Implementing an Electronic Health Record System

Implementing an Electronic wellness take SystemImplementing Electronic Health Record System Based on HL7 RIM -Re employ the RIM Model ArchetypesNancy MittalAbstractIt is difficult to exchange healthc ar in coiffeion among various HealthCare Systems. Health Level sevener is a universal regular to facilitate the communication surrounded by disparate HealthCare Systems. Electronic Health Record System is a software platform that store patient health information which maintained by hospital and medical practice. Health Level 7 Reference education Model was study to provide the interoperability between different HealthCare Systems. In this paper, we studied about the various version of Health Level Seven touchstone including HL7 v2.x, HL7 v3.0, HL7 RIM. This paper focused on how the exist structure of HL7 is improved by reusing the HL7 RIM classes such(prenominal) as Act, constituent, and Entity etc each are associated with stigmatise of attributes. It explains to modify the actual structure of HL7, need to modify the HL7 RIM because HL7 RIM mystify provide the structure of HL7. This paper also explained the design found queries are performed by the interested stakeholders like patients, doctors and hospitals. In this new structural form, role based information is maintained in the centralize selective informationbase. This seek fills the gap between skilled and semi-skilled users and wonder is performed on role base.Keywords HL7, RIM, Role, Archetypes1. IntroductionWith the continuous development of health records, maintain and exchange the information in different HealthCare systems has become unavoidable. So, the communication between different hospitals or between different HealthCare system need to improved. Electronic Health Record is a repository of health information in a digital format about an individual patient or population managed by hospitals or medical practice that shared across different HealthCare Systems. It reduces the chance s of data replication. More organizations adopt EHR physicians, nurses and clinicians have greater admission price to patient information which helps in accurate diagnosis and finish up data helps to interpret the best possible care.Electronic Health Record (EHR) system is needed to focus on two requirementsdynamic involvement of different hospitals, patients and HealthCare SystemsAnd the fashion of maintaining the information.Standard compliant EHR provide facility of communication and to exchange information of patients between different hospitals, doctors, HealthCare systems. Each patient has his own queries respective to their role in the system. The query user interface is designed to provide the effective knowledge among different kind of patients, hospitals.Health Level SevenHeath Level Seven is a standard developing organisation accredited by ANSI (American National Standard Institute) founded in 1987. HL71 name refers the top layer of the OSI (Open System Interconnecti on) layer communications protocol for the health environment. HL7 specifies a number of various standards health information and also provide communication between different HealthCare System.Standard are the embed of rules that on the wholeow information to be shared in standardized and reliable manner.HL7 messaging standardThere are two main HL7 messaging standard HL7 v2.x and HL7 v3.0.HL7 v2.x is also called as pipe hat. This standard provides the interoperability stipulation for health and medical transaction. HL7 v2.x message format are in human readable ASCII and non XML encoding syntax. It supports administrative, logistical, monetary as well as clinical messages.HL7 v3.0 provides the interoperability specification for health and medical transaction based on RIM (Reference selective information Model). HL7 v3.0 message format based on XML encoding syntax and also on HDF (formal methodology) and object oriented principle. It supports only clinical data. Movement from HL7 v 2 to HL7 v3 is that v3 would be model driven methodology core v3 standard support health care workflows through modelling the end result maximize reuse and increase consistency in HL7 specification.Another2 HL7 v2.7 supports all HealthCare section data for exchange between different HealthCare systems. It reduces the custom interface programming. But it is not plug and play and not support transaction process feature.Table1.Difference between HL7 v2.x and HL7 v3.0HL7 RIM3 (Reference Information Model)The HL7 Reference Information Model provides the structural information of HL7 in the form of information classes. HL7 RIM is an object oriented model to give away compatible the HL7 specification interoperability to all domains. It is important part of the HL7 v3.0 development model. It increases precision and reducing machineation costs. HL7 RIM is based on UML (Unified Modelling Language).Reference information model has five components Subject Area (major part of am model), class (about which information is collected), Relationship (relation between classes), attribute (information about class), and data type (specification of the format of an attribute).RIM has six main important classesAct- It represents actions that are executed by entity.Entity These are the physical things that take part in health care.Role Role that entity plays as they participate in health careParticipation It represent context for an act such as who perform, for whom and where.ActRelationship It represents the relationship between actions.RoleLink It represents the relationship between roles.2. Related WorkElectronic health record system based on health level seven, and HL7 used to provide the communication between different HealthCare systems, most of the research studies show perplexing which is further discussed in this paper review.Tung Tran, Hwa-Sun Kim1 studied the research on,A Development of HL7 Middleware for Medical twist Communication to developed HL7 compliant middlewa re. Researcher used HL7 as a middleware to facilitate data transfer to information system in hospitals. Middleware has capability of receiving data from monitoring device and converting into HL7 data type format. It receive raw data from medical devices and convert to HL7 data and passed to HIS based on HL7 interface engine.Li-Fan Ko, Jen-Chiun Lin, Chi-Huang Chen, Jie-Sheng Chang, Faipei Lai2 concluded the research on,HL7 Middleware Framework for Healthcare Information System. Researchers introduce HL7 and web services standard into framework which is basically Service Oriented architecture (SOA). HL7 directly transmitted data over transport layer protocol TCP/IP for small application HL7 message over TCP are simple and easy to implement for larger application, system become complex and attacker increases. This research solved that problem by introducing web services which provide interoperation between software systems.Jennifer Munnelly3 in his research study on, HL7 Healthcare I nformation steering Using Aspect-Oriented Programming focused the modification in application department without the requirement modification into complete structure by using HL7.Researcher suggested introduce HL7 functionality into exiting application without any modification through AOP.Wooshik Kim4 studied the research on, Integration of IEEE 1451 and HL7 Exchanging Information for Patients Sensor Data showed the IEEE 1451 interested with smart transducer and having plug play capabilities. Patients wear sensors that measure the patients status in real time and transmitted these data to remote sites such as hospital. HL7 accepted this kind of data and interpreted with various online sensor data.Pasquale De Meo5 studied on, Integration of the HL7 Standard in a Multiagent System to Support individualised entry to e-Health Services. In this paper, he presented a system which has multi agents to maintain patients in seek of health related services in e-health care by using various algorithms PPB, DS-PPB, AB. This proposed system increases the quality service and effectiveness.Maqbool Hussain6 concluded his research on, Healthcare Applications Interoperability through Implementation of HL7 Web Service Basic Profile studied all phases of web service component that implement HL7 Web Service Basic Profile. It is branch of the transportation subsystem progressed at NUST School of Electrical design and Computer Science, Pakistan.Naeem Khalid Janjua7 in research study presented work on, digital Health Care Ecosystem SOA Compliant HL7 based Health Care Information Interchange and proposed Service Oriented Architecture (SOA) based HL7 system design for patient information and showed the translation from HL7 V2 to V3 and mapping between database and user query.Sara Gaion8 researched on, Design of a Domain Model for Clinical Engineering within the HL7 Reference Information Model. This paper develop a DIM (Domain Information Model) by providing the HL7 RIM to clinical e ngineering in a item domain. This paper represent clinical engineering information in the HL7 RIM (Reference Information Model) with the reason of developing a HL7 v3 RIM model based on DIM (Domain Information Model) dedicated to CE(Clinical Engineering) by reuse of standard healthcare information models and show the process of repairing and maintenance of device used in hospital.N.A. Mamani Macedo9 studied the research on, Electronic Health Record Comparative Analysis of HL7 and Open EHR Approaches. This paper showed the comparison between HL7 and openEHR to automatism a Patients Record in any hospital which adopted HL7 and OpenEHR. The method includes analyzing each way, defining some criteria of evaluation, design a comparative chart.3. Design modelThe work is defined with the specification of the hospital and the relative attributes and the functional specification. It defines the role and requirement to specify the functional dependencies and its requirements. The role is defi ned for all the interested patients and hospitals and all interested users are committed to it along with their specified roles. The hospital is responsible for the information updating as well as to generate the query that queried by patients to drive the information access about the patient, disease or diagnose. Complete information is defined in the form of centralized repository. Model is in the form of a query interface in which the communication to the system and different hospitals maintain the information in different way so that the mapping is infallible between the query set and the hospitals. To establish this mapping, the structural constructs for the system are defined so that the functional based information transition will be take place.Steps in implementation modelFirst step is role identification and analysis Users in this system are patients and hospitals(health organization). Role is defined for all the interested users ,patients and hospitals and they are coonn ected to it along with their hospitals.Second step is role specific query generation Hospitals is reasponsible for the information updating as wel as to generate the query that queried by patients to obtain the information access about the patient,disease and diagnose.Third step is query filteration and mapping done by RIM model Complete information is defined in the form of centralized dataset.Model in the form of query interface in which the communication to the system and diff hospitals maintain the information in diff way. So that mapping is required between query set and hospitals.Last step query result are extraced.4. ConclusionIn changing the structure of HL7 and increasing the reusability over existing HL7 RIM model by reuse the RIM model archetypes. HL7 standard facilitate to exchange and sharing the healthcare information among different hospitals or in between different healthcare systems. We concluded that we extract the existing HL7 RIM model and improve the reusability over existing model by reusing the classes of RIM model and implement the user interface to accept request from different users and process the role base Queries.References1 Health Level Seven (HL7), http//www.hl7.org.2 Explorative study of healthcare data Interchange standards3http//www.openhre.org/local/rim202/rim.htmActs-sbj1 Tung, Kim, Cho, A Development of HL7 Middleware for Medical Device Communication, Fifth International Conference on Software Engineering Research, Management and Applications2 Li-Fan Ko, Jen-Chiun Lin, Chi-Huang Chen, Jie-Sheng Chang, Faipei Lai, HL7 Middleware Framework for Healthcare Information System. Basically framework is service oriented architecture (SOA).3 Jennifer Munnelly, HL7 Healthcare Information Management Using Aspect-Oriented Programming, International Symposium on Computer-Based Medical Systems, pp 1 420094 Wooshik Kim, Integration of IEEE 1451 and HL7 Exchanging Information for Patients Sensor Data, J Med Syst, pp 10331041, 20105 Pasqual e De Meo, Integration of the HL7 Standard in a Multiagent System to Support Personalized Access to e-Health Services, IEEE Transactions on Knowledge and Data Engineering, pp 1244 1260, 20116 Maqbool Hussain, Healthcare Applications Interoperability through Implementation of HL7 Web Service Basic Profile, Sixth International Conference on Information Technology New Generations, pp 308 313200977 Naeem Khalid Janjua, Digital Health Care Ecosystem SOA Compliant HL7 based Health Care Information Interchange, 3rd IEEE International Conference on Digital Ecosystems and Technologies, pp 329 334, 20098 8 Sara Gaion, Design of a Domain Model for Clinical Engineering within the HL7 Reference Information Model, IEEE Workshop on Health Care Management, pp 1 6 , 20109 N.A. Mamani Macedo, Electronic Health Record Comparative Analysis of HL7 and Open EHR Approaches, Pan American Health Care Exchange, pp 105 110, 2010