Investigation Interoperability Problems in Pharmacy Automation: A Case Study in Saudi Arabia

The aim of this case study is to investigate the nature of interoperability problems in hospital systems automation. One of the advanced healthcare providers in Saudi Arabia is the host of the study. The interaction between the pharmacy system and automated medication dispensing cabinets is the focus of the case system. The research method is a detailed case study where multiple data collection methods are used. The modelling of the processes of inpatient pharmacy systems is presented using Business Process Model Notation. The data collected is analysed to study the different interoperability problems. This paper presents a framework that classifies health informatics interoperability implementation problems into technical, semantic, organisational levels. The detailed study of the interoperability problems in this case illustrates the challenges to the adoption of health information system automation which could help other healthcare organisations in their system automation projects

Developing a conformance methodology for clinically-defined medical record headings:a preliminary report.

Background: The Professional Records Standards Body for health and social care (PRSB) was formed in 2013 to develop and assure professional standards for the content and structure of patient records across all care disciplines in the UK. Although the PRSB work is aimed at Electronic Health Record (EHR) adoption and interoperability to support continuity of care, the current technical guidance is limited and ambiguous. Objectives: This project was initiated as a proof-ofconcept to demonstrate whether, and if so, how, conformance methods can be developed based on the professional standards. Methods: An expert group was convened, comprising clinical and technical representatives. A constrained data set was defined for an outpatient letter, using the subset of outpatient headings that are also present in the ep-SOS patient summary. A mind map was produced for the main sections and sub-sections. An openEHR archetype model was produced as the basis for creating HL7 and IHE implementation artefacts. Results: Several issues about data definition and representation were identified when attempting to map the outpatient headings to the epSOS patient summary, partly due to the difference between process and static viewpoints. Mind maps have been a simple and helpful way to visualize the logical information model and expose and resolve disagreements about which headings are purely for human navigation and which, if any, have intrinsic meaning. Conclusions: Conformance testing is feasible but nontrivial. In contrast to traditional standards-development timescales, PRSB needs an agile standards development process with EHR vendor and integrator collaboration to ensure implementability and widespread adoption. This will require significant clinical and technical resources

Electronic Medical Record Adoption in New Zealand Primary Care Physician Offices

Describes EMR adoption in New Zealand's primary healthcare system, including how government investment was secured and data protection laws, unique patient identifiers, and standards and certification were established, with lessons for the United States

Adding HL7 version 3 data types to PostgreSQL

The HL7 standard is widely used to exchange medical information electronically. As a part of the standard, HL7 defines scalar communication data types like physical quantity, point in time and concept descriptor but also complex types such as interval types, collection types and probabilistic types. Typical HL7 applications will store their communications in a database, resulting in a translation from HL7 concepts and types into database types. Since the data types were not designed to be implemented in a relational database server, this transition is cumbersome and fraught with programmer error. The purpose of this paper is two fold. First we analyze the HL7 version 3 data type definitions and define a number of conditions that must be met, for the data type to be suitable for implementation in a relational database. As a result of this analysis we describe a number of possible improvements in the HL7 specification. Second we describe an implementation in the PostgreSQL database server and show that the database server can effectively execute scientific calculations with units of measure, supports a large number of operations on time points and intervals, and can perform operations that are akin to a medical terminology server. Experiments on synthetic data show that the user defined types perform better than an implementation that uses only standard data types from the database server.Comment: 12 pages, 9 figures, 6 table