Upload
katherine-pollard
View
219
Download
0
Tags:
Embed Size (px)
Citation preview
1September, 2005 What IHE Delivers
IHE-Cardiology Technical IHE-Cardiology Technical CommitteeCommittee
EP Key Data ElementsEP Key Data Elements
February 21, 2011February 21, 2011
Bryan Jennings - Medical Micrographics Bryan Jennings - Medical Micrographics
Nick Gawrit - HeartBaseNick Gawrit - HeartBase
2
AbstractAbstract
Define a medical data format for Define a medical data format for clinical documents containing at clinical documents containing at a minimum:a minimum:
Patient Conditions Patient Conditions
EP Lab procedure dataEP Lab procedure data
Discharge SummaryDischarge Summary
Pointers to other materialPointers to other material
3
Problem StatementProblem Statement
There is a need to be able to extract these data There is a need to be able to extract these data elements from the medical record in an elements from the medical record in an automated, standards based data model that automated, standards based data model that can operate in a cross-platform environment can operate in a cross-platform environment across multiple electronic health records and across multiple electronic health records and cardiac rhythm management devices cardiac rhythm management devices regardless of vendor. regardless of vendor.
4
Development of Data StandardsDevelopment of Data Standards
Currently, clinical personnel, data managers, Currently, clinical personnel, data managers, clinical investigators, and FDA reviewers clinical investigators, and FDA reviewers
must cope with a must cope with a plethora of data formatsplethora of data formats and and conventions. Some clinical investigators conventions. Some clinical investigators
report the presence of report the presence of many different many different computer systems for data entrycomputer systems for data entry at their sites at their sites
(for various trials), each of which uses (for various trials), each of which uses different data conventions. Lack of different data conventions. Lack of
standardization is not only inefficient, it standardization is not only inefficient, it multiplies the potential for error. …multiplies the potential for error. …
5
Current StateCurrent StateData Capture: Some Sites Looks Like ThisData Capture: Some Sites Looks Like This
The virtual version of this mess – multiple web apps on one workstation – is scant improvement.
6
Standards UsedStandards Used
CDA Release 2.0CDA Release 2.0
ASTM/HL7 Continuity of Care Document (CCD)ASTM/HL7 Continuity of Care Document (CCD)
HL7 V3 Laboratory DMIM HL7 V3 Laboratory DMIM
HL7 Care Record SummaryHL7 Care Record Summary
LOINC & SNOMEDLOINC & SNOMED
HIPAA Lab Claim Attachment NPRMHIPAA Lab Claim Attachment NPRM
Document Digital SignatureDocument Digital Signature
7
Use CaseUse Case
1.1. Health care provider needs to collect data Health care provider needs to collect data to submit to the ACC NCDR-ICD Registryto submit to the ACC NCDR-ICD Registry
2.2. EMR System would like to display Key EMR System would like to display Key Cardiology data in a meaningful wayCardiology data in a meaningful way
3.3. EP Lab System produces data but needs EP Lab System produces data but needs to integrate with other systems to to integrate with other systems to facilitate data sharingfacilitate data sharing
8
Systems that contain data (to name a few)Systems that contain data (to name a few)
Boston ScientificBoston ScientificSt. Jude MedicalSt. Jude MedicalMedtronicMedtronicBiotronikBiotronikSiemens SyngoSiemens SyngoSiemens Axiom SensisSiemens Axiom SensisBardBardEP MedicalEP MedicalPrucka (GE) Prucka (GE) Witt (Phillips)Witt (Phillips)
LumedxLumedxBiosenseBiosenseMacLab (GE)MacLab (GE)MergeMergeMcKessonMcKessonCernerCernerEpicEpicNextGenNextGenAllscriptsAllscripts
9
Boston Scientific
EP Medical
Medtronic
St. Jude Medical
GE Prucka
Epic
Siemens
Biotronik
Goal: A Common TerminologyGoal: A Common Terminology
Philips Witt
10
ScopeScope
The clinical CDA document is: The clinical CDA document is: A report of A report of a set of final resultsa set of final results (the fulfillment process (the fulfillment process
being completed) will also be shared later as “historical being completed) will also be shared later as “historical information”.information”.
Human-readableHuman-readable, shared between care providers of , shared between care providers of various specialties and patients (e.g. through a PHR)various specialties and patients (e.g. through a PHR)
May contain May contain machine readable coded entriesmachine readable coded entries (decision (decision support, registry submissions)support, registry submissions)
11
A CDA content profile is…A CDA content profile is…A sharable information component that can be exchanged… within an HIE or RHIO via Media or USB Device via Reliable Messages Point to Point
Document content using standards CDA Release 2.0 HL7 Care Record Summary ASTM/HL7 Continuity of Care Document
More complex documents have a library of reusable parts
12
Where Can Cardiology Use CDA?Where Can Cardiology Use CDA?
Clinical Reports (Cath, Echo, EP, etc.)Clinical Reports (Cath, Echo, EP, etc.) to go along with our pretty DICOM imagesto go along with our pretty DICOM images
Analyses of raw image and waveform dataAnalyses of raw image and waveform data backing up the Clinical Reportbacking up the Clinical Report
Documentation of the procedureDocumentation of the procedure provide context for the raw data and analysesprovide context for the raw data and analyses
Input to a clinical and Registry databaseInput to a clinical and Registry database for patient care over time, or outcomes analysisfor patient care over time, or outcomes analysis
13
Value PropositionValue Proposition
Supports interchange of PHR InformationSupports interchange of PHR Information
Patient DemographicsPatient Demographics
Procedure and Device InformationProcedure and Device Information
Current and Prior ResultsCurrent and Prior Results
Medications, Problems, AllergiesMedications, Problems, Allergies
Diagnoses HistoryDiagnoses History
Other InformationOther Information
14
ACC-ICD Registry Pre-Populated in InterfaceACC-ICD Registry Pre-Populated in Interface
15
ACC-Cath PCI Registry Pre-PopulatedACC-Cath PCI Registry Pre-Populated
16
ICD Data Acquisition WorkflowICD Data Acquisition Workflow
Patient Encounter in ICD Lab
Case completed in Lab and electronically signed
EP Lab data exported to external processing queue
Data processed into format needed for ICD Registry
EP Lab data validated by clinical user
Non-EP Lab data added for submission completion
Registry Submission validated using NCDR tools
17
Retrieve Forms for Data Capture (RFD)Retrieve Forms for Data Capture (RFD)
provides a method for gathering data provides a method for gathering data
within a user’s current application within a user’s current application
to meet the requirements of an external to meet the requirements of an external systemsystem
18
Retrieve Forms for Data CaptureRetrieve Forms for Data Capture
A standard way of displaying external data A standard way of displaying external data capture forms inside an EHR.capture forms inside an EHR.
Many-to-many integration – any EHR can Many-to-many integration – any EHR can retrieve forms from many external systems.retrieve forms from many external systems.
Low barrier of entry for EHR and external Low barrier of entry for EHR and external systems.systems.
Flexible profile to accommodate both low-tech Flexible profile to accommodate both low-tech and sophisticated implementations.and sophisticated implementations.
19
Retrieve Forms for Data captureRetrieve Forms for Data capture
Initial Phase – Done!Initial Phase – Done! Define standard format for formsDefine standard format for forms Define standard method for retrieving and submitting Define standard method for retrieving and submitting
formsforms
Content Profile Phase for Cardiology – now!Content Profile Phase for Cardiology – now! Provide domain-specific form requirementsProvide domain-specific form requirements Enable form population from EHR mapped dataEnable form population from EHR mapped data
20
RFD Profile Actors and TransactionsRFD Profile Actors and Transactions
Form Manager
B
Form Receiver
C
Form Filler
A
Form Archiver
D
Form Manager – Form Receiver pairing is a statically defined business relationship based upon the domain, e.g., clinical trials, drug safety, public health, that can be embedded within the RFD Forms
Form Filler – Form Archiver(s) pairing is a dynamic, Form Filler defined business relationship that cannot be embedded within the RFD Form
Form Archiver
D
Form Archiver
D
21
RFD WorldRFD WorldClinical Trials Sponsor
Federal or State Agency
Disease Registry
Drug Safety Data Collection Agency
Paired Form
Manager / Form
Receiver
Physician Office
CN-1
A robust Form Filler
Paired Form
Manager / Form
Receiver
22
Example of RFD Form Filler opened in an Example of RFD Form Filler opened in an EMREMR
23
RFD Displays and Archives Data for Many UsesRFD Displays and Archives Data for Many Uses
24
IHE Web Site - http://www.ihe.netIHE Web Site - http://www.ihe.net Technical FrameworksTechnical Frameworks Technical Framework Supplements – Trial Technical Framework Supplements – Trial
ImplementationImplementation Calls for ParticipationCalls for Participation IHE Fact Sheet and FAQIHE Fact Sheet and FAQ IHE Integration Profiles: Guidelines for BuyersIHE Integration Profiles: Guidelines for Buyers IHE Connectathon ResultsIHE Connectathon Results Vendors’ Product Integration StatementsVendors’ Product Integration Statements
More InformationMore Information
Questions?Questions?