1.-HL7-v3-基础-(Foundation)--基本概念-业务描述

InsertPictureHere王海彤[e-mail]7简介及其基于HL7的业务描述ary24,2000Adomain-specific,commonprotocolfortheexchangeofhealthcareinformation.ISO-OSI通讯结构模型1Physical2DataLink3Network4TransportCommunication5Session6Presentation7ApplicationFunction什么是“HL7”?HL7v3RIM发展19891996WorkonHL7RIMCommencedFrom1995to1999alotofworkwasdoneintheareasofmessagedevelopmentframework(MDF),RIMdevelopment,adoptionofstructuralvocabularyparadigm,firstv3tools,growingInternationalAffiliatecontributionstov3HL7RIMvotingFirstv3ballotsincoreareas20002003HL7RIMisexpanding-RIM,tools,vocabulary,WebtransportDSTUs-E-claims,Scheduling,CMETS,rel1,DSTUs:PatAdmin,MedRxMgmntHL7RIMis10yearsinthemaking!1987HL7formedTotalInitialMembers:14ReleasedfirstmessagingstandardDec-2003RIMacceptedasanANSIstandardMay-2009LatestRIMBallot2001HL7RIMv1.0releasedHL7v2Vs.HL7v3MessagingHL7v2MessagingHL7v3ReferenceInformationModelVocabularySharedInformationModel.Themainsignificantchangeinv3DataTypesCommonTerminologyServicesEntityIdentificationServiceAndother….从MDF到HDF语法(Syntax)vs语义(Semantics)•Syntaxstructure•HL7v2.xmessage•X12message•XMLdocument•Semanticsmeaning•ICD/CPT/SNOMED-CTcodesets•HL7v3message语义交互的支柱NecessarybutnotSufficient•Commonmodelacrossalldomains-of-interest:通用信息模型•Conceptsandrelationships•InformationmodelvsDatamodel•Robust,formalDataTypeSpecification:数据类型•Methodologyforbindingvaluesetstoconcept-basedterminologies:词汇库（Vocabulary）•Formalprocessfordefininginterchangestructures：消息结构HL7V3方法论StoryboardStoryboardInteractionApplicationRoleTriggerEventRIMD-MIMR-MIMHMDMessageExampleExampleSenderReceiverTriggersContentsInstantiateRestrictRestrictRestrictHL7模型交互模型HL7V3方法论•为一个特定的消息捕获所有相关信息：•应用程序角色（ApplicationRoles）：•发送和接收系统的责任：•触发事件（TriggersEvents）：•发送消息的原因•业务场景(Storyboard):•定义对于系统用户发生了什么事情医疗行为/事务CheckEquipmentAvailabilityPerformProcedureIneedaChestX-rayforMr.SmithOrderChestX-rayReportResultPlaceImageinRadiologistQueueInterpretStudyCheckTechnicianAvailabilityScheduleChestX-rayHL7Version3参照信息模型(ReferenceInformationModel)•Referral•Transportation•Supply•Procedure•Consent•Observation•Medication•Administrativeact•Financialact•Organization•Place•Person•LivingSubject•Material•Patient•Member•Healthcarefacility•Practitioner•Practitionerassignment•Specimen•LocationEntity0..*1Role10..*10..*ActRelationship11..*0..*1ParticipationAct•Author•Reviewer•Verifier•Subject•Target•Tracker医疗活动的基本信息结构Entity1..*0,*HealthcareActionIsinvolvedininvolves•一个实体(PersonorOrganization)参与0到N个医疗活动•一个医疗活动涉及1到多个实体(PersonsorOrganizations)问题：如何判断这个人是一个医生还是一个病人？医疗活动的基本信息结构Entity1..*0,*HealthcareActionplaysinvolves•一个实体(人或者组织)在医疗活动中担当的角色（0..N）问题：如何表述一个医生在一个具体的医疗行为中所担任的具体的职责？比如：在一个手术中，他是主刀医生还是助手？Role•一个实体(人或者组织)担当特定的角色参与到医疗活动中（0..N）10..*Entity0..*1Role1..*10..*1ParticipationHealthcareAction医疗活动的基本信息结构•一个实体(人或者组织)在医疗活动中担当的角色（0..N）•一个实体(人或者组织)担当特定的角色承担特定的职责（0..N）•一个实体(人或者组织)担当特定的角色承担特定的职责参与到具体的医疗活动中（0..N）医疗活动的基本信息结构1HealthcareAction•playsissourceofActRelationshipActRelationship用来表示医疗活动/行为之间的关系（因果/组成/参照标准等等）0..*1istargetfor1医疗活动的基本信息结构OBS:Temp39.5COBS:AbnormalCXROBS:ElevatedWBCAR:“issupportedby”AR:“issupportedby”AR:“issupportedby”hastargethastargethastargetOBS:DxPneumoniaissourceforHL7Version3参照信息模型(ReferenceInformationModel)•Referral•Transportation•Supply•Procedure•Consent•Observation•Medication•Administrativeact•Financialact•Organization•Place•Person•LivingSubject•Material•Patient•Member•Healthcarefacility•Practitioner•Practitionerassignment•Specimen•LocationEntity0..*1Role10..*10..*ActRelationship11..*0..*1ParticipationAct•Author•Reviewer•Verifier•Subject•Target•Tracker从RIMDIMRMIM参照信息模型通用的域信息模型特定领域的消息信息模型具体业务行为的HL7v3RIMDIMRMIM本地化的过程HL7V3如何描述医疗事务？基于HL7V3临床业务信息的描述（门诊业务）示例(Scenario)门诊病人就诊流程示例：门诊放射科检验科药房挂号处1病人挂号2医生接诊3测量体温4血检Order5胸透Order6血检结果7胸透结果8诊断结果9药品处方1..1patientPerson1..1providerOrganizationPatientclassCode*:=PATid*:II[1..1](挂号（病历号码）)code*:CECWE[0..1](病人类型)statusCode:CSCNE[0..1]effectiveTime:IVLTS[0..1]PatientRegistry(MFPM_RM010000HT02)SupportstheregistrationofPatientCMET:(ORG)E_Organization[universal](COCT_MT150000HT02)RegistrationEventclassCode*:=REGmoodCode*:=EVNtypeCode*:=SBJSubjectCMET:(PSN)E_Person[universal](COCT_MT030200)示例1：病人挂号注册行为病人角色挂号科室病人详细信息1E_Person(COCT_RM030200HT03)(universalCMET)SpecifiesinformationaboutaPersonincludingRolesplayed/scoped(guarantors,contacts,nextofkin),identifications(socialsecuritynumber,driver'slicensenumber,etc),primarycareproviders,andlanguageabilities/preferences.PersonclassCode*:=PSNdeterminerCode*:=INSTANCEid*:SETII[0..*](身份证号/其他证件号码)name*:SETPN[0..*](姓名)telecom:BAGTEL[0..*](电话号码（单位/家庭/手机/邮件/QQ等）)administrativeGenderCode*:CECWE[0..1]=AdministrativeGender(性别)birthTime:TS[0..1](出生时间)addr:BAGAD[0..*](地址（家庭/单位）)maritalStatusCode:CECWE[0..1]=MaritalStatus(婚姻状况)educationLevelCode:CECWE[0..1]=EducationLevel(教育程度)ethnicGroupCode:SETCECWE[0..*]=Ethnicity(民族)1..1emergencyContactPersonEmergencyContact0..*emergencyContactclassCode*:=ECONid:SETII[0..*]1..1guarantorPersonGuarantor0..*guarantorclassCode*:=GUARid:SETII[0..*]CMET:(ORG)E_Organization[identif