Perspective naționale și internaționale ale informaticii și

standardelor medicale Dr. ing. Andrei VASILATEANU

Universitatea POLITEHNICA Bucuresti

Cuprins

• Introducere, HL7 Romania

• Noi paradigme in asigurarea sanatatii

• Evolutia sistemelor informatice in sanatate

• Standardul HL7, RIM

• Metodologie

• Modelul domeniului LUMIR

• Catre ecosisteme digitale de sanatate

HL7 Romania

• Afiliata HL7 International

• Include furnizori şi beneficiari de servicii medicale, dezvoltatori de aplicaţii informatice, experţi tehnici.

• Nume consacrate din industria IT medical din Romania

• Dosarul Electronic al Pacientului dezvoltat de UTI bazat pe HL7

• Oferirea de cursuri HL7 in colaborare cu HL7 International si organizarea de examene de certificare

• Cursul HL7 Fundamental este un curs complet online, supervizat de tutori din SUA

• Presedinte: prof. Florica MOLDOVEANU

• Presedinte onorific: dr. Nicolae GOGA n.goga@rug.nl

Noi paradigme in asigurarea sanatatii

• "pay for performance“ - cost control

• "personalized medicine“ , "evidence-based medicine“ - quality of services

• "patient-centered care”- “The right care in the right way at the right time”

• "patient empowerment" Nothing about me without me”

• ICT joaca un rol fundamental in schimbarea paradigmei prin sustinerea procesului de inovare al proceselor business in sanatate, sustinerea re-inginerizarii domeniului sanatatii

Trenduri in e-health

• E-health “an emerging field in the intersection of medical informatics, public health and business”

• Dosarul longitudinal al pacientului

• Interoperabilitate semantica si organizationala – Interconnecting health

• Sisteme de sanatate interconectate national si regional

• Aplicatii dependente de context

Patient

summaries

Clinical Pathways

*

Workflow Engine

Care Plan

Drug and lab test prescriptions

Medical image and report

Lab test results

Discharge Summary

Emergency Summary

Vital Sign Progress Report

Sickness Prevalence Demographics

Trends in Episodes of Care

Patient

Notification /Alarm

Clinical Event Notification

Clinical Event Notification

Clinical documents

Contacts

Home Recovery

Hospitalization

Emergency

Observations

Therapy

Medication

GP Encounter

CAT analysis

Knowledge Base • Ontology • Clinical guidelines • Process Templates

• Service & Metadata Registry • Clinical Document

Repository

Process Instanc

e

Security & Privacy Repositories

• Care consumers • Care providers • Care organizations • Role profiles

Clinical Event Notification

Clinical Event Notification

Past medical history

Current health status

Ongoing treatments

Clinical Trial Evaluation Report

Health

conditions

L.D.Serbanati, F.Ricci, G.Mercurio, A.Vasilateanu, Steps towards a digital health ecosystem, J Biomed Inform, Elsevier, 2011

Standarde informatica medicala

• Interoperabilitate sintactica si semantica

• Metodologie de analiza si proiectare a domeniului de interes

Standarde si specificatii HL7

• Health Level 7, nivelul aplicatiilor din OSI

• Specificatii mesaje versiunea 2.x si 3.x

• Reprezentarea cunostiintelor si suportul deciziei (Sintaxa Arden)

• Standardizarea documentelor clinice (CDA)

• Vocabulare clinice

• Standarde, metodologii si servicii legate de dosare electronice de sanatate

HL7 vers 3 Reference Information Model

Metodologia HL7 V3

• Definirea aplicatiilor si problemelor din interfatare

• Definirea informatiei care trebuie comunicata intre aplicatii : definitie, format, relatii

• Evenimente care initiaza comunicarea

• Structurarea si distribuirea pe pachete a informatiei

Example

Restrict

Restrict

Restrict

RIM

D-MIM

R-MIM

HMD

Message

Type

Storyboard

Storyboard

Example

Application

Role

Trigger

Event

Interaction

Instantiate

Sender Receiver

Triggers

Content

References

Use Case Modeling

Information Modeling

Interaction Modeling

Message Design

Analiza domeniului LUMIR

Ecosistemul digital al sanatatii

EHR

Infrastructure

Digital Healthcare Ecosystem

Patient

GP Office

eE

Shared Resources

Medical Ontology

Clinical Guidelines

Research Laboratory

PHR

GP’s EMR

Mandate-based Organization

An ad-hoc Organization

Regional Health Organization

Organization Business’s Rules

GP's Virtual Avatar

Virtual Team Care Organization

Organizational Structure

Healthcare Ecosystem

Government

Organizational Mediator

Measurement device

POS

Organization’s Roles

eE

e-CRFs

eE

Reports

Gov. Agency's Virtual Entity

VHR's Virtual Entity

Researcher's Avatar

Supervisor

Home

GP

Hospital EMR Hospital's Virtual Entity

Hospital

Researcher

Governmental Agency

Patient's Avatar

HIS

Virtual Health Record

Va multumesc pentru atentie!

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