Information Architecture. It s utility with the NHS landscape. Presented by Richard Kavanagh, Head of

Transcription

1 Information Architecture It s utility with the NHS landscape Presented by Richard Kavanagh, Head of

2 Information Architecture for Interoperability An insight into current work to support a more capable Information Architecture within the HSCIC. The challenge Where we are on the solution Work yet to be undertaken How you can help? 2

3 The challenge The availability of usable information definitions to aid Interoperability does not support the current landscape. 3

4 The Complexity of Transforms Interoperability assumes compatibility on sending & receiving systems This applies to both the information content and the semantics Transforms are often hard, take excessive development time and are prone to errors 4

5 Messaging Standards 5

6 NHS Data Dictionary Predominantly used for central data collections Largely focussed on administrative and activity concepts Increasingly being asked to support more clinical concepts >2M Page views per year 6

7 NPfIT/ITK : HL7 Messaging Specifications Introduced by NPfIT for national messaging Based on HL7v3 standard Complicated to create, publish and use Difficult to understand the information content Utilisation is increasing though undoubtedly more difficult that it need be 7

8 Supporting a mixed technical landscape The variety of technical standards is expanding not contracting (HL7 FHIR) Existing systems will be in place for many years yet (Spine2) The local/national interface can not be ignored 8

9 Increased demands for consistency Increased demand for coded clinical information flows SNOMED CT usage is increasing Professional standards for content are arriving (e.g. CDGRS record headings) Exchanges between Health and Social 9

10 Back to basics Behind any information exchange is the definition of the information to be exchanged Make the definitions easier to create and share Lower the barriers for understanding Have a common way to define information 10

11 Standards for Information Content The nice thing about standards is that you have so many to choose from Andrew S. Tanenbaum 11

12 CEN/ISO An existing standard used both in Europe and the USA Allows the creation of Archetypes, constrained information models that can be created and understood by a wide set of stakeholders 12

13 Example : Blood Pressure (UML) dm Blood Pressure Blood Pressure Ev ent Blood Pressure Observ ation 1..* - +hasinterpretation Blood Pressure Finding type: Coded obs_time: DATETIME interpretation: Coded Reference Range Method - type: Coded = Auscultation, P... Systolic pressure value: mmhg - value: mmhg - /value: mmhg Cuff Size - type: Coded = small, large, s Diastolic Pressure 1 +phaseidentifier 0..1 Korotkoff Sounds - phase: Coded = 4,5 Dev ice - type: Coded = sphygmomanometer Mean Arterial Pressure Body Position - position: Coded = supine, sitting... Pulse Pressure /value: mmhg Patient State - factors: Coded [1..*] 0..* Body location - site: Coded 0..1 Laterality - side: Coded

14 Example : Blood Pressure (Mind Map) The Mind Map format chosen is fully compatible with free open source Mind Mapping tools. 14

15 Archetype Editor (LinkEHR) Each item of information can be constrained for Data Types (Integers, Quantities, Codes, Dates ) Cardinality ( Mandatory, Optional, Multiplicity etc. ) Terminology Binding (SNOMED CT or other) Default Values or Fixed Values 15

16 Model Publication & Governance The publication format and method is yet to be determined, hopeful for a 2015 delivery Governance process yet to be defined, though expect significant clinical input and federated structure Alignment to existing NHS Data Dictionary and Message Specifications will be built in where required 16

17 Using the Archetypes in HSCIC The Archetypes represent a logical view of the data and can be mapped to physical structures for messaging. For messaging the archetypes will need to be mapped to physical structures (e.g. HL7 CDA Templates or HL7 FHIR Profiles). 17

18 Phase 1 Pilot (Underway) Within HSCIC a Proof of Concept project underway for Child Screening Models. Newborn Physical Examination Newborn Birth Details Newborn Blood Spot Screening 18 Archetypes available in October together with

19 Relevance to Renal Care Domain? Child Screening not of direct relevance here Require input into utility of: archetypes terminology bindings mappings to messaging forms publication formats 19

20 A suitable carrot? 20

21 UKRDC Information Model 21

22 Phase 2 Pilot (Proposal) Create Archetypes for part of Information model Create terminology bindings and other constraints If useful, exemplar message fragments. Timeline Dec 13/Jan 14 22

23 Phase 2 Pilot (Proposal) Interested in participating? Further details will be circulated via UKRDC 23

24 Questions? 24