Using Rhapsody
2007 APHL Annual Meeting Dari Shirazi University of Iowa Hygienic Laboratory
Why we got involved
Data exchange with hospitals, public health departments
Issues with Local code, LOINC, SNOMED (vocabulary) Different HL7 structures (grammar)
Using PHINMS for message delivery Learn a lot & contribute
Why use an Interface Engine
Historical data exchange
Various formats: Comma delimited, Excel, MS Access, XML Delivery options: Floppy, FTP, Web
Complexity of HL7
Different versions: 2.2, 2.3, 2.4, 2.5, 3.0 We can use it for order, result, payment Validation
HL7 Example
MSH|^~\&|PHIMS|University of Iowa Hygienic Laboratory\S\102 Oakdale Campus H101\S\Iowa City\S\IA\S\52242-5002\S\800/421-4692^16D0648109^CLIA||MOON HOSPITAL^999^L|200705012358||ORU^R01|P123456T1234567890|T|2.4 PID|1||a12345/123123^^^^PI||DOE^JOHN||19230601|M||2106-3^WHITE^HL70005|10 STREET WAY^^BIGTOWN^IA^99999-||319/123-4567|||||||||U^UNKNOWN^HL70189 ORC|RE|a12345/123123|2006987654|||||||||^DOOLITTLE|||||||||MOON HOSPITAL - MOON HOSPITAL|123 ASH ST^^IOWA CITY^IA^52240OBR|1||2006987654|20729-0^B abortus Ab Titr Ser Plate^LN|||20061001|||||||200610030755|&Acute Serum&L|||||||200705011107|||F OBX|1|TX|SERO-RSLT1^Result 1^L||<1:20|||N|||F|||200705011107 NTE|1|GR|Patient's birth date omitted on the test request form which may result in delayed results or specimen rejection. A phone call was made to obtain this information. NTE|2|GI|<1:20 = Negative. 1:20-1:80 = Antibody detected, indicates prior exposure to Brucella. A single sample titer of =>1:160 is diagnostic. Suggest repeat testing in 14-21 days. A fourfold rise/change in titer in paired sera is diagnostic. For research use only, not approved by FDA for in-vitro diagnostic testing. OBR|2||2006987654|33684-2^F tular Ab Titr Ser Tube^LN|||20061001|||||||200610030755|&Acute Serum&L|||||||200705011107|||F OBX|1|TX|SERO-RSLT1^Result 1^L||<1:20|||N|||F|||200705011107 NTE|1|GI|<1:20 = Negative. 1:20-1:40 = Indicates prior exposure to tularemia. Suggest repeat testing in 14-21 days.
What can Rhapsody do
Route messages Map data
HL7 2.3.1 LIMS HL7 2.5 X12 Hospital A
Other State Public Health Laboratories
CDC
EPA
Routing
Look at the message Use database or built-in rules Use different communication point such as HTTP, FTP, IE to IE (VPN), PHINMS Filter messages based on partners need such as encryption Validate delivery or receipt of messages
Routing
One of our message based routes
Routing
CDC PHINMS route
Mapping
Map from one format to another
Map from XML to HL7 Map from HL7 2.3.1 to HL7 2.5
Map directly from database
To HL7 Some people use it to write reports in PDF
Validate mapped data
Mapping
Example of XML to HL7
Cost/Resources used by Iowa
1 FTE working on HL7 1/3 Analyst working on LOINC, SNOMED, local codes, and working with SMEs Programmer working on our LIMS to accommodate Orders/Results I spend (a lot of ) time on design and implementation SMEs for the PHLIP meetings, design, and vocabulary
Cost/Resources used (cont)
110K for Rhapsody for 50 communication points 15K yearly maintenance 15-25K for each partner to implement your interface 1-2 year startup time
Additional info
Open Healthcare Framework
[Link]
Mirth project Orion Health
[Link] [Link]
Contact information
Dari Shirazi University of Iowa Hygienic Laboratory 102 Oakdale Campus, H101 OH Iowa City, Iowa 52242-5002 319-335-4500 dshirazi@[Link]
