2011 May KP EMRLD - HL7

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Dec 13, 2013 (3 years and 8 months ago)

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EMRLD

A RIM
-
based Data Integration Approach


Pradeep

Chowdhury

Manager, Data Integration



Agenda


Introduction and Acknowledgements


EMRLD Approach


Pilot Details


Q&A



What is EMRLD

EMRLD is a proposed data integration approach for
RIM implementation connecting organization specifics
to RIM.

EMRLD (pronounced as “emerald”) encompasses:


Extract: source data extraction


Merge: merge and prepare data for RIM


RIM standardization: standardization including
terminology binding


Load: loading and persisting


Deliver: delivering integrated data from RIM data for
consumption by multiple use cases


Key Drivers for EMRLD


Clinical data Integration across regions and
subject areas


Integration of EMR data with data from ancillary
systems (Labs, Rx)


Attribution and integration of external data with
KP data


Standardization using terminology services



Alternatives to RIM


Build a home
-
grown integration model according
to business needs


Purchase and deploy industry available models

OR


Adopt a reference information model (model of
meaning): HL7 V3 RIM



Lack of a standard
-
based model is
driving towards creation of many
point
-
to
-
point solutions.


Downstream applications,
datamarts and analytics are forced
to do their own data integration.


External agencies are favoring use
of standard
-
based data interchange
approach (e.g., HL7 RIM V3).


More needs for standard
-
based
data integration are being driven
from Meaningful Use cases
implementation, BIOMED devices
integration, and data interchange
with CDC, VA , etc.

Needs

Suggestions


Needs & Suggestions


Adopt appropriate standards to support
meaningful information integration,
representation and exchange between
disparate systems.


Validate and adopt the HL7 Reference
Information Model as a standard,
explicitly targeted to enable “consistent
sharing and usage of data across
multiple contexts (both internal and
external).”


Model Of Meaning and EMRLD


RIM
implementation needs support for data extraction,
persistence and delivery


EMRLD: suggested approach to adopt and
implement RIM


Bridges model
-
of
-
use to model
-
of
-
meaning


Modular approach to implement RIMBAA


Scalability on addition and expansion of data sources


Helps in achievement of semantic interoperability


Helps in standardization, including terminology binding


Helps in adoption of HDF ( HL7 Development Framework)




EMRLD
-

Logical Approach


Implement a information model that enables “data
integration” or “staging” that provides:


Future scalability and extensibility and leverages
industry standards


Replaces point

to

point linkages and de
-
couples
consumption from access


Honors unique characteristics of healthcare data:
including sparseness, constantly changing
attributes, non
-
additive facts, and too many
references (dimensions)


Tie in with architectural tenets


Standardization including Terminology Services


Support multiple use cases


Support clinical domain and additional (financial,
administrative) and research


Security and access layer is built
-
in using access
policies that can be governance

HL7 v3 RIM


Data Sources

Potential Use Cases

Labs,
Rxs

Others

Subject

Data Marts

External

EMR

NHIN

HIE

Research

Regional

Data Store

Data

Exchanges

Program


Warehouse

BIOMED

Integration & Staging Layer


EMRLD Implementation View

EMR

Lab, Rx


External CDAs

(CDC, VA,DOD, etc.)

RIM

(Integrated Data layer)


Extract

&

Convert to

CDA

Merge

Bulk Load

CDA

Standard Docs

(CDA, Hl7)

HQL

Queries

On

Demand

Bulk Data

Extract

Terminology

Services


Data Integration & Staging Layer

Data Delivery

Layer

Datamarts

Data

Exchanges

NHIN

HIE

BIOMED

Use Case

Examples

Others

Research

Data Sources


EMRLD
-

Pilot Details


Imported KP EMR data via
CDEF into RIM


Imported clinical data from
external sources (as CDA
documents) into RIM


Created interfaces to
query/view data stored in RIM


Exported data stored in RIM
as CDA documents

Note:

Open Source Software including JSIG,
Hibernate (Object to Relational DB mapper)
and MySQL ( Database Layer) were used
for the pilot at no cost to KP



Screenshots from Pilot


EMRLD Pilot
-

Observations


Pilot was successful to demonstrate that the KP EMR clinical data can be imported and persisted
in a HL7 RIM environment.


In addition the pilot demonstrated capability to import external CDA documents (bulk data import),
export clinical data as CDA, and views the imported data using HQL queries.


This pilot was done using Open source platform created by the JavaSIG.** KP System Integration
team’s developed CDEF framework engine was used to extract information from KP EMR.


CDEF is Custom Data Extract Framework which extracts KP EMR real
-
time transaction data. The
extraction is based on pre
-
defined events and rules. The data is available from CDEF in table
format.


JSIG is an open source HL7 RIM implementation. It maps all RIM classes to SQL tables using
hibernate. Provides helper classes to create CDA document and persist in RIM data model.


Any database can be used to support RIM and for demonstration purposes, MySQL was used.


KP
-
JSIG is a web application built on top of JSIG to incorporate a way to import KP EMR data,
external CDA documents, export CDA documents, and execute HQL queries on RIM classes.


**Note that the
HL7 Java SIG (JSIG)

has been renamed to the
RIM Based Application Architecture
Work Group (the RIMBAA WG
).

Others

NHIN
-

HIE


The NHIN specifications states that clinical data
should be exchanged via CDA release
-
2
documents (one of the HL7 v3 standards), and
that all inter
-
NHIE (inter National Health
Information Exchange) messages (gateway to
gateway communication) in the NHIN will use
HL7 v 3.0 RIM based messages.


KP context will need an integration layer of data
collected via DOD, VA and internal KP.


KP HIE initiative is evaluating a standard based
approach like RIM for information exchange.

Downstream Applications, Analytics and Datamarts


KP EMR needs to interchange information with
other ancillary systems (e.g. Lab, Rx etc) in Real
Time.


These interfaces are today built point to point


Can be applied to situations like point
-
point
interfaces currently being used between EMR,
Labs, Rx


Can be a good foundation layer for integration
while we are approaching new Lab and Pharmacy
systems


BIOMED Devices: Information storage and retrieval of
biomedical device information is supported by an HL7 v3
RIM
-
mapable integrated staging approach. Device
messages, documents and services are also supported.


External information from agencies like CDC, VA can be
made efficient and easy to implement


PHR (Personal Health Record): Support for Patient
controlled EHR is being developed by HL7 RIM HER
Working Group


Foundation for upcoming integration needs for upcoming
Insurance Exchanges

Real Time Standards
-
based Interfaces


EMRLD
-

RIM Data Integration

Potential

Implementation Use Cases


Many applications, analytics and datamarts using KP
EMR data need additional information and need to
integrate via a manually/semi automated way or using a
point solution at their end.


This not only increases cost but also has time to market
and data quality issues.


An integrated staging layer will not only provide a
consistent layer of information, it will reduce cost and
improve information latency.



Questions?


pradeep.k.chowdhury@kp.org