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HIE Standards

Prof. Suptendra Nath Sarbadhikari, MBBS, PhD

Project Director, Centre for Health Informatics National Health Portal

NIHFW, Munirka, New Delhi 110 067supten@gmail.com

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IntroductionGoal: To provide better and cost effective patient care one needs to exchange healthcare information.Standard: Ability of two or more systems or components to exchange information and to use the information that has been exchanged [IEEE Standards Computer Dictionary]

3 Health Concept Triangle from: SCOTT, P., MACISAAC, P. SAAD, P., et al. An introduction to health terminologies. Brisbane: NCCH, 2002.

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Broad Categories• Vocabulary• Content Exchange• Transport• Privacy, Security and Confidentiality

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Common Vocabularies• ICD-9, 10, 11 (WHO)• SNOMED-CT (IHTSDO)• LOINC (Regenstrief Institute Inc.)• CPT-5 (AMA, USA)• ICHI (WHO, based on ICD-10-AM)• ICD-10 CPS • RxNorm (NLM, USA)

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Content Exchange Standards

• HL7 v2.x, v3.0, FHIR• HL7 CDA R2.0• CDA + CCR (ASTM) = CCD• DICOM

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Transport Standards

• SOAP (Simple Object Access Protocol)• XML (W3C)

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Security• A symmetric 128 bit fixed-block cipher

algorithm capable of using a 128, 192, or 256 bit encryption key

• An encrypted and integrity protected link to be implemented (e.g., TLS, IPv6, IPv4 with IPsec).

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• HL7 is an ANSI-accredited Standards Development Organization (SDO) operating in the healthcare arena.

• HL7 v2.x: Communication layer (Interaction and Message models)

• HL7 v3: Objects layer (Information model – RIM and Document – CDA)

• HL7 FHIR: Fast Health Interoperable Resources

What is Health Level Seven (HL7)?

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How to Harmonize different standards – e.g., HL7 and DICOM?HL7 communicates Clinical and Administrative (ADT) data between HIS and RISDICOM communicates between RIS and PACS for images and DICOM modality work list querySo there needs to be a Broker to communicate between HL7 and DICOMIHE Scheduled Workflow (SWF) integrates the ordering, scheduling, imaging acquisition, storage and viewing activities associated with radiology exams.

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