Dansk profilering af HL7 Hjemmemålinger og Spørgeskemadata
Data fra borgeren MedCom står for og deltager i standardiseringsarbejdet vedrørende opsamling af data borgernes hjem (i henhold til referencearkitekturen). Det drejer sig specielt om hjemmemålinger og spørgeskemadata
Digitaliseringsstrategi Initiativ 2.2: Bedre brug af pateinternes egne oplysninger i Fællesoffentlig strategi for digital velfærd 2013-2020: Digital Velfærd En lettere hverdag er det anført: Patientrapporterede oplysninger skal anvendes på sundhedsområdet på relevante områder. Inden udgangen af 2014 gennemføres en analyse af potentialerne ved systematisk anvendelse af patientrapporterede oplysninger i sundhedsvæsenet
PRO - spørgeskemaer Med henblik på at skabe fælles ramme for indhentning og udveksling af PRO oplysninger opsamlet via spørgeskemaer besluttede MedCom styregruppen 03. oktober 2014 at iværksætte en dansk profilering af HL7 standarder i CDA Release 2 formatet, herunder: QFDD - HL7 Implementation Guide for CDA Release 2: Questionnaire Form Definition Document, Release 1 QRD - HL7 Implementation Guide for CDA Release 2: Questionnaire Response Document, Release 1 Disse standarder understøtter de almindeligste spørgsmål/svartyper.
Standardiseret PRO data Ved at bruge de nævnte standarder til deling af PRO data opnås: Mulighed for at udveksle pre-definerede spørgeskemaer i et fælles format Mulighed for at udveksle PRO data i et fælles format Mulighed for at udveksle PRO data indenfor den eksisterende telemedicinske infrastruktur Mulighed for at integrere PRO data i eksisterede fagsystemer (Standarden er fuldt struktureret) Mulighed for at vise PRO data i en simpel browserløsning (standarden understøtter dette)
Hjemmemonitorering HL7 PHMR (Personel Healthcare Monitoring Report) HL7 CDA-2 level 3 Højt struktureret Menneskeligt læsbart Anvendes i KIH Databasen til lagring og deling af hjemmemålinger tværsektorielt (via IHE/XDS på NSP)
PHMR CDA format <?xml version="1.0" encoding="utf-8" standalone="no"?><?xml-stylesheet type="text/xsl" href="cda.xsl"?><clinicaldocument xmlns:xsi="http://www.w3.org/2001/xmlschema-instance" xsi:schemalocation="urn:hl7- org:v3 http://svn.medcom.dk/svn/drafts/standarder/hl7/phmr/schema/cda_sdtc.xsd" xmlns="urn:hl7-org:v3" classcode="docclin" moodcode="evn"> <typeid root="2.16.840.1.113883.1.3" extension="pocd_hd000040"/> <templateid root="2.16.840.1.113883.3.4208.11.1"/> <id root="aa2386d0-79ea-11e3-981f-0800200c9a66"/> <code code="dk-phmr-01" codesystem="2.16.840.1.113883.3.4208.100.6" codesystemname="medcom Message Codes" displayname="hjemmemonitorering (PHMR)"/> <title>hjemmemonitorering for 2303439995</title> <effectivetime value="20130823101525+0100"/> <confidentialitycode code="n" codesystem="2.16.840.1.113883.5.25"/> <languagecode code="da-dk"/> <recordtarget typecode="rct" contextcontrolcode="op"> <patientrole classcode="pat"> <id extension="2303439995" root="2.16.840.1.113883.3.4208.100.2"/> <addr> <streetaddressline>adressem33 33</streetAddressLine> <city>bym33</city> <postalcode>9998</postalcode> <country>denmark</country> </addr> <telecom value="tel:99999999" use="hp"/> <patient classcode="psn" determinercode="instance"> <name> <given>fornavnm33</given> <family>efternavnm33</family> </name> <administrativegendercode code="m" codesystem="2.16.840.1.113883.5.1"/> <birthtime value="19430323000000"/> </patient> </patientrole> </recordtarget> <author contextcontrolcode="op" typecode="aut"> <time value="20130912120522"/> <assignedauthor classcode="assigned"> <id extension="7676767" root="1.2.208.176.1"/> <!-- SOR kode--> <addr> <streetaddressline>brendstrupgaardsvej 100</streetAddressLine> <city>aarhus N</city> <postalcode>8200</postalcode> <country>danmark</country> </addr> <telecom value="tel:78450000" use="wp"/> <assignedperson> <name> <given>carsten</given> <family>nieboehl</family> </name> </assignedperson> </assignedauthor> </author> <custodian typecode="cst"> <assignedcustodian classcode="assigned"> <representedcustodianorganization classcode="org" determinercode="instance"> <id root="1.2.208.176.1" extension="8686868"/> <name>medcomdemo</name> <telecom value="tel:65452030"/> <addr> <streetaddressline>forskerparken 10</streetAddressLine> <postalcode>5230</postalcode> <city>odense M</city> </addr> </representedcustodianorganization> </assignedcustodian> </custodian> <documentationof typecode="doc"> <serviceevent classcode="mprot" moodcode="evn"> <effectivetime> <low value="20130810101525"/> <high value="20130826102020"/> </effectivetime> </serviceevent> </documentationof> <component typecode="comp" contextconductionind="true"> <structuredbody classcode="docbody" moodcode="evn"> <component typecode="comp"> <section classcode="docsect" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.1.7"/> <templateid root="2.16.840.1.113883.3.4208.11.1.1"/> <code code="8338319" codesystem="2.16.840.1.113883.3.4208.100.6" codesystemname="medcom Message Codes" displayname="medical Equipment"/> <title>medical Equipment</title> <text>some text regarding the Medical Equipment</text> <entry typecode="comp" contextconductionind="true"> <organizer classcode="cluster" moodcode="evn"> <templateid root="2.16.840.1.113883.3.4208.11.1.9.1"/> <statuscode code="completed"/> <participant typecode="sbj"> <templateid root="2.16.840.1.113883.3.4208.11.1.9.6"/> <participantrole classcode="manu"> <playingdevice> <code code="epq12225" codesystem="2.16.840.1.113883.3.4208.100.7" displayname="lung Monitor"/> <!-- MedCom prompttable --> <manufacturermodelname>medcom ID: EPQ12225 / Manufacturer: Vitalograph / ProductType Lung Monitor / Model: Lung Monitor Bluetooth</manufacturerModelName> <softwarename>sw: 10.0.3452r45</softwareName> </playingdevice> </participantrole> </participant> </organizer> </entry> </section> </component> <component typecode="comp"> <section> <templateid root="2.16.840.1.113883.10.20.1.16"/> <templateid root="2.16.840.1.113883.3.4208.11.1.2"/> <code code="4851925" codesystem="2.16.840.1.113883.3.4208.100.6" codesystemname="medcom Message Codes" displayname="vital Signs"/> <title>vital Signs</title> <text>vital Signs left out</text> </section> </component> <component typecode="comp"> <section> <templateid root="2.16.840.1.113883.10.20.1.14"/> <templateid root="2.16.840.1.113883.3.4208.11.1.3"/> <code code="4327952" codesystem="2.16.840.1.113883.3.4208.100.6"/> <title>results</title> <text> <paragraph>lungefunktionsundersøgelse</paragraph> <table border="1" width="100%"> <tbody> <tr> <th>type</th> <th>measuremnt</th> <th>unit</th> <th>time</th> <th>by</th> </tr> <tr> <td>fev1</td> <td>2.9</td> <td>liter</td> <td>2013-08-22 11:20:20.0</td> <td>unknown</td> </tr> <tr> <td>fev1</td> <td>3.7</td> <td>liter</td> <td>2013-08-24 11:15:25.0</td> <td>unknown</td> </tr> <tr> <td>fev1</td> <td>2.8</td> <td>liter</td> <td>2013-08-12 09:15:25.0</td> <td>unknown</td> </tr> <tr> <td>fev1</td> <td>3.1</td> <td>liter</td> <td>2013-08-10 10:15:25.0</td> <td>unknown</td> </tr> <tr> <td>fev1</td> <td>3.5</td> <td>liter</td> <td>2013-08-26 10:20:20.0</td> <td>unknown</td> </tr> <tr> <td>fev1</td> <td>2.9</td> <td> Liter</td> <td>2013-08-25 09:15:25.0</td> <td>unknown</td> </tr> <tr> <td>fev1</td> <td>2.5</td> <td> Liter</td> <td>2013-08-14 11:20:20.0</td> <td>unknown</td> </tr> <tr> <td>fev1</td> <td>3.9</td> <td> Liter</td> <td>2013-08-13 10:20:20.0</td> <td>unknown</td> </tr> <tr> <td>fev1</td> <td>3.7</td> <td> Liter</td> <td>2013-08-11 11:15:25.0</td> <td>unknown</td> </tr> <tr> <td>fev1</td> <td>3.2</td> <td> Liter</td> <td>2013-08-23 10:15:25.0</td> <td>unknown</td> </tr> </tbody> </table> </text> <entry typecode="comp"> <organizer classcode="cluster" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.1.35"/> <templateid root="2.16.840.1.113883.10.20.9.8"/> <statuscode code="completed"/> <component> <observation classcode="obs" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <code code="fixme" codesystem="fixme" displayname="fev1"/> <effectivetime value="20130822112020"/> <value xsi:type="pq" unit="liter" value="2.9"/> </observation> </component> </organizer> </entry> <entry typecode="comp"> <organizer classcode="cluster" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <statuscode code="completed"/> <component> <observation classcode="obs" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <code code="fixme" codesystem="fixme" displayname="fev1"/> <effectivetime value="20130824111525"/> <value xsi:type="pq" unit="liter" value="3.7"/> </observation> </component> </organizer> </entry> <entry typecode="comp"> <organizer classcode="cluster" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <statuscode code="completed"/> <component> <observation classcode="obs" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <code code="fixme" codesystem="fixme" displayname="fev1"/> <effectivetime value="20130812091525"/> <value xsi:type="pq" unit="liter" value="2.8"/> </observation> </component> </organizer> </entry> <entry typecode="comp"> <organizer classcode="cluster" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <statuscode code="completed"/> <component> <observation classcode="obs" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <code code="fixme" codesystem="fixme" displayname="fev1"/> <effectivetime value="20130810101525"/> <value xsi:type="pq" unit="liter" value="3.1"/> </observation> </component> </organizer> </entry> <entry typecode="comp"> <organizer classcode="cluster" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <statuscode code="completed"/> <component> <observation classcode="obs" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <code code="fixme" codesystem="fixme" displayname="fev1"/> <effectivetime value="20130826102020"/> <value xsi:type="pq" unit="liter" value="3.5"/> </observation> </component> </organizer> </entry> <entry typecode="comp"> <organizer classcode="cluster" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <statuscode code="completed"/> <component> <observation classcode="obs" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <code code="fixme" codesystem="fixme" displayname="fev1"/> <effectivetime value="20130825091525"/> <value xsi:type="pq" unit="liter" value="2.9"/> </observation> </component> </organizer> </entry> <entry typecode="comp"> <organizer classcode="cluster" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <statuscode code="completed"/> <component> <observation classcode="obs" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <code code="fixme" codesystem="fixme" displayname="fev1"/> <effectivetime value="20130814112020"/> <value xsi:type="pq" unit="liter" value="2.5"/> </observation> </component> </organizer> </entry> <entry typecode="comp"> <organizer classcode="cluster" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <statuscode code="completed"/> <component> <observation classcode="obs" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <code code="fixme" codesystem="fixme" displayname="fev1"/> <effectivetime value="20130813102020"/> <value xsi:type="pq" unit="liter" value="3.9"/> </observation> </component> </organizer> </entry> <entry typecode="comp"> <organizer classcode="cluster" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <statuscode code="completed"/> <component> <observation classcode="obs" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <code code="fixme" codesystem="fixme" displayname="fev1"/> <effectivetime value="20130811111525"/> <value xsi:type="pq" unit="liter" value="3.7"/> </observation> </component> </organizer> </entry> <entry typecode="comp"> <organizer classcode="cluster" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <statuscode code="completed"/> <component> <observation classcode="obs" moodcode="evn"> <templateid root="2.16.840.1.113883.10.20.9.8"/> <code code="fixme" codesystem="fixme" displayname="fev1"/> <effectivetime value="20130823101525"/> <value xsi:type="pq" unit="liter" value="3.2"/> </observation> </component> </organizer> </entry> </section> </component> </structuredbody> </component></clinicaldocument>
PHMR menneskeligt læsbart
Publicerede standarder Hjemmemålinger HL7 PHMR CDA-2 Spørgeskemadefinition- HL7 QFDD CDA-2 Spørgeskemabesvarelse HL7 QRD CDA-2 Fælles HL7 CDA-2 Header Standarderne er publiceret her: http://svn.medcom.dk/svn/releases/standarder/hl7/ Det forventes at standarderne skal teknisk implementeres og klinisk afprøves i forbindelse med national udbredelse af telemedicinske løsninger. Standarderne er specielt relevante i forhold til NSP, KIH Databasen, hjemmemonitoreringsløsninger (fx OpenTele) og fremtidige danske profileringer af HL7 standarder
MedCom testcenter/colab Der undersøges et samarbejde mellem CoLab og MedCom vedrørende fælles testfaciliteter MedCom stiller testredskaber til rådighed Et samlet testmiljø hvor hele kommunikationskæden fra borgerens hjem til Praksis/EOJ/EPJ systemer kan testes og certificeres