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CompanyLogo
Seoul National
UniversityCollege of Medicine
@
1
CDA and Virtual EMR
Jinwook Choi Seoul National University
MILAB of SNU BME
Overall System Objectives
RIM
Arden Syntax
Development of CDA Based Clinical Data
Exchange System
CDA
HL7 V3 Message
To share clinical data across heterogeneous institutions
MILAB of SNU BME
Background
Pioneering Pilot Project of HL7 V3 in Korea Reference Information Model (RIM)
Shared information model and terminologyClinical Document Architecture (CDA)
Common structure for persistent documentsArden Syntax for Medical Logic
Formalism for expressing medical logic rulesVersion 3 Messaging
Focus on data interchange for data basesEnhanced for compound structures such as EHR elements
MILAB of SNU BME
HIS
Echo-Cardiology System
CDA Server
CDA LocalRepository
CDSS Server
CDABuilder
CDR Interface
CDARetriever
ECA Engine
MLM Vocabulary
MLM in Arden Syntax
HL7 messages
CDR
CDA Documents CDA
Documents
Overall System Architecture
CompanyLogo
Seoul National
UniversityCollege of Medicine
@
5
CDA Server
MILAB of SNU BME
Main Components of CDA Server
CDA BuilderToolkits for creating, viewing and transforming CDA templates and documents
CDA RetrieverWeb-based CDA document processing engine
CDR InterfaceHL7 messaging-based gateway for exchanging CDA documents with CDR
CDA
SERVER
MILAB of SNU BME
Design Objectives of CDA Builder
Compatible with a wide range of clinical information system
Impose minimal overhead on the existing clinical information system
Automatically create CDA documents by extracting data from the existing database
Independent of the underlying storage mechanism
Achieve software reuse throughComponent Based Development (CBD) methodology
Use open standards
CDA
SERVER
MILAB of SNU BME
Architecture of CDA Builder
CDA Graphical Viewer
CDA2DB Mapper
DB Mapping Class
SourceGenerator
CDA GeneratorDATABASE Event Manager CDA
Documents
CDAComposer
DB Trigger Register
CDA XML Schema(CDA Templates)
Sample CDADocument
CDA Refiner
Version Transformer
XSL
Automatic CDA Generator
Initialize variables
SQL queries
Import Import
CDA
SERVER
MILAB of SNU BME
Use Case Diagram of CDA Composer
HIS Manager
DBMS Manager
CDA Specialist
Generate Sample CDA Document
Generate DB Mapping Class
Change Cardinality
<<extend>>
Manage File
View CDA
Manage DB Connection
Manage Vocabulary Domain
Refine CDA Schema<<extend>>
Define CDA Contents Mapping
Transform CDA Version
Generate CDA Template
Generate CDA Mapper
<<include>>
Start CDA Generator
Manage Project File
Validate CDA
<<include>>
User
CDA
SERVER
MILAB of SNU BME
UI Design of CDA Composer
DescriptionWindow
Debug Window
Tool Bar
Menu Bar
Attribute Groupclinical_document_header (1..1)
id (1..1)
body (1..1)
provider (1..*)
Attribute Group
section (1..*)non_xml (1..1)
levelone
complextype
1minOcc
unboundedmaxOcc
sectionname
Element Property
name
Fixed
Default
Type
requireduse
Group nameAttribute Property
Fixed String ValueFixed String Value
Free Textvalues
없음vocabulary
Database ValuesDatabase Values
Method Name
Table Field
Table Name Field Name
ModifyXMLSchemaitself
DefineContentMapping
WorkspaceProject
CDA TemplateMapping Info
Mapping ClassSample Doc
MILAB of SNU BME
Design Objectives of CDA Retriever
Should be scalable to accommodate continuously increasing CDA documentsCan accommodate any clinical documents that conform CDA specificationDisplay CDA documents in a user preferred view using XML-aware browsersSupport keyword search for CDA documentsUse open standards
CDA
SERVER
MILAB of SNU BME
Architecture of CDA Retriever
CDA LocalRepository
CDADocument Parsing
Indexing
Storing
Index # Extraction
Query Formulation
1
User’s Query
2
3
1.1 update
1.2
1.3
CDA
SERVER
MILAB of SNU BME
CDA Local Repository Schema
CDA
SERVER
CompanyLogo
Seoul National
UniversityCollege of Medicine
@
14
CDSS Server based on Arden Syntax
MILAB of SNU BME
Background
Using intelligent medical logic modules has lots of profits
Prevent significant medical errorsReduce hospital costs
Medical knowledge is highly specialized knowledge
A medical expert cannot cover all the medical field
Sharing of MLM will enrich the CDSS environment
CDSS
SERVER
MILAB of SNU BME
Design Objectives
Establish MLM sharable environment among institutionsMake an easy-to-use interface to write and register an MLM
Arden Syntax editorMLM register
Implement an MLM running environmentCompilerVocabulary ECA engine(Monitor Events)Runner
CDSS
SERVER
MILAB of SNU BME
MLM in Overall System Architecture
Compiler
Echo-CardiologyLocal
Database
MiddleWare
MLMVocabulary
Compiler
Database
MLMMiddleWare
Vocabulary
Compiler
Database
MLMMiddleWare
Vocabulary
Compiler
Database
MLMMiddleWare
Vocabulary
SourceRepository
CommonVocabulary
Server
MLM
Echo-Cardiology Server
Echo-Cardiology Repository
ObjectManager
CDA Server
CDABuilder
CDARepository
RIM
GatewayMsg Queue
HL7 IE
SourceMLM
…
MILAB of SNU BME
MLM Running Environment
CDSS
SERVER
MILAB of SNU BME
MLM Compiler
1. Input MLM
…
Dictionary
Compiler
3. Parser2. Lexer(Scanner)
4. Compiled MLM
Event InformationXML Doc.
MicroEvent …MicroEvent
Java Class file
Condition
Action
5. Send toECA Engine
5. Send toRunner
CDSS
SERVER
MILAB of SNU BME
Dictionary for MLM Compiler
Dictionary
1. Query data terms2. Vocabulary Mapper
3. Return DB MappingInformation
variable nametable name
patient ID field nameprimary time field name
code field namecode
value field
Mapping Tables
..
CDSS
SERVER
MILAB of SNU BME
ECA Engine
…ED3ED2ED1
Event Detect Manager
Database
1. Register Event
3. Register_trigger(microEvent)
4. signal microEvent
6. Signal macroEventto runner
MacroEvent
…
MicroEvent
MicroEvent
MicroEvent
monitormicroEvent
insertion / update
5. Check if a macroEvent
happened
2. Split macroEventinto microEvents
monitormicroEvent
monitormicroEvent
CDSS
SERVER
MILAB of SNU BME
Runner
Runner
Java class
2. Event signal from ECA Engine
Database
E-mailFax
AlarmMessage
…
4. CheckCondition
5. Action
3. Check event fire
Get the real DB value
1. Register runnableJava Class filesfrom compilerC
DSS
SERVER
CompanyLogo
Seoul National
UniversityCollege of Medicine
@
23
Echo-Cardiology Information System
MILAB of SNU BME
Architecture of Echo-Cardiology System
SearchSearch
InputInput
PrintPrint
Client Interface
HIS ReportTable
Views
Database
Data
HL7 Gateway
Sender : Build & Send HL7 MsgSender : Build & Send HL7 Msg
Receiver : Receive & Parse HL7 MsgReceiver : Receive & Parse HL7 Msg
Socket
SelectInsertUpdate
Timer Insert
HL7 Message
MILAB of SNU BME
Receiver in HL7 Gateway
Receiver
HIS
Reservation
Database
ReservationData Table
HL7 Message
Receive MsgParse DataInsert to DBWrite to Log
ECho CardIology
System
MILAB of SNU BME
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Reservation Message LogECho CardIology
System
MILAB of SNU BME
Sender in HL7 Gateway
Sender
ReportTable
HIS
Searched in HIS Program
Database
HL7 Message
Make MsgSend Msg to HISWrite to Log
ECho CardIology
System
MILAB of SNU BME
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Observation Result Message LogECho CardIology
System
MILAB of SNU BME
Client Interface for Retrieval
Login
Database
ReportTable
Views
Data
Input Result
Search Reservation
Search Result
ECho CardIology
System
MILAB of SNU BME
Interface for Patient Search
xxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
xx xx xx xx xx xx xx xx xx xx xx xx xx xx xx xx xx xx xx xx xx xx xx xx
(XXX)
ECho CardIology
System
MILAB of SNU BME
Interface for Result Report
XXX
XXXXXXXXXX
XXX(XXXXXXX)(XXX)
ECho CardIology
System
MILAB of SNU BME
Data transferred to HIS
xxxxxx xxxx
ECho CardIology
System
