Subscribe to RSS
DOI: 10.1055/s-0042-1749331
Standard Document Development for Health Information Exchange in Korea
Funding This work was supported by the Industrial Strategic Technology Development Program (grant number 20017341) funded by the Ministry of Trade, Industry & Energy (MOTIE) and by the Korea Health Technology R&D Project (grant number HI19C1026) through the Korea Health Industry Development Institute (KHIDI) funded by the Ministry of Health & Welfare, Republic of Korea.Abstract
Background Health information exchange (HIE) allows healthcare providers to access a patient's medical information to improve patient care continuity. The standardized data realize the HIE values. Since the Health Level 7 Clinical Document Architecture (CDA) is flexible, implementation guides (IG) are needed for use cases. Although many CDA IGs have been developed, they did not describe how these CDA IGs were developed. A national CDA IG that meets the local requirements is demanded since the data differs according to the digital divide and social–cultural background of the country that wants to establish HIE. Due to their localized contents, other countries cannot directly adopt the published CDA IGs.
Objectives We developed the national CDA IG, namely, Korean (K)-CDA IG that meets the local requirement, including reusable structured templates, value sets, and object identifiers (OIDs). We present a detailed description of the development process and the technical methods of the national CDA IG in the Korean context.
Methods The K-CDA IG was developed in the following stages: analysis, development, and evaluation. First, we investigated the health information environment and electronic health record (EHR) systems and conducted a gap analysis with published CDA IGs. Second, a templated CDA approach was taken for designing modular. Lastly, we consulted a technical advisory group for comments on the validity of the K-CDA IG.
Results A total of 35 CDA templates were developed. We improved 28 value sets of which 13 were Korea specific and 15 were based on the ones used in other IGs, and made a set of rules to establish the OID structure.
Conclusion We presented the development process and the technical specifications of K-CDA IG. We explored how the results can be used as interoperability criteria in the national EHR systems certification program. Finally, we provided recommendations that could guide other entities planning their HIE programs.
Keywords
healthcare information exchange - health level-7 clinical document architecture - value set - object identifier - implementation guide - fast healthcare interoperability resourceProtection of Human and Animal Subjects
This paper described the development process and lessons learned from national implementation guides for healthcare information exchange; therefore, informed consent was not required.
Publication History
Received: 17 January 2022
Accepted: 08 April 2022
Article published online:
22 June 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Kaelber DC, Bates DW. Health information exchange and patient safety. J Biomed Inform 2007; 40 (6, suppl) S40-S45
- 2 Pine KH. The qualculative dimension of healthcare data interoperability. Health Informatics J 2019; 25 (03) 536-548
- 3 Yaraghi N, Du AY, Sharman R, Gopal RD, Ramesh R. Health Information exchange as a multisided platform: adoption, usage, and practice involvement in service co-production. Inf Syst Res 2015; 26 (01) 1-18
- 4 Spronk R. HL7 version 3: Message or CDA Document?. Accessed May 2, 2022 at: http://ringholm.com/docs/04200_en.htm
- 5 Dolin RH, Alschuler L, Boyer S. et al. HL7 clinical document architecture, release 2. J Am Med Inform Assoc 2006; 13 (01) 30-39
- 6 Dolin RH, Garber L, Solutions I. HL7 implementation guide for cda release 2: consolidated CDA Release 2.2. Accessed May 2, 2022 at: https://build.fhir.org/ig/HL7/cda-ccda-2.2/
- 7 Kay S, Cangioli G, Nusbaum M. The international patient summary standard and the extensibility requirement. Stud Health Technol Inform 2020; 273: 54-62
- 8 Heitmann KU, Cangioli G, Melgara M, Chronaki C. Interoperability assets for patient summary components: a gap analysis. Stud Health Technol Inform 2018; 247: 700-704
- 9 Kusiak L. Europese patient summary is urgent. Zorgvisie ICT. 2019; 20 (01) 28-30
- 10 Nalin M, Baroni I, Faiella G. et al. The European cross-border health data exchange roadmap: case study in the Italian setting. J Biomed Inform 2019; 94: 103183
- 11 International IHE. Technical frameworks. Accessed December 12, 2021 at: https://www.ihe.net/resources/technical_frameworks/
- 12 Pearce C, Bainbridge M. A personally controlled electronic health record for Australia. J Am Med Inform Assoc 2014; 21 (04) 707-713
- 13 HealthIt.gov. 2015 Edition Test Method. Accessed December 12, 2021 at: https://www.healthit.gov/topic/certification-ehrs/2015-edition-test-method#:~:text=The%20Test%20Method%20provides%20the,EHR)%20Definition%2C%20and%20ONC%20Health
- 14 D'Amore JD, Mandel JC, Kreda DA. et al. Are meaningful use stage 2 certified EHRs ready for interoperability? Findings from the SMART C-CDA collaborative. J Am Med Inform Assoc 2014; 21 (06) 1060-1068
- 15 Jung S, Kim S, Yoo S, Choi J. Toward the automatic generation of the entry level CDA documents. Journal of Korean Society of Medical Informatics. 2009; 15 (01) 141-151
- 16 Han SH, Lee MH, Kim SG. et al. Implementation of medical information exchange system based on EHR standard. Healthc Inform Res 2010; 16 (04) 281-289
- 17 Lee SH, Song JH, Kim IK, Kim JW. Clinical document architecture integration system to support patient referral and reply letters. Health Informatics J 2016; 22 (02) 160-170
- 18 Ministry of Health and Welfare. My Chart. Accessed December 12, 2021 at: https://mychart.kr/portal/main/main.do
- 19 Ribeiro LS, Viana-Ferreira C, Oliveira JL, Costa C. XDS-I outsourcing proxy: ensuring confidentiality while preserving interoperability. IEEE J Biomed Health Inform 2014; 18 (04) 1404-1412
- 20 Lee M, Heo E, Lim H. et al. Developing a common health information exchange platform to implement a nationwide health information network in South Korea. Healthc Inform Res 2015; 21 (01) 21-29
- 21 Lantana Consulting Group. CDA Validator. Accessed December 12, 2021 at: https://validator-legacy.lantanagroup.com/validator/
- 22 Trifolia Workbench. Trifolia. Accessed December 12, 2021 at: https://trifolia.lantanagroup.com/TemplateManagement/List
- 23 Healthcare Information Standard. What is the SNOMED CT NRC(National Release Center)?. Accessed March 28, 2022 at: https://hins.or.kr/menu.es?mid=a30104000000
- 24 Korean Standard Statistical Classification. Classification of disease. Accessed December 12, 2021 at: https://kssc.kostat.go.kr:8443/ksscNew_web/ekssc/main/main.do#
- 25 Health Insurance Review & Assessment Service. Korea Pharmaceutical Information Service. Accessed December 12, 2021 at: https://biz.kpis.or.kr/kpis_biz/index.jsp
- 26 Repository OID. Accessed December 12, 2021 at: http://www.oid-info.com/index.htm
- 27 HL7.org. HL7 FHIR Release 4. Accessed December 12, 2021 at: http://hl7.org/fhir/
- 28 Rinner C, Duftschmid G. Bridging the gap between HL7 CDA and HL7 FHIR: a JSON based mapping. Stud Health Technol Inform 2016; 223: 100-106
- 29 C–CDA on FHIR implementation Guide. Accessed March 30, 2022 at: http://www.hl7.org/fhir/us/ccda/
- 30 U.S. Centers for Medicare & Medicaid Services. Search NPI records. Accessed December 12, 2021 at: https://npiregistry.cms.hhs.gov
- 31 Ministry of Health and Welfare. Complaints of license. Accessed December 12, 2021 at: https://lic.mohw.go.kr