I'm reading the documentation and at this moment I'm very impressed. I know other interesting works like infoway.

At this moment I have a question, even thought I'm not sure if this is the right forum. The question is about how you talk about structuring the Patient Record. What's de meaning of 'spells of care'. Do you have any patient record sample that show all the concepts?.

 

 

First of all, let me congratulate you for being the first to post on this forum :-)

In terms of patient record, there are several aspects to consider. Are you talking about the clinical repository structure of the clinical data exchange?

In the first case you might want to consider the HL7 RIM as a source of your inspiration. I say inspiration because the HL7 RIM, while a very comprehensive information model for healthcare, it still represents a partial view of the information that you might need for your application. Many of the concepts that you will need are already defined there.

The second aspect is focused on the information exchanged on the wire and the main activities are in HL7 with CDA CCD/CRS and ASTM CCR.

hope this helps

Ciao,
-RR

Both, clinical repository and exchange are challenges in new conceptions around TI in healthcare.

I know how the RIM can aid (or inspire) some ideas for the clinical repository, EHR-S show us the functional aspects of the system, and why not, talk about openehr, CTS, MPI, RBAC and other necessary parts (inside HL7).

About exchange CCD,CRS or e-ms clinical document summary are real solutions for exchanging clinical summary between rhio or systems.

 But what about use the concept in ccd or crs to manage the clinical repository. Think about a RHIO that has (conceptually speaking) a crs document that grows every day with added or changed clinical information. Only a few xml tranformations and you will have diferents views of a Patient Record (one doctor , one diferent view in a extreme world) and according with patient consent too!!!!.

I'm just digesting page 40 of part 2 of CHF and I know that it is a good knowledge to use.

 

 

jvillagrasa:

Think about a RHIO that has [...] a crs document that grows every day with added or changed clinical information. Only a few xml tranformations and you will have diferents views of a Patient Record [...]

Ah, the nirvana of healthcare integration!! What you described is what everybody is after :-)

The reality is a different beast and what you described is in practice very difficult to achieve due to the multitude of format standards (HL7 v2, v3, CDA...) and vocabularies (ICD9/10, SNOMED, CPT, ICD...) with less than clear rules on how to transition from one to another.

And let's not talk about data lineage, ownership and maintenance...

Nonetheless it's good to think in those terms and move the industry agenda towards bold goals :-)

Hi roberto,

is it possible to get a more detailed view of the CHF function decomposition? 

What do you mean exactly? Part 3 of the CHF goes into a lot of detail on that aspect...

Hi Roberto, A long time ago..........

 

I was really busy. But the question I did is answered: the Microsoft Health Connection Engine 2.1. Great Job, Great implementation.

 

Hope to see you in Cologne.