1. Referentie Domeinen Model &
EPD Systeem Functioneel Model (EHR-S FM)
iZiekenhuis RDZ Werkconferentie
25-apr-2012
Michael van der Zel
Michael van der Zel <m.van.der.zel at umcg.nl> 25-apr-2012 1/19
2. Hoeden
● EHR WG NL &
Internationaal
● CIMI & ISO DCM
●
●
● Rol: HealthCare / Clinical
Research Information Systems
Architect
Michael van der Zel <m.van.der.zel at umcg.nl> 25-apr-2012 2/19
3. “Always in motion, the future is”
Michael van der Zel <m.van.der.zel at umcg.nl> 25-apr-2012 3/19
4. Contents
● Wat is het FM? Wat krijg je als het gekoppeld is
aan het FM?
● RDZ = globaal model van Ziekenhuis bedrijf
● EHR-S FM = samenhangende lijst van functies
met requirements van een EPD Systeem
● Koppeling RDZ + EHR-S FM geeft je …
Michael van der Zel <m.van.der.zel at umcg.nl> 25-apr-2012 4/19
5. Michael van der Zel <m.van.der.zel at umcg.nl> 25-apr-2012 5/19
7. Michael van der Zel <m.van.der.zel at umcg.nl> 25-apr-2012 7/19
8. DC.1.4.1 Manage Allergy, Intolerance
and Adverse Reaction List
DC.1.4.1#1 The system SHALL provide the ability to capture true allergy, intolerance, and
adverse reaction to drug, dietary or environmental triggers as unique, discrete entries.
DC.1.4.1#2 The system SHOULD provide the ability to capture the reason for entry of the
allergy, intolerance or adverse reaction.
DC.1.4.1#3 The system SHALL provide the ability to capture the reaction type.
DC.1.4.1#4: The system SHOULD provide the ability to capture the severity of a reaction.
DC.1.4.1#7 The system SHOULD provide the ability to capture the source of allergy,
intolerance, and adverse reaction information.
Functionally and
DC.1.4.1#8 The system SHALL provide the ability to deactivate an item on the list.
mostly about Content
DC.1.4.1#9 The system SHALL provide the ability to capture the reason for deactivation of
an item on the list.
DC.1.4.1#10 The system MAY present allergies, intolerances and adverse reactions that
have been deactivated.
DC.1.4.1#11 The system MAY NOT provide the ability to display user defined sort order of
+ CUI Guidance for
list.
Recording Adverse system SHOULD provide the ability to indicate that the list of medications
DC.1.4.1#12 The Drug Reactions
and other agents has been reviewed.
DC.1.4.1#13 They system SHALL provide the ability to capture and display the date on
which allergy information was entered.
Michael van der Zel <m.van.der.zel at umcg.nl> 25-apr-2012 8/19
9. Function = aprox. Service
DC.1.4.1 Manage Allergy, Intolerance and Adverse Reaction List
S e e A l so (d irect)
Widget & Service
DC.2 .3.1 .1 S u p p o rt fo r Dru g Inte ra ctio n Ch e cki n g S .2 .2.1 He a lth Re co rd O u tp u t
S .2 .2 .3 A d Ho c Q u e ry a n d Re p o rt G e n e ra ti o n
Query Tool .3d.7.1 sCl in ica l De cisi o n S u p p o rt S yste m G u id e l in e s
S
Up a te
IN.2.5 .2 M a n a g e S tru ctu re d He al th Re co rd In fo rm a ti o n IN.2 .5 .1 M a n a g e Un stru ctu re d He a lth Re co rd Info rm a ti on
Care Record Store Service Document Service
IN.4.2 M a i n te na n ce a n d V e rsi o n i n g o f S ta n d a rd IN.4 .1 S ta n d a rd T e rm i n o l o g ie s a n d T e rm i n o lo g y M o d e l s
T e rm in o l o g i e s
IN.6 B u si ne ss Ru l e s M a n a g e m e n t IN.4 .3 T e rm in o l og y M a p p i n g SNOMED CT
Rule Engine Terminology Service
S e e A l so (i n d ire ct)
S .2 .2 Re p o rt G e n e rati o n IN.1 .2 E n ti ty A u th o riza ti o n
Report Generator Authorisation Service
IN.1.1 E n ti ty A u th e n ti ca ti o n IN.1 .4 P a ti e n t A cce ss M a n a g e m e n t
IN.1.3 E n ti ty A cce ss Co n tro l IN.2 .4 E xtra ctio n o f He a l th Re co rd In fo rm a ti o n
IN.2.1 Da ta Re te n ti o n , A vai l a b i l i ty a nd De stru cti on IN.5 .1 In te rch a n g e S ta n d a rd s
IN.2.2 A u d i ta b l e Re co rd s
HL7 v3
Michael van der Zel <m.van.der.zel at umcg.nl> 25-apr-2012 9/19
10. IN.2.5.2 Manage Structured Health
Record Information
1. The system SHALL capture structured health record information as part of the patient EHR.
2. The system SHALL retrieve structured health record information as part of the patient EHR.
3. The system SHALL provide the ability to update structured health record information.
4. The system SHALL conform to function IN.2.1 (Data Retention, Availability and Destruction) to provide
the ability to inactivate, obsolete, or destroy structured health record information.
5. The system SHOULD provide the ability to report structured health record information.
The Behaviour of the
6. The system MAY track structured health record information over time.
Care Record Store Service
7. The system SHOULD provide the ability to retrieve each item of structured health record information
discretely within patient context. and IF Operations
8. The system SHALL provide the ability to append corrected structured health record information to the
original structured health record information. A specific type of implementation is not implied.
9. The system SHALL provide the ability to append structured health record information to the original
structured health record information. A specific type of implementation is not implied.
10. The system SHALL provide the ability to append augmented structured health record information to
the original structured health record information. A specific type of implementation is not implied.
Michael van der Zel <m.van.der.zel at umcg.nl> 25-apr-2012 10/19
11. Verder ontwikkelingen
● EHR-S FM R2 nu in Ballot bij HL7, ISO, ANSI
● samensmelting van aantal specifiek domein profielen, e.g. Clinical
Research, Behavioural Health, Medication
● Functional Information Model
● Business Activiteiten gekoppeld aan Informatie Objecten en
Systeem Componenten
● EHR-S FM R2 Profiling Tooling
● Huidige “tooling” is spreadsheet → foutgevoelig HL7 v2.4 NL,
AGB, WGBO,
● Metadata Profile XDS, etc.
● per functie criteria ophangen lokaal, nationaal, internationaal
→ geeft PvE start!
Michael van der Zel <m.van.der.zel at umcg.nl> 25-apr-2012 11/19
12. Michael van der Zel <m.van.der.zel at umcg.nl> 25-apr-2012 12/19
13. Michael van der Zel <m.van.der.zel at umcg.nl> 25-apr-2012 13/19
14. RDZ 1.0 BA
M ED3 e n M E D4 ve rke erd o m ?
E erst be re i de n da n a fl e ve re n,
Ap oth e e k
li jkt m e ?
Hie r wo rd h e t o ve rzi ch t b e d oe
BA.M ED1 B A.M E D2 Ve rwe rke n BA .M E D4 Be rei d e n BA.M ED3 BA .M E D5 T o ed i e ne n B A.M E D6 Be wa ken
m e d i ca tie va n m e di ca ti e m e d ica ti e b i j d e ee n p ati e n t.
Vo orsch rijve n vo orsch rift m e d i ca ti e A fle ve re n/ve rstre kke n
In ve n ta ri sa ti e su g g ere e rd b ij
m e d icati e m ed ica ti e
lij st m e t m e d i ca tie d i e i n de
zi eke n h u is a p oth e e k b esch i kb
IO .M ED2 o m zettin g
n a a r IO .M ED3
RDZ 1.0 IO
IO .M ED7 IO .M ED2 IO .M ED3 IO .M ED4 IO .M E D5 IO .M ED6 M ed i ca tie
IO .M E D1 M e d icij n
Co n tra -in d i ca ti e M ed i ca tievoo rschrift M e d icatie o p d ra ch t M ed i ca tie a fl e ve ri n g M ed i ca tieto e di e n i ng in ve n tari satie
Is d i t d e G-
stan d a ard ?
« tra ce » « trace » « trace » « tra ce»
E HR-S FM R1 .1 CIM
Medication Orders Medication List Patient
+ m a n ag e () : vo i d + m a n a ge () : void
1 1
+ cre a te () : vo id + cre ate () : vo i d
+ m a i n tai n () : voi d
E HR-S FM R1 .1 Fu n cti on s
DC.1 .7 .1 M a na g e DC.1.4 .2 M a n ag e DC.1.8 .1 M a n ag e
M e d ica tio n Orde rs M ed ica tion L i st M ed ica ti on Ad m ini stra ti o n
BA .M ED4 B e re id e n m e di ca tie h e e ft g e e n l in k m et h e t FM ? Wo rdt e r in d a t p ro ce s n ie t n a ar m e di ca tie li jst o f o rd e rs g e ke ke n ?
DC.1 .1 .3.2 Ca p ture Pa ti e nt-O rig in a te d Data a lle e n l in k m e t B e wa ke n van m ed i ca ti e? In de te kste n sta a t d e re la tie n i e t b e schre ve n .
De l i nk tusse n de IO's sn a p ik n i e t. Wa a ro m is e r e e n li n k tu sse n m e d icijn e n m e di ca tie vo orsch rift?
Michael van der Zel <m.van.der.zel rift wo rd t g eb ru i kt25-apr-2012n B A.M ED2 .
M e d ica tie vo o rsch
at umcg.nl> i n B A.M ED1 e 14/19
15. Conclusies
● RDZ, EHR-S FM en FIM zijn allemaal kapstokken voor
verschillende views
● Koppeling RDZ + EHR-S FM geeft je …
… consistente (deel) PvE's
● Leveranciers zouden hier veel aan hebben, in
tegenstelling tot de nu vaak onsamenhangende,
verschillende PvE's, kost veel tijd (en dus geld) van huis
en leverancier.
Michael van der Zel <m.van.der.zel at umcg.nl> 25-apr-2012 15/19
