Health Informatics Service Architecture

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The European Committee for Standardization (CEN) Standard Architecture for Healthcare Information Systems (ENV 12967), Health Informatics Service Architecture or HISA is a standard that provides guidance on the development of modular open information technology (IT) systems in the healthcare sector. Broadly, architecture standards outline frameworks which can be used in the development of consistent, coherent applications, databases and workstations. This is done through the definition of hardware and software construction requirements and outlining of protocols for communications. [1] The HISA standard provides a formal standard for a service-oriented architecture (SOA), specific for the requirements of health services, based on the principles of Open Distributed Processing. [2] The HISA standard evolved from previous work on healthcare information systems architecture commenced by Reseau d’Information et de Communication Hospitalier Europeen (RICHE) in 1989, and subsequently built upon by a number of organizations across Europe. [3]

European Committee for Standardization standards organization

The European Committee for Standardization is a public standards organization whose mission is to foster the economy of the European Union (EU) in global trading, the welfare of European citizens and the environment by providing an efficient infrastructure to interested parties for the development, maintenance and distribution of coherent sets of standards and specifications.

Information technology (IT) is the use of computers to store, retrieve, transmit, and manipulate data, or information, often in the context of a business or other enterprise. IT is considered to be a subset of information and communications technology (ICT). An information technology system is generally an information system, a communications system or, more specifically speaking, a computer system – including all hardware, software and peripheral equipment – operated by a limited group of users.

Service-oriented architecture (SOA) is a style of software design where services are provided to the other components by application components, through a communication protocol over a network. The basic principles of service-oriented architecture are independent of vendors, products and technologies. A service is a discrete unit of functionality that can be accessed remotely and acted upon and updated independently, such as retrieving a credit card statement online.

Contents

Development of Health Informatics Service Architecture EN/ISO 12967

The HISA standard was developed by CEN Technical Committee (TC) 251, the technical committee for Health Informatics within the federation of European national standards bodies (CEN). [4] The CEN/TC 251 was made up of four working groups, covering: information models; systems of concepts and terminology; security; and technologies for interoperable communication. [5] Working Group I were responsible for information models and completed the specifications that became the HISA standard. Working Group I worked with experts from across Europe, plus contributors from Australia and the United States in the development and finalization of ENV 12967.

The CEN HISA standard was adopted by the International Organization for Standardization (ISO) in 2009, with the stated aim of ISO 12967 being to provide guidance on:

International Organization for Standardization An international standard-setting body composed of representatives from national standards organizations

The International Organization for Standardization is an international standard-setting body composed of representatives from various national standards organizations.

Middleware computer software that provides services to software applications

Middleware is computer software that provides services to software applications beyond those available from the operating system. It can be described as "software glue".

The Standard

EN/ISO 12967 is broken down into three parts: Enterprise Viewpoint; Information Viewpoint; and Computational Viewpoint, all of which deal with different aspects of ensuring service architecture supports openness and vendor-independence. [7]

Part One: Enterprise Viewpoint

The Enterprise Viewpoint component of EN/ISO 12967 provides health services with guidance in describing, planning and developing new IT systems, utilizing an open distributed processing approach. In addition to this it provides direction for the integration of existing information systems, within the one enterprise and across different healthcare organizations. Part one of the standard sets forth the common enterprise-level requirements (e.g. workflows, authorizations) that must be supported through the HISA, which integrates the common data and business logic into a specific architectural layer (i.e. the middleware), accessible throughout the whole information system of the health service. [8]

Part Two: Information Viewpoint

The Information Viewpoint component of EN/ISO 12967 sets forth the fundamental characteristics of the information model to be implemented by the middleware to provide comprehensive, integrated storage of the common enterprise data and to support the fundamental business processes of the healthcare organisation, as defined in ISO 12967 Part One. The specifications were designed to be universally relevant, whilst being sufficiently specific to allow implementers to derive an efficient design of the system for their organisation. This specification does not aim to provide a fixed, complete specification of all possible data that may be necessary for any given health service. It specifies only a set of characteristics, in terms of overall organisation and individual information objects, identified as fundamental and common to all healthcare organizations. [9]

Part Three: Computational Viewpoint

The Computational Viewpoint component of EN/ISO 12967 provides details on the fundamental characteristics of the computational model to be implemented by the middleware, to provide a comprehensive and integrated interface to the common, fundamental business processes of the health service. The computational model, like the information model is designed to be universally relevant, whilst still being sufficiently specific to allow implementers to derive an efficient design of the system for their organisation, irrespective of the specifics of the pre-existing information technology environment in which it will be implemented. [10]

Use of common services

The implementation of a modular, open architecture in healthcare IT systems (as specified by the HISA) relies upon disparate heterogeneous applications interacting and communicating through a middleware layer, made up of common services. In the case of the HISA, these common services are divided into Healthcare-related Common Services and Generic Common Services. [11]

Healthcare-related Common Services (HCS)

Healthcare-related Common Services are those middleware components responsible for supporting the functionalities and information relevant to the healthcare business domain, including subject of care, activities, resources, authorization, health characteristics and concepts. [12]

Generic Common Services (GCS)

Generic Common Services are those middleware components are those middleware components responsible for supporting the generic functionality and information requirements that are non-specific to the healthcare domain, and may be broadly relevant to any information system in the business domain. [13]

See also

Related Research Articles

Health informatics discipline at the intersection of information science, computer science, and health care

Health informatics is information engineering applied to the field of health care, essentially the management and use of patient healthcare information. It is a multidisciplinary field that uses health information technology (HIT) to improve health care via any combination of higher quality, higher efficiency, and new opportunities. The disciplines involved include information science, computer science, social science, behavioral science, management science, and others. The NLM defines health informatics as "the interdisciplinary study of the design, development, adoption and application of IT-based innovations in healthcare services delivery, management and planning". It deals with the resources, devices, and methods required to optimize the acquisition, storage, retrieval, and use of information in health and bio-medicine. Health informatics tools include computers, clinical guidelines, formal medical terminologies, and information and communication systems, among others. It is applied to the areas of nursing, clinical medicine, dentistry, pharmacy, public health, occupational therapy, physical therapy, biomedical research, and alternative medicine, all of which are designed to improve the overall of effectiveness of patient care delivery by ensuring that the data generated is of a high quality.


Health Level-7 or HL7 refers to a set of international standards for transfer of clinical and administrative data between software applications used by various healthcare providers. These standards focus on the application layer, which is "layer 7" in the OSI model. The HL7 standards are produced by the Health Level Seven International, an international standards organization, and are adopted by other standards issuing bodies such as American National Standards Institute and International Organization for Standardization.

Message-oriented middleware (MOM) is software or hardware infrastructure supporting sending and receiving messages between distributed systems. MOM allows application modules to be distributed over heterogeneous platforms and reduces the complexity of developing applications that span multiple operating systems and network protocols. The middleware creates a distributed communications layer that insulates the application developer from the details of the various operating systems and network interfaces. APIs that extend across diverse platforms and networks are typically provided by MOM.

Electronic health record a program used to document a patients medical history on a computer

An electronic health record (EHR), or electronic medical record (EMR), is the systematized collection of patient and population electronically-stored health information in a digital format. These records can be shared across different health care settings. Records are shared through network-connected, enterprise-wide information systems or other information networks and exchanges. EHRs may include a range of data, including demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information.

openEHR is an open standard specification in health informatics that describes the management and storage, retrieval and exchange of health data in electronic health records (EHRs). In openEHR, all health data for a person is stored in a "one lifetime", vendor-independent, person-centred EHR. The openEHR specifications include an EHR Extract specification but are otherwise not primarily concerned with the exchange of data between EHR-systems as this is the focus of other standards such as EN 13606 and HL7.

The Clinical Data Interchange Standards Consortium (CDISC) is an open, multidisciplinary, neutral, 501(c)(3) non-profit standards developing organization (SDO) that has been working through productive, consensus-based collaborative teams, since its formation in 1997, to develop global standards and innovations to streamline medical research data and ensure a link with healthcare. The CDISC mission is "to develop and support global, platform-independent data standards that enable information system interoperability to improve medical research and related areas of healthcare". The CDISC vision is "informing patient care and safety through higher quality medical research". The CDISC suite of standards supports medical research of any type from protocol through analysis and reporting of results. They have been shown to decrease resources needed by 60% overall and 70–90% in the start-up stages when they are implemented at the beginning of the research process.

The HL7 Clinical Document Architecture (CDA) is an XML-based markup standard intended to specify the encoding, structure and semantics of clinical documents for exchange. In November 2000, HL7 published Release 1.0. The organization published Release 2.0 with its "2005 Normative Edition."

RM-ODP

Reference Model of Open Distributed Processing (RM-ODP) is a reference model in computer science, which provides a co-ordinating framework for the standardization of open distributed processing (ODP). It supports distribution, interworking, platform and technology independence, and portability, together with an enterprise architecture framework for the specification of ODP systems.

European Institute for Health Records

The European Institute for Health Records or EuroRec Institute is a non-profit organization founded in 2002 as part of the ProRec initiative. On 13 May 2003, the institute was established as a non-profit organization under French law. Current President of EuroRec is Prof. Dipak Kalra. The institute is involved in the promotion of high quality Electronic Health Record systems in the European Union. One of the main missions of the institute is to support, as the European authorised certification body, EHRs certification development, testing and assessment by defining functional and other criteria.

The Health informatics - Electronic Health Record Communication was the European Standard for an information architecture to communicate Electronic Health Records (EHR) of a patient. The standard was later adopted as ISO 13606 and later replaced with ISO 13606-2 and recently ISO 13606-5:2010.

CEN/TC 251 is a technical decision making body within the European Committee for Standardization (CEN) working on standardization in the field of Health Information and Communications Technology (ICT) in the European Union. The goal is to achieve compatibility and interoperability between independent systems and to enable modularity in Electronic Health Record systems.

The ISO/TC 215 is the International Organization for Standardization's (ISO) Technical Committee (TC) on health informatics. TC 215 works on the standardization of Health Information and Communications Technology (ICT), to allow for compatibility and interoperability between independent systems.

CEN ISO/IEEE 11073 Health informatics - Medical / health device communication standards enable communication between medical, health care and wellness devices and with external computer systems. They provide automatic and detailed electronic data capture of client-related and vital signs information, and of device operational data.

The Healthcare Services Specification Project (HSSP) is a standards development effort to create health industry service-oriented architecture (SOA) standards supportive of the health care market sector. HSSP is a jointly sponsored activity operating within the Health Level Seven (HL7) and the Object Management Group (OMG) standards group. Formally beginning as a collaboration between the HL7 Service-oriented Architecture Special Interest Group and the OMG Healthcare Domain Task Force, HSSP is developing healthcare middleware standards addressing interoperability challenges.

Health informatics in China is about the Health informatics or Medical informatics or Healthcare information system/technology in China.

View model

A view model or viewpoints framework in systems engineering, software engineering, and enterprise engineering is a framework which defines a coherent set of views to be used in the construction of a system architecture, software architecture, or enterprise architecture. A view is a representation of a whole system from the perspective of a related set of concerns.

The system of concepts to support continuity of care, often referred to as ContSys, is an (ISO and CEN standard . Continuity of care is an organisational principle that represents an important aspect of quality and safety in health care. Semantic interoperability is a basic requirement for continuity of care. Concepts that are needed for these purposes must represent both the content and context of the health care services.

Medical device connectivity is the establishment and maintenance of a connection through which data is transferred between a medical device, such as a patient monitor, and an information system. The term is used interchangeably with biomedical device connectivity or biomedical device integration. By eliminating the need for manual data entry, potential benefits include faster and more frequent data updates, diminished human error, and improved workflow efficiency.

Health Level Seven International (HL7), is a non-profit organization involved in the development of international healthcare informatics interoperability standards known as Health Level 7 (HL7).

Dipak Kalra

Professor Dipak Kalra is President of the European Institute for Health Records and of the European Institute for Innovation through Health Data. He undertakes international research and standards development, and advises on adoption strategies, relating to Electronic Health Records.

References

  1. ↑ Engel, Kjeld. Blobel, Bernd. Pharow, Peter. (2006) Standards for Enabling Health Informatics Interoperability, Ubiquity: Technologies for Better Health in Aging Societies IOS Press
  2. ↑ Klein, Gunnar. Sottile, Pier Angelo. Endsleff, Frederik. (2007) Another HISA - The new standard: Health Informatics - Service Architecture,Studies in Health Technology and Informatics,129(Pt 1):478-82
  3. ↑ Kalra,Dipak. (2002) Clinical Foundations and Information Architecture for the Implementation of a Federated Health Record Service, University College, London
  4. ↑ Klein, Gunnar. Sottile, Pier Angelo. Endsleff, Frederik. (2007) Another HISA - The new standard: Health Informatics - Service Architecture,Studies in Health Technology and Informatics,129(Pt 1):478-82
  5. ↑ Kalra,Dipak. (2002) Clinical Foundations and Information Architecture for the Implementation of a Federated Health Record Service, University College, London
  6. ↑ "ISO 12967 - Health Informatics Service Architecture". ISO. Retrieved 14 April 2013.
  7. ↑ Klein, Gunnar. Sottile, Pier Angelo. Endsleff, Frederik. (2007) Another HISA - The new standard: Health Informatics - Service Architecture,Studies in Health Technology and Informatics,129(Pt 1):478-82
  8. ↑ European Committee for Standardization: http://www.cen.eu/cen/Pages/default.aspx
  9. ↑ European Committee for Standardization: http://www.cen.eu/cen/Pages/default.aspx
  10. ↑ European Committee for Standardization: http://www.cen.eu/cen/Pages/default.aspx
  11. ↑ Kalra,Dipak. (2002) Clinical Foundations and Information Architecture for the Implementation of a Federated Health Record Service, University College, London
  12. ↑ Kalra,Dipak. (2002) Clinical Foundations and Information Architecture for the Implementation of a Federated Health Record Service, University College, London
  13. ↑ Kalra,Dipak. (2002) Clinical Foundations and Information Architecture for the Implementation of a Federated Health Record Service, University College, London
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