Health Level Seven [HL7]

mustardpruneΔίκτυα και Επικοινωνίες

23 Οκτ 2013 (πριν από 4 χρόνια και 16 μέρες)

98 εμφανίσεις

Health Level Seven [HL7]

HL7 est le standard d'échange pour les données médicales et administratives entre les systèmes
d'information médicaux. Ce standard décrit la structure et le contenu des messages mais ne détaille pas
leur mode de transmission actuel
le.


HL7 3.0 XML représente l’application d’XML à l’EDI la plus aboutie aujourd’hui. Son développement
est suffisant avancé pour permettre les premières démonstrations. Il s’est d’ores et déjà aligné sur les
composants CORBA... HL7 a été fondé en 1987 aux
Etats Unis pour développer des normes d'échange
électronique d'informations cliniques, financières et administratives parmi des systèmes informatiques
médicaux indépendants; par exemple, les systèmes d'informations des hôpitaux, cliniques et
laboratoires,
ceux des entreprises sous
-
traitantes ainsi que ceux des pharmacies. HL7 signifie «

Health
Level Seven

», ce qui désigne la couche 7 du modèle OSI (couche Application). Cette couche supporte
des fonctions telles que la sécurité, le contrôle, l’identificatio
n de participants, les contrôles de
disponibilité, les négociations de mécanisme d'échange, et surtout, elle permet de structurer l'échange
de données. Le standard a été pensé de manière à être indépendant de la localisation des données dans
les applicatio
ns. Il peut en particulier supporter un système central comme un environnement plus
distribué où les données résident dans des serveurs départementaux.


HL7 CDA

Up to the current version 2.5 [HL03] the scope of the HL7 standard was limited to the exchange
of
messages between medical information systems. Starting with version 3.0 which is still under
development support for persistent documents has been introduced. The Clinical Document
Architecture (CDA), previously called Patient Record Architecture (PRA),

defines structure and
semantics of medical documents for the purpose of exchange. The CDA model is derived from the
central HL7 Reference Information Model (RIM) and uses the same data types as the future HL7
messages. Both CDA documents and HL7 version 3
.0 messages are represented in XML format.


Unlike other standards HL7 CDA does not specify services or protocols that are used to exchange a
document. From the perspective of HL7 messages, a CDA document is just a multimedia object than
can be exchanged a
s a MIME (Multipurpose Internet Mail Extensions) package.

Many national and international pilot projects use HL7 CDA Release One as a format for clinical
documents, e. g. SCIPHOX (Standardized Communication of Information Systems in Physician
Offices and H
ospitals using XML) [SC04] in Germany and the EU project PICNIC (Professionals and
Citizens Network for Integrated Care) [Pic03]. Also commercial products implementing CDA are
starting to become available. Since medical reports are currently mainly stored
in clinical information
systems which already use the HL7 standard it can be expected that these systems will also support
CDA when switching to HL7 version 3 in the future.

Strictly speaking, the HL7 Clinical Document Architecture (CDA) is not an EHR stan
dard since it only
defines parts of an EHR architecture. However, the CDA forms an important component of an EHR
and is currently being harmonised with the equivalent structures in EN 13606 and openEHR. CDA is a
subset of the EN 13606 Reference Model and E
N 13606 will be compliant with CDA Release Two.


HL7
-

S

The Special Interest Group HL7 Electronic Health Record (HL7 EHR) is an initiative of the HL7
organisation which intends to provide a functional model for the development of EHR Systems (EHR
-
S). The
scope of the functional model is to standardise a user selected set of functions a EHR
-
S may
provide. It is not within the scope of the EHR
-
S functional model to offer country specific care settings.
The EHR
-
S Special Interest Group (SIG) does not make any

assumptions about the underlying system
and uses a broad definition of EHR Systems from ISO and CEN. In July 2004, HL7 EHR SIG
published the current “HL7 EHR System Functional Model


Draft Standard for Trial Use” [HL04b].
Details about the prior version
of the draft can be found in section 3.5 of ARTEMIS Deliverable 3.1.1
part 4.

The EHR
-
S functional model does not prescribe how the functions have to be implemented, which
technologies have to be used, nor does it make any assumptions about the underlying
system
architecture. Furthermore, the model does not make any statement about an EHR itself, nor the content
of an EHR. The functional model is composed of a list of functions which are divided into three main
sections, and an overall of thirteen subsectio
ns listed below. Each function is described from a user
point of view and not from a software developer or system manufacturer point of view.