医用软件技术2012-3-27-第四章医疗信息交换标准

第四章医疗信息交换标准•查询(Queries)触发事件——检查预定QRY/DSR–originalmodedisplayquery–immediateresponsemessageQRYQueryMessageChapterMSHMessageHeader2QRDQueryDefinition2[QRF]QueryFilter2[DSC]ContinuationPointer2DSRDisplayResponseMessageChapterMSHMessageHeader2MSAMessageAcknowledgment2[ERR]Error2[QAK]QueryAcknowledgment2QRDQueryDefinition2[QRF]QueryFilter2{DSP}DisplayData2[DSC]ContinuationPointer2查询消息举例原始模式显示查询消息（QRY)查询事务将患者基本信息通过QRY/QRF消息来实现——由MSH、QRD(查询定义)、QRF组成通常是通过患者的姓名和ID号码以及特定的查询条件来获取需要的数据P74例：HIS查询ID号为10032002的病人的检查报告MSH|^~\&|HIS||LIS||200405201200||QRY^R02|MSG0001|P|2.4CRQRD|200404180943|R|I|Q4412|||10|ID||10032002|RESCRQRF|LIS||200401120100CRP74QRD段为查询定义段,用来定义查询的内容QRF段在QRD段后，用来进一步定义查询的内容、查询者所在信息•显示应答消息（DSR）LIS可以使用DSR(显示应答消息)立即将查询结果发送给HIS也可以先发送一个查询确认消息(QCK),表示已经收到查询请求然后在以后的某个时间再将查询的结果通过DSR发送给HIS显示应答消息DSR举例MSH|^~\&|LAB01||ICU||||DSR|ZXT23461|P|2.3CRMSA|AA|MSG00001CRQRD|199909111012|D|I|4387|||20^LI|12233|RES|ALLCR第一段为MSH，说明由LAB发給ICU部门的编号为ZXT23461确认消息DSR第二段为MSA，回应编码MSG00001消息第三段为QRD，說明此消息是1999年9月11日10时12分发出查询病人（号码#12233）的所有检查资料P75•第四段为DSP，显示此消息为病人（号码#12233）SMITH,JOHNH.的资料DSP|||RESULTSFORPATIENT#12233SMITH,JOHNH.09/11/99CRDSP|||SPECIMEN#H85COLLECTED09/11/87/07/0/0CRDSPCRDSP|||ELECTROLYTESCRDSP|||SODIUM140[135-148]MEQ/LSTATCRDSP|||POTASSIUM4.0[3.5-5.0]MEQ/LSTATCRDSP|||CHLORIDE89[95-111]MEQ/LSTATCRDSP|||CO220[20-30]MEQ/LSTATCR•第十一段为DSP，显示病人（号码#12233，SMITH,JOHNH）血液內含的二氧化碳CO2数为20，其标准值为[20-30]ENHANCEDMODEQUERYMESSAGESEQQ-embeddedquerylanguagequery(eventQ01)EQQEmbeddedQueryLanguageQueryChapterMSHMessageHeader2EQLEQLDefinition2[DSC]ContinuationPointer2VQQ-virtualtablequery(eventQ01)VQQVirtualTableQueryChapterMSHMessageHeader2VTQVTQDefinition2[RDF]TableRowDefinition2[DSC]ContinuationPointer2P76MSH|^~\&|CLINIC||CENTRAL-REG||||EQQ|MSG00001|P|2.3crEQL|TAG001|T|SQL_PID_QRY_01|SELECT@00108.1,@00108.2,@00114.1,@00114.2,@00114.3,@00114.4,@00114.5,@00122,@00110FROMPIDWHERE@00108.1=‘EVANS’crENHANCEDQUERYMODERESPONSEP77EDREnhancedDisplayResponseChapterMSHMessageHeader2MSAMessageAcknowledgment2[ERR]Error2QAKQueryAcknowledgment2{DSP}DisplayData2[DSC]ContinuationPointer2TBRTabularDataResponseChapterMSHMessageHeader2MSAMessageAcknowledgment2[ERR]Error2QAKQueryAcknowledgment2RDFTableRowDefinition2{RDT}TableRowData2[DSC]ContinuationPointer2ResponsetotheabovequeryMSH|^~\&|CENTRAL-REG||CLINIC||||TBR|MSG99001|P|2.3crMSA|AA|MSG00001crQAK|TAG0001|OKcrRDF|9|@00108.1^ST^20~@00108.2^ST^20~@00114.1^ST^30~@00114.2^ST^30~@00114.3^ST^20~@00114.4^ST^2~@00114.5^ST^5~@00122^ST^11~@00110^TS^8crRDT|Evans|Aaron|105MapleSt.||Lancaster|PA|19786|156-96-2542|19520809crRDT|Evans|Bart|166NorwoodLn.||Hershey|PA|19987|765-58-4615|19701217crRDT|Evans|Beth|15ElmwoodCt.|Apt.15|Gap|PA|19724|58-96-7619|19401119crRDT|Evans|Carolyn|903DianeCircle||Phoenixville|PA|19460|156-96-2542|19620324crDSC|00005cr思考题查询与主动更新的关系？分析原始查询与增强查询的特点?P874.8HL7接口引擎5.8.1HL7接口引擎简介图5.11HL7引擎HL7引擎：第一种层次数据交换第一种层次数据交换应用，是对现有的信息进行处理，只是“交换”现有的系统中存在的信息数据•第二种层次是基于不同系统之间进行整合的数据通讯，其目的达到不同系统之间的无缝连接而进行的数据通讯和数据交换应用HL7Ready：第二种层次数据交换P137问题1、HL7Engine交换的内容？交换的目的？2、HL7Ready交换的内容？交换的目的？3、HL7Engine与HL7Ready的相同点与区别？如何主动获得信息？HL7Ready：系统之间的交互HL7引擎核心子成分层、数据成分链表指针重复字段指针字段指针段指针消息子成分层、数据成分链表指针重复字段指针字段指针段指针消息消息解析过程消息构造过程消息传输过程HL7消息构造/解析方法在消息中保存段的链表的指针段中保存字段的指针数组字段中保存重复字段链表的指针重复字段中保存成分链表的指针成分中保存子成分链表的指针数据保存在子成分层基于文本框的HL7消息构造与解析过程示意图HL7V3AnHL7Version2.XSpecCommonSpecsChapter-SpecificSpecsChapter-SpecificSpecsChapter-SpecificSpecsChapters2and8Chapters3,4,6,...TriggerEventandMessagesSegmentsandFieldsAnHL7Version3.XSpecCommonSpecsChapter-SpecificSpecsUseCaseModelInformationModelMessageModel2-ndOrder1choiceof0-nDrug0-1NursingImplementableMessageSpecificationEDIFACT**FutureConsiderationImplementableMessageSpecificationOLE/CORBAImplementableMessageSpecificationXML/ER7/…HL7ReferenceModelInteractionModelVersion3isachangetotheHL7ArchitectureTheHL72.xspecificationshave:–Segmentsthatimplyinformationentities–Eventsthatindicateimpliedbehaviors–DescriptivecontentthatsuggestsusecasesbutneverformallydocumentstheseVersion3seekstoformalizethisbyapplyingobjectanalyticmethodsandstyle–toimprovetheinternalconsistencyofHL7–toprovidesoundsemanticdefinitions–toenablefuturearchitectures–toproduceanevolutionnotarevolutionDonebyapplyingMODELINGtotheHL7processHL7ModelingAbstractions:Activities(UseCaseModel)DispenseMedicationsManageCarePerformLabTestsReviewUtilizationObjects(InformationModel)AccountPatientProviderEncounterOrderCommunication(InteractionandMessageModels)ADTPharmacyHL7messageFinanceVersion2.xfocuseditsenergiesatthecommunicationlevelandcoveredtheotherabstractionsonlylooselyinthespecifications.Bydemandinganalysisoftherequirementsandinformationcontent,Version3assuresconsistencyinandenhancesthevalueoftheresultingmessages.HL7messageV2.3AbstractMessage-ADTMSHMessageHeaderEVNEventTypePIDPatientIdentification[PD1]AdditionalDemographics[{NK1}]NextofKin/AssociatedPartiesPV1PatientVisit[PV2]PatientVisit-AdditionalInfo.…[{GT1}]Guarantor[{IN1Insurance[IN2]InsuranceAdditionalInfo.[IN3]In