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Interoperability training for clinicians - Coggle Diagram
Interoperability training for clinicians
Paradigm - moving the data from A to B
How can paradigm effect clinical safety
Can effect usability of the solution
Can effect the timelines of the data
Can effect how complete the data is for the intended task
How usable will the workflow be?
The clinical payload - semantic interoperability and maintaining meaning
Transformation between models
May well be necessary even when systems are using same messaging standard e.g. FHIR
Degradation of data can occur
Different coding systems
Different meta data
Different units when representing measurements
Locally coded data
Different meta data in local data models e.g. GP system referrals models
The more times data is transferred in between models the greater the possibility of degradation
Common semantics shared by different systems
openEHR
National Apps
The exponential factor of multiple systems and unique pathways between them
Representing the clinical data
Clinical Coding
Terminology
Read2
CTV3
Loinc
SNOMED
Term server
Classification
Messaging and storage standards
FHIR
HL7 v2
openEHR
HL7 v3
XDS
Different methods of achieving semantic inter
Shared data models
openEHR
National apps
Transforming between data models (lossy)
The more times data is transferred in between models the greater the possibility of degradation
Reasons for degradation of data
local codes
uncommon units
Similar but different qualifying data
Basic principles
The meaning of the data in the sending system MUST not be misrepresented in the receiving system -it MUST be semantically interoperable
The amount of data transferred must be appropriate for the safe operating of the receiving system. e.g. Lab reports may contain many comments that affect how results are interpreted. EG on warfarin
The sending system must only allow authorised access to it's records and must be passed an audit of who has accessed the data, from what organisation and for what purpose.
The attribution of any data transferred into the system MUST be clear and who recorded the data, who for, the context and time date should be available
The quality of the data MUST be maintained wherever possible. It should be possible to quantify any loss of data quality
Clinical safety is the most important driver for any implementation
The clinical safety process for assuring interoperability implementations (DCB0129 and DCB0160)
Output documents from the process
Clinical safety case
Clinical hazard log
Stages of assurance
Gathering professional requirements
Validation of requirements
Writing the specification
Clinical assurance of the specification
Clinical Hazard workshop
Clinical assurance of the solution in a test environment
Clinical monitoring of FOT process
Answering clinical queries during the building of the software
Clinical signify for use in live
Agreement of clinical safety aspects of the service of the software
The relevant standards
DCB0129 - standard for manufacturers
DCB0160 - standard for commissioners