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2015-02-16 1
15th International HL7 Interoperability Conference
Lessons Learned from the Transition of the
Polish National...
15th International HL7 Interoperability Conference
Presentation plan
• P1 – the core eHealth programme in Poland
• HL7 CDA...
15th International HL7 Interoperability Conference
eHealth programme in Poland
• Core eHealth programme in Poland (P1) aim...
15th International HL7 Interoperability Conference
HL7 CDA adoption in Poland
• Formally, usage of HL7 CDA as a standard f...
15th International HL7 Interoperability Conference
Format of the Polish national IG for CDA
• The previous versions of nat...
15th International HL7 Interoperability Conference
Work that was done
• Development environment of ART-DECOR has been set ...
15th International HL7 Interoperability Conference
Observations
• Lack of support for definition of business rules
• Abstr...
15th International HL7 Interoperability Conference
Support for definition of business rules
• Business rules are perceived...
15th International HL7 Interoperability Conference
Abstract and non-abstract document templates
• Sometimes, the template ...
15th International HL7 Interoperability Conference
Using closed and open templates in one DECOR project
• ART-DECOR genera...
15th International HL7 Interoperability Conference
Relationships between templates
• Dynamic relationship in ART-DECOR mea...
15th International HL7 Interoperability Conference
Conclusion
• DECOR proved to be very useful format for HL7 CDA IG on
na...
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IHIC 2015 Presentation (2)

International HL7 Interoperability Conference 2015 Presentation: Lessons Learned from the Transition of the Polish National Draft Implementation Guide for HL7 CDA Standard into DECOR Format

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IHIC 2015 Presentation (2)

  1. 1. 2015-02-16 1 15th International HL7 Interoperability Conference Lessons Learned from the Transition of the Polish National Draft Implementation Guide for HL7 CDA Standard into DECOR Format Roman Radomski, Sebastian Bojanowski iEHR.eu, Poland Prague, February 10, 2015
  2. 2. 15th International HL7 Interoperability Conference Presentation plan • P1 – the core eHealth programme in Poland • HL7 CDA adoption status in Poland • Polish national implementation guide for CDA • Observations from the transition of IG to ART-DECOR • Conclusions
  3. 3. 15th International HL7 Interoperability Conference eHealth programme in Poland • Core eHealth programme in Poland (P1) aims at building a national platform for clinical documents exchange. • It will be a registry and repository for 3 types of clinical documents: – Drug Prescription – Medical Equipment Prescription – Referral • It will be just a registry for other electronic clinical documents, locally stored. • P1 Platform will go live this year. The regulatory obligation to process clinical documents at P1 Platform will be introduced gradually 2015-2017.
  4. 4. 15th International HL7 Interoperability Conference HL7 CDA adoption in Poland • Formally, usage of HL7 CDA as a standard for clinical documents in electronic form is just a recommendation. • In practice, CDA is the only standard, that is being taken into account in any specification for electronic clinical documents. • The biggest private medical provider adopted CDA in 2010 and there are several other (smaller) implementations of CDA. • The first draft national IG for CDA has been developed in 2013-2014 and covered 3 types of documents, that are going to be stored at P1 platform. • Now, the 10th version of the draft national IG gained operational status and has been published as the Polish National Implementation of HL7 CDA version 1.0
  5. 5. 15th International HL7 Interoperability Conference Format of the Polish national IG for CDA • The previous versions of national IG were developed in the form of text document, where constraints were presented in hierarchical description format. • In 2014 the decision has been made to adopt DECOR as the official format of Polish national IGs for HL7 CDA. • Our work was to recreate the IG in the form of value sets and CDA templates in the ART-DECOR environment and prepare them to be published in the HTML format using ART-DECOR tools.
  6. 6. 15th International HL7 Interoperability Conference Work that was done • Development environment of ART-DECOR has been set up and references to the base HL7 CDA building block repositories. • New value sets (from the existing external international and Polish code systems) have been defined. • OID Registry for Polish eHealth agency (CSIOZ) node has been designed using ISO-13582 conformant XML syntax. • One new code system for Polish specific HL7 V3 qualifiers in ClaML format has been defined. • 194 CDA templates including 17 document-level templates have been created.
  7. 7. 15th International HL7 Interoperability Conference Observations • Lack of support for definition of business rules • Abstract and non-abstract document templates • Problem with using open and closed templates together (in one DECOR project) • Unclear DECOR relationships between templates
  8. 8. 15th International HL7 Interoperability Conference Support for definition of business rules • Business rules are perceived by some of the specification readers as the most valuable part of specifications. • Template description is not enough (readibility and maintenance problem) • Our solution/proposal: – New XML structure has been defined for business rules – Business rules can be specified on the document-level template – In general, the specialized templates include business rules from the original templates – If specified, the business rule can override another business rule
  9. 9. 15th International HL7 Interoperability Conference Abstract and non-abstract document templates • Sometimes, the template is not intended to be implemented directly, but it is created just as a source of common/shared constraints for another templates. • In released IG there should be clear indication, that such template “is abstract”. • Our solution/proposal: – The main list of releases/published IG contains only non-abstract document level templates with schematron files and business rules set for each such template.
  10. 10. 15th International HL7 Interoperability Conference Using closed and open templates in one DECOR project • ART-DECOR generates schematron rules for closed templates to check if no forbidden element is used, but this works properly only if you use only closed templates in your project. • There is a need for both: closed and open templates in one IG. • Our solution/proposal: – still under investigation
  11. 11. 15th International HL7 Interoperability Conference Relationships between templates • Dynamic relationship in ART-DECOR means only that at the time of template creation, it references to the newest version of the template being contained or specialized. • Our solution/proposal: – We use two DECOR projects for each IG: “source “ and “final” – All changes are being done in the source file – Final file is being generated by transformation from the source file, at the time of publishing new release of IG
  12. 12. 15th International HL7 Interoperability Conference Conclusion • DECOR proved to be very useful format for HL7 CDA IG on national level, both for specification developers and for implementers. • The most important „feature” of ART-DECOR is its Expert Group, which consists of people who know the best not only their product, but also what you want/should to do with it and how to do that. Thank you!

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