Post on 15-Oct-2020
transcript
HL7 Deutschland e. V.
International Healthcare Interoperability Conference IHICPortsmouth (UK), July 11-12, 2018
GLOBAL INFORMATION SHARINGUPDATE ON THE INTERNATIONAL PATIENT SUMMARY
Dr Kai U. Heitmann
International Patient Summary
In case of emergency: Patient Summary ▶ minimal and non-exhaustive▶ specialty-agnostic and condition-independent,▶ but still clinically relevant
Dr. Kai U. Heitmann • International Patient Summary
© m.mphoto – fotolia.de
International Patient Summary
HL7 Int. & CEN/TC 251 agreement (April, 2017)
Vision
• “In order to further the care for citizens across the globe, we agree to collaborate on a single, common International Patient Summary (IPS) specification that is readily usable by all clinicians for the (cross-border) unscheduled care of a patient.”
Scope
• “The IPS specification shall focus on a minimal and non-exhaustive Patient Summary, which is specialty-agnostic and condition-independent, but still clinically relevant.”
Dr. Kai U. Heitmann • International Patient Summary
…a single “project” … conducted by several organizations...… with “informal” coordination…
International Patient SummaryA common intent…
HL7 IPS Project [aka INTERPAS]
CEN/TC 251IPS Project
Joint Initiative Council Standards Set[Global]
Dr. Kai U. Heitmann • International Patient Summary
European Guidelines Patient Summary[EU]
International Patient Summary
Parents and Companions▶ epSOS 2008-2012 / EXPAND 2012-2014 Continued as eHealth Digital Service Infrastructure
▶ Continuity of Care / Consolidated CDA 2.1▶ 2010 EU/US Memorandum of Understanding ONC Standards and Interoperability Framework
EU/US eHealth Cooperation Initiative EU project Trillium Bridge, continued as Trillium II
▶ 2016 Transatlantic eHealth/health IT Cooperation Roadmap
Dr. Kai U. Heitmann • International Patient Summary
The HL7 IPS Approach
Meet-in-the-middle
International Patient Summary
Implementable▶ Promote (the evolution and
convergence of) existing standards
▶ Rely on solutions that are already implemented or ready for implementation
▶ Consider new or additional solutions as they become available
Implementable
Applicable for Global Use
Extensible and Open
Sustainable
IPS P
rinciples
Dr. Kai U. Heitmann • International Patient Summary
The HL7 IPS Project History…
October 2016: Approved by the HL7 Technical Steering Committee▶ CDA R2 Implementation Guide for the IPS
and possible FHIR Implementation Guide.▶ Open template: extensible core specifications▶ Challenge: globally usable value sets for the IPS
CDA: First Standard for Trial Use (STU) ballotSept 2017 (passed)▶ 443 Comments reconciled, 33 Negatives, 85% Quorum
CDA: Second STU ballot January 2018 (passed)▶ 49 Comments reconciled, 10 Negatives, 87% Quorum
Dr. Kai U. Heitmann • Medizininformatik-Initiative • AG Interoperabilität
The HL7 IPS Project History…
January 2018 updated the IPS Project Scope▶ Scope: developing the IPS FHIR Implementation Guide▶ Started the development of a FHIR IG,
May 2018 HL7 International Ballot Round▶ FHIR IG balloted in April/May 2018▶ 105 Comments (21 negative) reconciled,
44 Affirmative and8 Negatives Votes84% Quorum
HL7 IPS Project Overview
Two products▶ HL7 CDA R2 Implementation Guide▶ HL7 FHIR Implementation Guide
Tooling▶ ART-DECOR®▶ Forge▶ Simplifier▶ Wiki platform
Dr. Kai U. Heitmann • International Patient Summary
The IPS Dataset and Sections
Collection influenced byprevious projects andexperiences
Trillium II Survey SAMPLE IPS Dataset, IPS Sections
▶ Required▶ Recommended▶ Optional
Dr. Kai U. Heitmann • International Patient Summary
The IPS Sections
MedicationSummary
Allergies andIntolerances
Problem List
Immunizations
History of Procedures
Medical Devices
Diagnostic Results
Past history of illnesses
Pregnancy (status and history summary)
Social History
Functional Status (Autonomy / Invalidity)
Plan of care
Advance Directives
Vital Signs
Dr. Kai U. Heitmann • International Patient Summary
IPS CDA Implementation Guide
Maintained in a Wiki, generated from the Wiki
Dr. Kai U. Heitmann • International Patient Summary
IPS FHIR Implementation Guide
Same conceptual content in boththe CDA R2 and FHIR specifications▶ Dataset = semantic bridge CDA / FHIR
▶ Out of scope: provide or require capability forautomatic transformation of instancesfrom CDA to FHIR and vice versa
FHIR Implementation Guide based on FHIR STU3 Ballot May 2018 passed
Dr. Kai U. Heitmann • International Patient Summary
Future extensions and useIntended Use
IPS FHIR Implementation Guide
As a document
1. FHIR IPS is a document (i.e. a composition)
2. FHIR IPS is a set of shared data blocks
Immunization
Allergies andIntolerances
Plan of care
Dr. Kai U. Heitmann • International Patient Summary
As shared data blocks
Next steps
Complete & Publish the
STU IPSCDA IG
Develop the IPS FHIR IG
Move the IPS IGs to
Normative
Make theIPS “real”
Dr. Kai U. Heitmann • International Patient Summary
√
√
The IPS Project Plan…
20
CDA R2 STU Reconciliation 2018 Jan - 2018 Apr
Request CDA R2 HL7 STU Publication 2018 MayCDA R2 STU Period – 24 months 2018 May - 2020 MayFHIR IPS IG STU ballot 2018 MayFHIR STU reconciliation 2018 May – 2018 Aug
FHIR STU IG publication 2018 SepFHIR STU period – 24 months 2018 Sep – 2020 Sep
Submit CDA R2 and FHIR IGs for HL7 Normative Ballot
2019 Sep
CDA R2 and FHIR normative reconciliation(re-ballot if needed)
2019 Sep – 2020 Sep
Dr. Kai U. Heitmann • International Patient Summary
Resources
Wiki▶ http://wiki.hl7.org/index.php?title=
International_Patient_Summary_(IPS) Implementation Guides (Wiki for editing)
▶ CDA: http://international-patient-summary.net/mediawiki/index.php?title=IPS_implementationguide_1
▶ FHIR: http://hl7.org/fhir/uv/ips/index.html ART-DECOR®
▶ Dataset, CDA, Value Sets, FHIR Mapping▶ https://art-decor.org/art-decor/decor-project--hl7ips-
Mailing list: ips@hl7.org
Dr. Kai U. Heitmann • International Patient Summary
A final word for today
Structures and semantics of the International Patient Summary is one thing. We did it.
The greater challenge comes with the processes, that has to address questions like▶ When and why is an IPS generated? When updated?▶ By whom?▶ Automatically or human curated?▶ Who determines the content: human, algorithmic?▶ Who is the custodian of the IPS?
Dr. Kai U. Heitmann • International Patient Summary
Thanks to
The whole HL7 IPS primary editor team for contributions to the project and to the slides▶ Giorgio Cangioli, PhD, Consultant, HL7 Italy ▶ Rob Hausam, Hausam Consulting LLC ▶ François Macary , Phast▶ Dr Kai U. Heitmann, Consultant, CEO HL7 Germany
…and to all contributors▶ see http://international-patient-summary.net/
mediawiki/index.php?title=IPS_Authors_and_Contributors
Dr. Kai U. Heitmann • International Patient Summary
HL7 Deutschland e. V. THANK YOU!
Questions?
Dr. med. Kai U. Heitmann, MD, FHL7CEO HL7 Germany
Heitmann Consulting and ServicesGefyra GmbH
ART-DECOR Expert GroupART-DECOR Open Tools
Templates Co-chair HL7 Internationalinfo@kheitmann.de