1 ge healthcare ehealth solutions data dictionary february 22, 2012
TRANSCRIPT
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GE HealthcareeHealth Solutions
Data DictionaryFebruary 22, 2012
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Architecture / Data SourcesData Types: Demographics
& ClinicalMonthly MetricsHIE Data Dictionary
AGENDA
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PATIENT• Personal Health Records
PRIMARY CARE PHYSICIANS• Practice Management
• EMR
LAB• Results
PUBLIC HEALTH• Registries
PHARMACY/PBMs• RX History SPECIALTY
PRACTICE• Practice Management
• EMR
HOSPITAL 1• EMR/PM’s
• Lab
• PACS Archive
HOSPITAL 2• EMR/PM’s
• Lab
• PACS Archive
PAYERS• Claim Data
Document Repositori
es
Document Repositori
esPatient ID Manager
Document Registry
GE eHealth Information ExchangeKey Components
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SPECIALTYPRACTICE• Practice Management
• EMR
HOSPITAL 2• EMR/PM’s
• Lab
• PACS Archive
PRIMARY CARE PHYSICIANS• Practice Management
• EMR
PATIENT• Personal Health Records
PRIMARY CARE PHYSICIANS• Practice Management
• EMR
MRN 111MRN 111
MRN 222MRN 222
MRN 333MRN 333
PUBLIC HEALTH• Registries
PHARMACY/PBMs• RX History SPECIALTY
PRACTICE• Practice Management
• EMR
HOSPITAL 1• EMR/PM’s
• Lab
• PACS Archive
HOSPITAL 2• EMR/PM’s
• Lab
• PACS Archive
PAYERS• Claim Data
LAB• Results
Patient ID Manager
John Doe PCP 111 99
John Doe Specialty222 99J. Dow Hospital 2333 30
Name Site MRN %
Patient Identity FeedIHE PIX
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SPECIALTYPRACTICE• Practice Management
• EMR
PATIENT• Personal Health Records
PRIMARY CARE PHYSICIANS• Practice Management
• EMR
PIX QUERY:
MRN 111
PIX QUERY:
MRN 111
PIX RESPONSE: MRN 222
PIX RESPONSE: MRN 222
LAB• Results
PUBLIC HEALTH• Registries
PHARMACY/PBMs• RX History SPECIALTY
PRACTICE• Practice Management
• EMR
HOSPITAL 1• EMR/PM’s
• Lab
• PACS Archive
HOSPITAL 2• EMR/PM’s
• Lab
• PACS Archive
PAYERS• Claim Data
Patient ID Manager
John Doe PCP 111 99
John Doe Specialty222 99J. Dow Hospital 2333 30
Name Site MRN %
Patient Identity Cross-ReferenceIHE PIX
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PRIMARY CARE PHYSICIANS• Practice Management
• EMR
PRIMARY CARE PHYSICIANS• Practice Management
• EMR
PATIENT• Personal Health Records
SPECIALTYPRACTICE• Practice Management
• EMR
HOSPITAL 1• EMR/PM’s
• Lab
• PACS Archive
HOSPITAL 2• EMR/PM’s
• Lab
• PACS Archive
PAYERS• Claim Data
LAB• Results
PHARMACY/PBMs• RX History
PUBLIC HEALTH• Registries
CCD• Allergies• Problems• Meds• Etc, Etc.
REGISTER DOCUME
NT
REGISTER DOCUME
NT
PUBLISH
PUBLISH
Patient ID Manager
Document Registry
Publish DocumentsIHE PIX
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PATIENT• Personal Health Records
PRIMARY CARE PHYSICIANS• Practice Management
• EMR
REQUEST DOCUMENT
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REQUEST DOCUMENT
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RETRIEVE
RETRIEVE
LAB• Results
PUBLIC HEALTH• Registries
PHARMACY/PBMs• RX History SPECIALTY
PRACTICE• Practice Management
• EMR
HOSPITAL 1• EMR/PM’s
• Lab
• PACS Archive
HOSPITAL 2• EMR/PM’s
• Lab
• PACS Archive
PAYERS• Claim Data
SPECIALTYPRACTICE• Practice Management
• EMR
RETRIEVE DOCUMENT
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RETRIEVE DOCUMENT
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CCD• Allergies• Problems• Meds• Etc, Etc.
Patient ID Manager
Document Registry
REQUESTREQUEST
Query for DocumentsIHE PIX
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Technical Diagram of Data Sources
ADTMDMORU
ADTMDMORU
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Architecture / Data SourcesData Types: Demographics
& ClinicalMonthly MetricsHIE Data Dictionary
AGENDA
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Data TypePatient Demographics
“R” Required
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Document ExampleXD*LAB
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Document ExampleXDS*SD
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Architecture / Data SourcesData Types: Demographics
& ClinicalMonthly MetricsHIE Data Dictionary
AGENDA
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Monthly Metrics: # of Patients
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Monthly Metrics: # of Clinical Documents
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Architecture / Data SourcesData Types: Demographics
& ClinicalMonthly MetricsHIE Data Dictionary
AGENDA
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Schemas / Tables / Data Elements
Schemas(HIE+MPI has ~5), plus POL, CDT, CCD, etc
Tableseach schema has 11 to 168 tables
Columns = Data ElementsEach table has ~10 columns (or data elements)
Column Definitions
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2
3
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Sample Data Elements
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Data Dictionary: Example #1
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Data Dictionary: Example #2
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Lab ResultHL7 2.x ORU(FH & OH)
TransformerService
(GE)
HITSP/IHEXD*Lab
(GE)
MSH|^~\&|QDXPT|OH||STJOHMC.3|20091115205600||ORU^R01|R31061680326.3.2|P|2.2PID|1||401017564||TESTS^PATIENTS^K^^^||19750103|F|||1313 Mockingbird Lane^^LONGVIEW^ WA^98632||""|||||80897339|572-12868PV1|1|E|ED NA-NA|E|||31543^TRAN^MIMI^^^^MD||26837^MELGAR^GERARDO^R^^^MD||||||||31543^TRAN^MIMI^^^^MD|PH||||||||||||||||||||||||||20091115ORC||8257603248^PLW-OIF|||||||||||||||^SJMC^^SJMCOBR|1|8257603248^PLW-OIF|LA93264515|31305^OML|S|200911152015|200911152015|||KENDUL||||200911152026|GNL^BLD|31543||||LA93264515|SJMC^PeaceHealth Lower Columbia Region^Clinical Laboratory S|200911152056||HM|F||^^^200911152015^^S|||||||||200911152008OBX|1|TX|300500^GLUCOSE|1|103|mg/dL|70-99|H|||F||||SJMC|WANBRUOBX|2|TX|300600^UREA NITROGEN (BUN)|1|22|mg/dL|6-20|H|||F||||SJMC|WANBRUOBX|3|TX|300700^CREATININE|1|0.7|mg/dL|0.44-1.03||||F||||SJMC|WANBRUOBX|4|TX|310100^SODIUM|1|139|mEq/L|135-145||||F||||SJMC|WANBRUOBX|5|TX|310200^POTASSIUM|1|4.2|mEq/L|3.5-5.2||||F||||SJMC|WANBRUOBX|6|TX|310300^CHLORIDE|1|107|mEq/L|95-109||||F||||SJMC|WANBRUOBX|7|TX|310400^CO2 CONTENT|1|26|mEq/L|22-32||||F||||SJMC|WANBRUOBX|8|TX|301100^CALCIUM|1|9.0|mg/dL|8.6-10.2||||F||||SJMC|WANBRUOBX|9|TX|312000^SGOT(AST)|1|24|IU/L|15-41||||F||||SJMC|WANBRUOBX|10|TX|310900^ALBUMIN|1|3.7|g/dL|3.5-5.0||||F||||SJMC|WANBRUOBX|11|TX|311700^ALKALINE PHOS|1|92|IU/L|30-110||||F||||SJMC|WANBRUOBX|12|TX|311400^BILIRUBIN,TOTAL|1|0.2|mg/dL|0.1-1.2||||F||||SJMC|WANBRUOBX|13|TX|310800^PROTEIN,TOTAL|1|6.8|g/dL|6.2-8.4||||F||||SJMC|WANBRUOBX|15|TX|311800^SGPT(ALT)|1|27|IU/L|15-54||||F||||SJMC|WANBRUOBX|17|TX|300720^GFR CALCULATED|1|>60|mL/min|>60||||F||||SJMC|WANBRUNTE|1||*estimated GFR calculated using MDRD Study equation.NTE|2||*serum creatinine affected by gender, age, race, diet, body habitus,NTE|3|| medications and creatinine method.NTE|4||*eGFR not validated in acute renal failure, extreme body size,NTE|5|| diseases of skeletal muscle, severe malnutrition, pregnancy,NTE|6|| patients with normal renal function or children.NTE|7||*multiply by 1.21 in African American patient.NTE|8||Stages of chronic kidney disease (CKD):NTE|9|| 30-59 ml/min-stage 3NTE|10|| 15-29 ml/min-stage 4NTE|11|| <15 ml/min -stage 5
HIE Standards: HITSP/IHE standards-based HIEPublish
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HIE Standards: HITSP/IHE standards-based HIE
Consume
Lab ResultHL7 2.x ORU
TransformerService
HITSP/IHEXD*Lab
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PRIMARY CARE PHYSICIANS• Practice Management
• EMR
PRIMARY CARE PHYSICIANS• Practice Management
• EMR
PATIENT• Personal Health Records
SPECIALTYPRACTICE• Practice Management
• EMR
HOSPITAL 1• EMR/PM’s
• Lab
• PACS Archive
HOSPITAL 2• EMR/PM’s
• Lab
• PACS Archive
LAB• Results
PHARMACY/PBMs• RX History
PUBLIC HEALTH• Registries
CCD• Allergies• Problems• Meds• Etc, Etc.
REGISTER DOCUME
NT
REGISTER DOCUME
NT
PUBLISH
PUBLISH
HIE & Analytics
Patient ID Manager
Document Registry (DRR)
CCD• Allergies• Problems• Meds• Etc, Etc.
Parsed
PAYERS• Claim Data
ANALYTICSCDR
LabsAllergie
sProblems
NOTE:The CFRHIO HIE Architecture allows for secure document exchange (“document” is a generic term to describe payloads that may contain freetext or discrete data (Labs, CCDs) or images (PDF, JPG, DICOM)) between authorized parties (the HIE enforces the consent policy).
Policy Questions:1. Does Patient Consent / Authorization allow for data to be used for research?2. Does it need to be De-Identified or Pseud-onomized (which can limit its value)?3. Who owns the aggregated data (and assumes risks / benefits)?
