HL7集成|HL7接口|医疗保健|OSP实验室

Each of the systems – Radiology Information System (RIS), Lab Information System (LIS),医院信息系统（他的），电子健康记录（EHR）和电子病历（EMR）以不同的语言相互通信。医疗保健应用的数量增加以及集中电子健康记录的必要性推动了应用程序中通用语言的要求。为了解决此问题，HL7在1987年被引入为单一，灵活和通用的沟通标准。本文总结了成功的HL7集成所涉及的重要性和步骤。

关键的缩写

HL7 - 健康级7
HIPAA – Health Insurance Portability and Accountability Act
RIS – Radiology Information System
LIS - 实验室信息系统
他的 - 医院信息系统
EHR - 电子健康记录
EMR - 电子病历
边缘 - 参考信息模型
ISO – International Organization for Standardization
ANSI - 美国国家标准学院
FIFO – First In First Out
CDA – Clinical Document Architecture
CCR – Continuity of Care
XML – Extensible Markup Language

DESCRIPTION:

什么是HL7

HL7是通用用户友好的标准，可实现两个或多个之间的通信healthcare management申请。与健康相关的信息将以一份或多个HL7消息的形式转移，例如患者记录和计费信息。

HL7互操作性standard is often called the nonstandard standard, since it does not consider any specific part as special and, hence, there is no standard business or clinical model for clinical interaction.

HL7 development needs the involvement of clinical application analyst, integration specialist, application programmers and system analyst.

What does HL7 stand for?

HL7 (Health Level Seven) symbolizes a 7-layer ISO communication model

物理:连接实体的传播media
数据链接：提供相邻节点之间的错误控制
Network: Routes the information in the network
Transport: Provides end-to-end communication control
会话：处理不是沟通问题的问题
Presentation: Converts the information
Application: Provides different services to the applications

1-4 deals with Communication; 5-7 deals with Function. All these layers are used by HL7 interface engine for transfer and retrieval of HL7 data.

HL7 Interoperability Standard versions

2.0 – 1988 – Prototype
2.1 – 1990 – First standard
2.2 - 1994 - 广泛采用
2.3 – 1997 – In operation
2.3.1 – 1999 – Approved ANSI standard
2.4 – 2000 – Approved ANSI standard
2.5 – 2003 – Current ANSI standard
3.0 – In development

OBJECTIVES:

The vision of HL7 development is a world where everyone can securely access and use the right health data when and where they need it. In order to achieve that goal, the workflow should be simplified betweenhealthcare management solutionsand various vendors for the enhanced quality, accuracy, cost and efficiency ofld乐动官方 .

Strategies:

制定明确的医疗保健信息标准，以在计算机应用程序之间进行交换以进行增强的患者护理。
从HL7参考信息模型（RIM）开发HL7互操作性标准的方法。
Educate the healthcare industries, policy makers and public about the benefits of healthcare information standardization.
通过建立HL7国际会员组织，促进全球HL7互操作性标准的使用。
Encourage domain experts from healthcare industry stakeholder organizations to join in HL7 for developing healthcare information standards in their area of expertise.
Collaborate with other standards development organizations and national and international sanctioning bodies (e.g. ANSI and ISO), to promote the use of compatible standards.
与医疗保健信息技术用户合作，以确保HL7标准满足现实世界的要求。

HEALTHCARE INTEGRATION SOLUTIONS

医疗保健整合概述

导出端点 - 发送申请
Import endpoint – receiving application
Methodology – move data between two endpoints
Methodology – handling the queuing messages
Methodology – sorting the message flow

必须访问每个医疗保健申请才能发送和接受患者数据。有一定的固定规则可以接受和发送方便交换。此访问受每个应用程序供应商严格控制，以确保其应用程序中的数据完整性。

Healthcare Integration Requirements

First In, First out (FIFO)

The exchange of clinical data must be in FIFO order. The first HL7 message received will also be the first HL7 message delivered.

Flexibility to Address Varying Requirements

Since HL7 is essentially a platform for negotiation, the interface solution must be flexible to deal with HL7 V2.3.1, V2.4, V2.5, etc. It should be able to send one message in varied versions to multiple applications.

External Application and Provider Integration

Real-world integration takes place between multiple applications in multiple locations. Healthcare interface traffic can be intense so a strong traffic director in the middle is extremely important. Else, the output will get delayed which might lead to costly implementations, application modifications, etc. Each application in the integration path should be able to send and/or receive data, ideally in an HL7 format.

短实施周期：

The workflow for interface configuration should be easy, logical and GUI driven. The developer does not have to be available to implement each application or site.

Scalable:

The number of interfaces will grow over time. An interface solution must also be able to grow with the demands of the market.

Different Data Formats

In addition to HL7, the interface solution should be able to handle other clinical standards including the Clinical Document Architecture (CDA), Continuity of Care (CCR), and XML.

Ease of Interface Testing & Maintenance

Delivering quality interfaces is crucial. Hence, few testing functions such as conformance checking, message unit testing, and communication testing should be incorporated within the interface solution.

Ease of Monitoring & Management:

To keep customer support costs low, interface implementations should be easy to monitor and resolution tools should be readily available to fix any upcoming error.

HIPAA & HL7 INTEGRATION PROTOCOLS

Data sharing between clinical and financial systems is always a challenging task, in terms of reliability, security and compliance. That is where exactly, the importance of HL7 and HIPAA arises.

HL7交换来自不同供应商的医疗保健应用之间的临床日期。HIPAA（健康保险可移植性和问责制法）于1966年实施，以更新医疗保健交易并维护患者隐私权。

HL7 will be triggered by the events like patient admission and billing within the enterprise like hospitals. Whereas between enterprises like hospitals and insurance companies, HIPAA enabled EDI-X12 transactions will be exchanged. HL7 is also used in certain HIPAA EDI-X12 transactions.

For instance, if a patient is admitted in hospital, the Patient Administration System (PAS) maintain the details about that patient. If other system like Pharmacy Systems need information about this patient, it sends an HL7 message about the patient to the properhospital systems.

Later, when the hospital sends a claim for payment to another enterprise, like an insurance company, the hospital and theinsurancecompany exchange HIPAA EDI-X12 messages. These HIPAA EDI-X12 messages may contain an embedded HL7 message about the patient also.

INTEGRATION OPTIONS AVAILABLE

An enterprise such as hospital has got many HL7 enabled applications. To reduce data entry duration and increase overall efficiency of the facility, these applications should communicate with each other.
An HL7 interface development includes:

An export endpoint for the sending application
An import endpoint for the receiving application
两个端点之间移动数据的方法

有效沟通有两种基本方法：

Point-to-point它的每一对应用程序通信在哪里endently of other applications. Point-to-point interfaces send data from system A to system B through an interface in between (FIFO). It is very expensive and time consuming to implement communications. Hence it may not would not work effectively for a vendor.
Using an界面 /集成引擎placed in the midst of all the applications to aid in information exchange and monitoring. Hence the互操作性of entire system would remain effective. It is comparatively less time consuming and less expensive due to engine flexibility. Interface monitoring and adding new or replace existing application is considerably better.

Each provider should decide which option would be more productive and cost-effective for their organization. If the interfacing environment is limited and focused, then the point-to-point approach may work. If the interfacing requirements are growing internally to streamline workflow and externally to meetEMRrequirements, then the interface engine approach would be better.

HL7集成程序

与其实施HL7集成的最新阶段，不如分析您的卫生系统的需求并构建定制的接口解决方案，该解决方案将满足您的预算以及当前和将来的需求。由主题专家进行协调测试的强大界面团队可以在HL7实施中获得成功的结果。

Step 1: Plan the interface

HL7 interfaces are required to support data integration. Properly integrated HL7 interfaces can reduce duplicate data entry and enhance user workflow due to application互操作性.
Common HL7 interfaces used within health care organizations.

ADT - 入院，出院，转移
DFT – Detailed financial transaction
ORU – Observation results
ORM - 订单
MDM – Medical document management
MFN - 主文件通知
SIU - 调度
酒吧 - 计费帐户记录

下面提到的流程图显示了右接口的计划步骤。

In addition to this flow, the right staff members and consultants should be included for the project execution.

应审查右HL7接口及其各自的现场内容的识别，以避免数据不规则。特别是，应根据发送和接收数据来审查ADT工作流程。

Step 2: Build the Interface

Execution-

This is the project execution phase where many steps are involved. First, interface engineers should complete application side work efforts. They should define each port along with their respective content.

Interface build—

The specifications should be kept in mind before building the appropriate interface. Setting up the interface to handle the content and field locations for medical record numbers is included in this step.

测试 -

在进行验证步骤之前，应就接口构建阶段进行连接测试。进行连接测试是为了检查HL7数据交换是否在没有任何网络障碍的情况下成功地从源到目的地传递。

Step 3: Test and Validate

The testing phase is another important phase of the HL7 integration. A proper review of the design, utilization and content of these interfaces is the most important step for the successful completion. Unit and integrated testing involve the expertise of application subject matter experts. They are typically great at working with the technical items relevant to an interface.

Unit testing涉及验证特定的提要并查看数据以确保准确性。此步骤将在初始差距分析期间确定接口工程师错过的任何问题。
集成测试involves reviewing data as it flows through upstream and downstream systems via HL7 interface development. Whoever is familiar with the data should be involved in validation steps.

技术人员扮演什么角色？

In order to implement a cost effective HL7 Interface engine, the operations should be streamlined. For that, all departments and processes should work together for an effective communication with the help of tech person.
The workflow should be documented on how data passes internally within the departments and externally with outside providers and specialists.
The tech person analyzes how the components of the system work together and how to code inbound / outbound messages.
Such analysis will help in implementing the right integration engine, which will transform your data into user friendly content for better patient care management.
After creating the strategy, reviewing systems for integration, and identifying the right interface, your IT team will begin to create inter-operability through the customization of a new interface engine.
This technical step involves finding the right system for data storage, retrieval and analysis.
After determining the appropriate approach, data from your existing system should be integrated into your interface, without interrupting the current operation.
Finally, your IT team will perform the testing step before going live with the new interface engine.

结论

Healthcare communications such as HL7 need security measures added for both existing and new installations. At present, various security measures such as encryption and SSH tunneling are used to secure HL7 data exchange. Healthcare needs to do more for data protection and that updation should take place soon.

同样，HL7的每个更新版本都包含新功能和选项，使标准版本复杂化。随着新的HIPAA指南的出现，最佳接口引擎应允许与内部和外部应用程序进行多个连接，以方便数据交换。因此，HL7将继续成为医疗保健进化的主要组成部分。