Overview
This course surveys XML and other related open standards, including HL7, that are being applied to the management and exchange of information in healthcare.
We focus on how XML can be used as the core technology in patient-centred health records systems, implemented in local, regional and national architectures. We show how XML provides key advantages for shared care systems, where information is exchanged across traditional boundaries of the caring professions, including its role in clinical governance. This is combined with practical feedback on the real-life application of XML in the NHS in England and around the world.
Learning Objectives
After taking this course you will understand:
- How XML can be applied to the management and exchange of information in healthcare
- The role of other related open standards
- The key components of a full patient-centred, shared care system
- Architectures that can be implemented on local, regional and national scale
- How XML is being used in the National Programme for IT in the NHS in England
- Where XML-based systems are being adopted around the world
Who Should Attend
This course is aimed specifically at healthcare IT professionals, planners, managers and clinical IT users who need to understand the way in which XML is being applied to information management and exchange in healthcare, across the world.
Faculty
This course is prepared and delivered by a world-renowned faculty, including:
- Ron Summers (Chair)
- John Chelsom
- Dave Nurse
- Ann Wrightson
- Steve Arnold
- Additional Speakers TBC
Curriculum
Module 1 – XML and Open Standards in Healthcare
1.1 Anatomy of a shared care system
Speaker: TBC
Providing a view on a complete patient journey, showing how an XML-based health record, delivered at the point of care, supports clinical practice across the caring professions. We identify the key components of a shared care system and the way in which implementation using XML provides benefit to end users.
- The patient journey – shared care across professions
- Patient-centred view – creating a single record
- Recording clinical information
- Integrated care pathways
- Care Planning
- Supporting discharge and referral
- Ordering and results reporting
- Electronic prescribing
You will see a walk through a sample care pathway, with a demonstration of a care records application, taking the covers off to show the role of XML, HL7 and related technologies.
1.2 XML and open standards applied in healthcare
Speaker: Ann Wrightson
A survey of how XML and related open standards are currently being applied in healthcare. Serving as a useful introduction for those who are new to the subject, and an update on current initiatives and thinking, for those who already have a basic understanding.
- Content – the health record with structure and free text narrative
- Meta data and ontologies – terminology
- Process – integrated care pathways
- Messaging – integration and data transfer
- Security – encryption and digital signatures
- Access Control – identifying users and controlling access to clinical information
You will gain an understanding of how these key components fit together in a healthcare application, which XML technologies are available and how they are being applied.
1.3 HL7 implementation practice
Speaker: TBC
HL7 has been widely adopted as a standard for representing and exchanging healthcare information. This lecture provides a brief overview of key concepts of HL7 and focuses on how the XML implementation of HL7 is being adopted across the world, including use of the Clinical Document Architecture (CDA).
- Interoperability – what, how and why
- HL7 basics – history and main elements
- HL7 RIM – the Reference Information Model
- HL7 CDA – the Clinical Document Architecture
- HL7 in action – in the NHS and around the world
You will learn the basic principles of HL7 – what it is, how it used and where in the world it is being applied successfully.
1.4 How XML supports clinical governance in shared care
Speaker: TBC
XML technology provides ways to manage and exchange structured information at varying degrees of granularity. These properties of XML and associated standards are can be used to enable and monitor good clinical practice, right at the heart of information management and exchange systems.
- Access control
- Audit trail and provenance
- Security and identity
- Secondary uses of clinical data
- Archive
See the important areas of clinical governance in shared care that either create issues for technology or can be addressed by it (and sometimes both), with specific focus on the role of XML.
Module 2 – Architectures for health records
2.1 Information models for health records
Speakers: Dave Nurse and Ann Wrightson
An overview and assessment of published information models for health records, including the role played by XML and HL7 in the models. As well as the information models themselves, there are also issues on the best way to define and represent the model – using UML, XML, or other modelling techniques and notations.
- HL7 RIM and EHR-S
- HL7 CDA and the Clinical Statement pattern
- CEN standards, including ENV 13606
- OpenEHR
- Messages and models
- Representing models
Gain an overview of the general approach to information modelling for health records, and some specific initiatives and standards that exist or are under development.
2.2 Local, regional and national architectures for health records
Speaker: Dave Nurse
Examines the logical and physical architectures needed to deploy health records systems on a local, regional and national basis, using XML and HL7. Includes examples and experience from the National Programme for IT in England (NPfIT) which is demonstrating how health records can be rolled out on a national scale.
- Local shared care systems
- Regional architectures
- Nationwide records systems and supporting infrastructure
- Examples and experience from NPfIT in England
- Other architectural models (e.g. from the US, Wales and Finland)
Understand both the theory and practice of creating architectures for local, regional and national systems.
2.3 Towards clinical decision support
Speaker: John Chelsom
XML can provide the ‘glue’ between the routine clinical record and integrated knowledge bases, which can deliver decision support to clinicians as they interact with the care records system. Unified XML architectures can be created for the care records system, the knowledge management system, knowledge delivery system and reasoning engines, with the clinical context propagated between those systems.
- Ingredients for an XML-based Knowledge Integration Framework
- XML for knowledge representation
- Reasoning engines
- Towards clinical decision support
- HL7 CCOW for conduction of clinical context
- TermInfo - applying SNOMED CT to the HL7 RIM and Clinical Statements
See the potential of XML technology to provide the stepping stones from operational clinical systems; to delivery of knowledge in context in support of decision making; to the ultimate goal of decision making systems.
2.4 A global market for standards-based health records
Speaker: TBC
The NHS in England has pioneered the way forward for health records using open standards technology. Here we examine the current status of standards-based health records initiatives in England, the rest of the UK and around the world, assessing the future direction and requirements for deployment using XML and other open standards in global markets.
- Connecting for Health and the National Programme for IT
- National systems and providers
- Local Service Providers and Regional Systems
- Initiatives in global markets
- The role of XML and open standards
Gain an overall view of the progress towards standards-based health information systems across the world, the lessons being learned and the places to watch in the future.
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