ศูนย์พัฒนามาตรฐานระบบข้อมูลสุขภาพไทยThai Health Information Standards Development Center

PHARMACY INFORMATICS EDUCATIONAL SERIESโครงการอบรมการพัฒนาและจัดการระบบข้อมูลเภสัชกรรมในโรงพยาบาล

: การเตรียมข้อมูลยาเพื่อการเบิกจ่ายวันที่ 3-4 มีนาคม 2557

คณะเภสัชศาสตร์ จุฬาลงกรณ์มหาวิทยาลัย

นพ.ดาวฤกษ์ สินธุวณิชย์ นพ. บุญชัย กิจสนาโยธิน Ph.D.(Health Informatics)

BHI-ED-SIG

Thai

Hea

lth I

nfor

mat

ics

Acad

emy

Thai

Hea

lth

Info

rmat

ion

Stan

dard

Dev

elop

men

t C

ente

r(TH

IS) กรอบการน าเสนอ

แนวคิดการแลกเปลี่ยนข้อมูลสุขภาพ (Health information exchange) การท างานร่วมกันของระบบข้อมูล(Interoperability) และ มาตรฐานข้อมูลสุขภาพ (Health information standards)

รหัสยามาตรฐาน: บัญชีข้อมูลยาและรหัสยามาตรฐานไทย (Thai Medicines

Terminology) TMT

รหัสยามาตรฐาน 24 หลัก

รหัสสินค้าและบริการมาตรฐาน GS1

2

Thai

Hea

lth I

nfor

mat

ics

Acad

emy

Thai

Hea

lth

Info

rmat

ion

Stan

dard

Dev

elop

men

t C

ente

r(TH

IS)

Patient Data

Clinical Research

Quality Improvement

Management

Financing

Business Intelligence

EMR, CPOE

Lab, Pharm Data

Clinical Notes

Reimbursement

Claim Data (DRG)

Individual Data

Aggregated Data

Clinical Data Administrative Data

Thai

Hea

lth I

nfor

mat

ics

Acad

emy

Thai

Hea

lth

Info

rmat

ion

Stan

dard

Dev

elop

men

t C

ente

r(TH

IS)

Patient Data

Administrative data Clinical data

Use for reimbursement,

administration and reports

Diagnosis, Procedure codes

Charge/cost data

Use for clinical care

Laboratory data, Pharmacy

data

Clinical notes

Individual Data Aggregated dataOperational, Transactional Report form

Thai

Hea

lth I

nfor

mat

ics

Acad

emy

Thai

Hea

lth

Info

rmat

ion

Stan

dard

Dev

elop

men

t C

ente

r(TH

IS)

5

Thai

Hea

lth I

nfor

mat

ics

Acad

emy

Thai

Hea

lth

Info

rmat

ion

Stan

dard

Dev

elop

men

t C

ente

r(TH

IS)

6

National Health Information Systems Blueprint

(the Architecture)A Health Information Exchange (HIE) makes the sharing of

health data across information systems possible

1) who received health

services

2) who provided those

services,

3) where did they

receive the services

4) what specific care

did they receive.

From: http://ohie.org/architecture/

Why Health Information Exchange(HIE)

Interoperability and information standards?

Integration & Exchange of Health Information

Health Information Systems Interoperability

Health Information Standards

What is Interoperability?

is ability of two or more systems or

components to exchange information

and to use the information that has been

exchanged.

IEEE standard computer dictionary: a compilation of IEEE standard computer glossaries.1990.

Level of Interoperability

• is realised through invocation of services

accessed via standardised interfaces. Here,

common business models are needed.

Process/Service

Interoperability

• harmonised information models based on

common references and agreed, ontology-based

terminology

Semantic

Interoperability

• harmonised messaging and document exchangeSyntactic

Interoperability

• is based on the exchange of agreed data.Structure

Interoperability

• establishes harmonisation at the plug and play, signal and protocol level

Technical Interoperability

Benson T: Principles of Health Interoperability HL7 and SNOMED. 2nd ed. 2012. Springer; 2012.

Bobel B: Making Hospital IT Interoperable Hospital Information Technology Europe 2008

Why Standards is needed?

The number of interfaces = 𝑁2−𝑁

2Linking 6 nodes ->15 interfaces, Linking 100 nodes -> 4,950 interfaces.

Benson T: Principles of Health Interoperability HL7 and SNOMED. 2nd ed. 2012. Springer; 2012.

Interoperability and Standards

Thai

Hea

lth I

nfor

mat

ics

Acad

emy

Thai

Hea

lth

Info

rmat

ion

Stan

dard

Dev

elop

men

t C

ente

r(TH

IS)

Landscape ของมาตรฐานข้อมูลสุขภาพ

From: Standards – Yesterday, Today and Tomorrow: Integrating the Standards for Healthcare presentation , Ken Lunn, 17 October 2011

Categories of Health Information Standards

Health data Standards Category

Content Exchange Standards - Core data sets

Health Data Dictionary: eg. Referral letter, Billing Data Set

Patient summary data set

Continuity Care Document (CCD) - HL7 CDA

Standard Vocabularies Standards - Semantic

Patient, Providers identifiers

Classification : ICDs

Terminology: SNOMED-CT, LOINC

Apple

What is Semantic? มาตรฐานความหมาย

Messaging Standards - Syntactic :

HL7 V2, HL7 V3 messaging standards

Security and Privacy standards

Rules & Regulations

PKI (Public Key Infrastructure)

Health Information Standards

Thai

Hea

lth I

nfor

mat

ics

Acad

emy

Thai

Hea

lth

Info

rmat

ion

Stan

dard

Dev

elop

men

t C

ente

r(TH

IS)

Standards (มาตรฐานข้อมูล) National

1. Core data set standards (ชุดข้อมูล) 12 & 18 files standards

2. Semantic standards (ค าจ ากัดความความหมาย)

ICD 10 TM, ICD 9 CM

Citizen IDs, Facility IDs

3. Syntactic standards (รูปแบบการส่งข้อมูล) X

4. Security and privacy standards (ความเป็นส่วนตัว และความม่ันคงของข้อมูล) X

Thai Health Data Standards: Current

Thai Health Information Standards Development

Standards (มาตรฐานข้อมูล) National

1. Core data set standards (ชุดข้อมูล) Referral, Chronic Diseases

2. Semantic standards (ค าจ ากัดความความหมาย)

Drug Terminology (TMT),

Lab. Code (LOINC)

Providers ID

3. Syntactic standards (รูปแบบการส่งข้อมูล) HL7 messaging,HL7-CDA

4. Security and privacy standards (ความเป็นส่วนตัว และความมั่นคงของข้อมูล) X

Groupers

Continuum of Health Semantic Standards

Nomenclature-Highly detail descriptions (SNOMED-

CT)

Classification-organized aggregation of descriptions

into rubric (ICDs)

Groupings-High level categories of rubrics (DRGs)

Nomenclatures Classification Groups

Aggregation

Details Grouped SNOMED-CT ICD DRG

World Health Assembly Resolution

WHA66.24 May 2013

Urges member state to

1. Draw up a road map for implementation of ehealth and health

data standards at national and subnational levels.

2. Develop policies and legislative mechanisms linked to an

overall national eHealth strategy, in order to ensure

compliance in the adoption of ehealth and health data

standards.

http://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_R24-en.pdf

Dr Margaret Chan, Director-General of WHO