler@oridashi.com.au

2. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
From Where is this Coming...
• Implementer – compliance for 2x GP systems:
– HI Services (IHI)
– Shared Health Summary (3a) x 2 GP Systems
– Authoring System, Rendering System
– PCEHR B2B (CIS)
– SMD Sender Role
• NEHTA – implementation group:
– CCA Vendor Analyses
– FAQ Guidance
– CCA Guidance

3. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
Standards Implementation Perspective
• Destination ‘compliant’
– what is that?
• Where do I start?
– implementer perspective
• My system is ‘different’
– grey edge of standards
• Standards as product
– why do standards?

4. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
Destination ‘Compliant’
• Compliance, Conformance and Accreditation
• Compliance is a process
– Understand scope of interest:
• Clinical Document types (SHS, ES, eDS, SL etc.)
• Services interaction (PCEHR B2B, HI)
– Understand compliance resources:
• Specifications (CIC, SCS, IG)
• Validation Tools (Schema, CDA Validator)
– Understand ‘getting compliance’:
• Notice of Connection
• Observed self-assessment
• Lab testing

5. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
Resources: Content Specifications
• CIC : high level recommended data
– Core Information Components
– Information Requirements
• SCS : structured data for transfer
– Structured Content Specification
– Structured Document Template
• IG: CDA implementation of the SCS
– CDA Implementation Guide

6. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
vendors.nehta.gov.au

7. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
Resources: Common Specifications
• CDA Package:
– Digital signing
– Attachments
• CDA Rendering:
– Rules on narrative (common) authoring
– Required support for narrative (safe) rendering

8. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
Where do I Start?
• Understand your own system:
– Information Components
– Structured Content
– Semantics
• Compare to Specifications:
– Map high level concepts
– Work through specific data elements
– Determine supported content

9. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012

10. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
Produce Content
• Use reference implementations
• Use XML Schema
• Know at which level you are aiming
• Use CDA Validator Tool:
– Work up from schema compliance
– Work through levels 1, 2, 3
• Self-assess ahead of time

11. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
industry.ehealthcollaborate.com.au

12. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
Resources: Validation
CDA Validator

13. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
My System is ‘Different’
• Specific CCA CDA Test Cases are defined
• Some content is not relevant:
– I have no entry for that at all
– Address, Communications, Exclusion Statement
• Some detail can not be exactly produced:
– I cannot produce same words
– Date/Date-time, Diagnosis, Procedure, Medication
• Some basic data structure is different:
– I have a status rather than an end date
– I cannot distinguish one type from another

14. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
Resources: FAQ
vendors.nehta.gov.au

15. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
CCA: Grey Areas
• The IG is not clear
• The IG needs additional content
• Issue resolution is part of CCA
• FAQs can support resolution
• Validation tools incorporate FAQ

16. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
Observed Self-Assessment
• Having self-assessed
• Raise queries with CCA team
• Define needs not met by the specification
• Define when pathway unclear
• Define a suggested solution/approach
• Have your observed self assessment session
• Get a ruling on what to do

17. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
Standards as Product
Why do standards?
• Your product in the eHealth eco-system
• Ready: future capability (Clinical Documents)
• Effective information sharing beyond PCEHR
• IHE connects people and systems creating
industry cohorts – ‘in crowd’
• Interoperability is a feature, marketing tool

18. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
Incentive to Collaborate
• Small vendors:
– demonstrate capability
– industry status/profile
• Large vendors:
– demonstrate large scale benefits
– can‘t own interoperation
• All vendors:
– industry leadership

19. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
Incentive to Collaborate
• Consumers
– need for quality health record information
– need information at the point of care
– better decisions can be made
– better service delivery outcomes
– better patient outcomes
– better population health outcomes

20. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
Take aways
• CCA is a process
• Understanding your system is key
• Standards are product
• Benefits to vendors, consumers, patients

21. www.oridashi.com.au
Implementing the Australian
PCEHR IHE-XDS October 2012
Brett Esler
www.oridashi.com.au
brett.esler@oridashi.com.au