CUMC Health Care Systems

1
CUMC Health Care Systems
Web Browser Javascript
SunOne Web Server
IBM Mainframe CICS TPS DB2 database
CGI Programs (C)
2
HTTPS
SunOne Directory Server (LDAP)
Sockets Proprietary
MED Replica (Shmed)
1
2
2
CUMC Health Care Systems
Web Browser Javascript
SunOne Web Server
IBM Mainframe CICS TPS DB2 database
CGI Programs (C)
HTTPS
EKG Tracing Image Database
Sockets Proprietary
Reports
Images
Interface Engine
GE EKG System (MUSE)
3
CUMC Health Care Systems
Web Browser Javascript
SunOne Web Server
IBM Mainframe CICS TPS DB2 database
CGI Programs (C)
HTTPS
Sockets Proprietary
HL7
Interface Engine
Vigilence Alerting System (Monitoring)
HL7
4
CUMC Health Care Systems
Web Browser Javascript
SunOne Web Server
IBM Mainframe CICS TPS DB2 database
CGI Programs (C)
HTTPS
MED Replica (Shmed)
Sockets Proprietary
SFTP
Interface Engine
Jim Ciminos PC MED
MED Distribution Server
5
CUMC Health Care Systems
SunOne Web Server
IBM Mainframe CICS TPS DB2 database
CGI Programs (C)
Web Browser Javascript
SunOne Directory Server (LDAP)
HTTPS
Sockets Proprietary
Lab, Rad, Many others
Citrix Client
Orders
Citrix ICA
Interface Engine
Eclipsys XA Order Entry (.com/.net)
Citrix Server
Lab, Rad, Pharmacy Results
6
Health Care Systems
IBM Mainframe CICS TPS DB2 database
Eclipsys SCC NYH campus
Interface Engine
DB2 Replication
Unix Warehouse Sybase database Research queries
Business Intelligence Systems
TIBCO
7
Electronic Master Patient Index
Eagle Registration System (NYWC)
Eagle Registration System (CUMC)
Interface Engine
ADT
ADT
EMPI Database
ADT
IDX Registration System (Cornell)
Registration System NYMH
Registration System NYQ
Query
Registration Workstation
Etc..
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Data
ProductionDatabases
Replicate
Enterprise Repository/ Data Warehouse
Query
Distribute
WorkgroupDatamarts
Query
Replicate
Query
PersonalMobileDatamarts
9
Patient Data
ADT
Handling
Warehouse
Translation
Lab
Routing
Monitoring
Rad
Access
Workstation
ICU
Repository
DAMs
Pharm
MLMs, Rules
Destinations
MED, Tables
Billing
HL7, formats
10
Patient Data
ADT
Handling
Warehouse
Translation
Lab
Routing
Monitoring
Rad
Access
Workstation
ICU
Repository
DAMs
InterfaceEngine
Pharm
MLMs, Rules
Destinations
MED, Tables
Billing
HL7, formats
11
Application Layer HL7 Message

• Standards define
• Message triggering events
• Events that initiate exchanges between systems
• Message structures
• Define a limited form of message semantics using
  a restricted terminology of explicit data types
• Encoding rules
• Define message syntax or grammar

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Application Layer HL7 Message

• Message types
• ACK (General Acknowledgement Originator)
• ADT (Admission/Discharge/
• Transfer)
• ORM (Order Message Originator)
• ORO (Order Response Originator)
• OBX (Order Result Originator)

HL7 Message
Segment
Segment
Segment
Field
Field
Composite
Field
Composite
Field
Composite
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HL7 Message

• MSH\MENDONCUPLABCICSU920000209025800ORU
  0000000001
• P2.1
• PID3131313SANDIEGOCARMENF
• OBRM09000HABC0000159058TROPONINIL32506
• 2000020902580020000209025800NOR
• HEFR
• OBX1NM59058TROPONIN IMED00.1ng/ml0-0.4
  

Field
Segment
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The Medical Entities Dictionary
Medical Entity
Plasma Glucose Test