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ศนยพฒนามาตรฐานระบบขอมลสขภาพไทย Thai Health Information Standards Development Center
PHARMACY INFORMATICS EDUCATIONAL SERIES
โครงการอบรมการพฒนาและจดการระบบขอมลเภสชกรรมในโรงพยาบาล
: การเตรยมขอมลยาเพอการเบกจาย
วนท 18 มถนายน 2557
คณะเภสชศาสตร จฬาลงกรณมหาวทยาลย
นพ.ดาวฤกษ สนธวณชย
นพ. บญชย กจสนาโยธน Ph.D.(Health Informatics)
BHI-ED-SIG
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แนวคดการแลกเปลยนขอมลสขภาพ (Health information
exchange) การทางานรวมกนของระบบขอมล(Interoperability)
และ มาตรฐานขอมลสขภาพ (Health information standards)
รหสยามาตรฐาน:
บญชขอมลยาและรหสยามาตรฐานไทย (Thai Medicines
Terminology) TMT
รหสยามาตรฐาน 24 หลก
รหสสนคาและบรการมาตรฐาน GS1
2
Meaningful Use of Health Information
Personal Health
(Provision of info to patient)
Public Health (Reports,
Surveillance)
Health care
Delivery (EHR use, HIE,
etc)
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Patient Data
Clinical Research
Quality Improvement
Management Financing Business
Intelligence
EMR, CPOE Lab, Pharm
Data Clinical Notes
Reimbursement Claim Data
(DRG)
Individual Data
Aggregated Data
Clinical Data Administrative Data
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Patient Data
Administrative data Clinical data Use for reimbursement,
administration and reports Diagnosis, Procedure codes Charge/cost data
Use for clinical care Laboratory data, Pharmacy data Clinical notes
Individual Data Aggregated data Operational, Transactional Report form
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6
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7
National Health Information Systems Blueprint (the Architecture)
A Health Information Exchange (HIE) makes the sharing of health data across information systems possible
1) who received health services
2) who provided those services,
3) where did they receive the services
4) what specific care did they receive.
From: http://ohie.org/architecture/
Why Health Information Exchange(HIE) Interoperability and information standards?
Integration & Exchange of Health Information
Health Information Systems Interoperability
Health Information Standards
What is Interoperability?
is ability of two or more systems or components to exchange information
and to use the information that has been exchanged.
IEEE standard computer dictionary: a compilation of IEEE standard computer glossaries.1990.
Level of Interoperability • is realized through invocation of services accessed via standardized interfaces. Here, common business models are needed.
Process/Service Interoperability
• harmonised information models based on common references and agreed, ontology-based terminology
Semantic Interoperability
• harmonized messaging and document exchange Syntactic
Interoperability
• is based on the exchange of agreed data. Structure
Interoperability
• establishes harmonization at the plug and play, signal and protocol level
Technical Interoperability
Benson T: Principles of Health Interoperability HL7 and SNOMED. 2nd ed. 2012. Springer; 2012. Bobel B: Making Hospital IT Interoperable Hospital Information Technology Europe 2008
What is Standardization?
is the process of agreeing on standards represent the common language allows the exchange of data between disparate data
systems. Goals are to achieve comparability, compatibility, and
interoperability between independent systems to ensure compatibility of data to reduce duplication of effort and redundancies.
ISO
What is a Standard?
is a definition, set of rules or guidelines, format, or document that establishes uniform engineering or technical specifications, criteria, methods, processes, or practices
approves by a recognized standard development organization (SDO), or have been accepted by the industry
From: Public Health data standards consortium http://www.phdsc.org/default.asp 2011
Why Standards is needed? The number of interfaces = 𝑁
2−𝑁2
Linking 6 nodes ->15 interfaces, Linking 100 nodes -> 4,950 interfaces.
Benson T: Principles of Health Interoperability HL7 and SNOMED. 2nd ed. 2012. Springer; 2012.
Interoperability and Standards
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Landscape ของมาตรฐานขอมลสขภาพ
From: Standards – Yesterday, Today and Tomorrow: Integrating the Standards for Healthcare presentation , Ken Lunn, 17 October 2011
Categories of Health Information Standards
Health data Standards Category
Content Exchange Standards - Core data sets Health Data Dictionary: eg. Referral letter, Billing Data Set Patient summary data set Continuity Care Document (CCD) - HL7 CDA
Standard Vocabularies Standards - Semantic Patient, Providers identifiers Classification : ICDs Terminology: SNOMED-CT, LOINC
Apple What is Semantic? มาตรฐานความหมาย
Messaging Standards - Syntactic : HL7 V2, HL7 V3 messaging standards
Security and Privacy standards Rules & Regulations
PKI (Public Key Infrastructure)
Health Information Standards
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Standards (มาตรฐานขอมล) National
1. Core data set standards (ชดขอมล) 12 & 18 files standards 2. Semantic standards (คาจากดความ
ความหมาย) ICD 10 TM, ICD 9 CM Citizen IDs, Facility IDs
3. Syntactic standards (รปแบบการสงขอมล) X 4. Security and privacy standards (ความเปนสวนตว และความมนคงของขอมล)
X
Thai Health Data Standards: Current
Thai Health Information Standards Development
Standards (มาตรฐานขอมล) National
1. Core data set standards (ชดขอมล) Referral, Chronic Diseases
2. Semantic standards (คาจากดความ
ความหมาย)
Drug Terminology (TMT), Lab. Code (LOINC)
Providers ID
3. Syntactic standards (รปแบบการสงขอมล) HL7 messaging,HL7-CDA
4. Security and privacy standards (ความเปนสวนตว และความมนคงของขอมล)
X
What is Standardization?
is the process of agreeing on standards represent the common language allows the exchange of data between disparate data
systems. Goals are to achieve comparability, compatibility, and
interoperability between independent systems to ensure compatibility of data to reduce duplication of effort and redundancies.
ISO
What is a Standard?
is a definition, set of rules or guidelines, format, or document that establishes uniform engineering or technical specifications, criteria, methods, processes, or practices
approves by a recognized standard development organization (SDO), or have been accepted by the industry
From: Public Health data standards consortium http://www.phdsc.org/default.asp 2011
OBX|1|CE|ABO ABO GROUP||O Type O| OBX|1|CE|BLDTYP ABO GROUP||TYPEO Type O| OBX|1|CE|ABOTYPE ABO GROUP||OPOS Type O|
Groupers
Continuum of Health Semantic Standards
Nomenclature-Highly detail descriptions (SNOMED-CT)
Classification-organized aggregation of descriptions into rubric (ICDs)
Groupings-High level categories of rubrics (DRGs)
Nomenclatures Classification Groups
Aggregation
Details Grouped SNOMED-CT ICD DRG
World Health Assembly Resolution WHA66.24 May 2013
Urges member state to 1. Draw up a road map for implementation of ehealth and health
data standards at national and subnational levels. 2. Develop policies and legislative mechanisms linked to an
overall national eHealth strategy, in order to ensure compliance in the adoption of ehealth and health data standards.
http://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_R24-en.pdf
Dr Margaret Chan, Director-General of WHO