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Perspective naționale și internaționale ale informaticii și standardelor medicale 
Dr. ing. Andrei VASILATEANU 
Universitatea POLITEHNICA Bucuresti
Cuprins 
•Introducere, HL7 Romania 
•Noi paradigme in asigurarea sanatatii 
•Evolutia sistemelor informatice in sanatate 
•Standardul HL7, RIM 
•Metodologie 
•Modelul domeniului LUMIR 
•Catre ecosisteme digitale de sanatate
HL7 Romania 
•Afiliata HL7 International 
•Include furnizori şi beneficiari de servicii medicale, dezvoltatori de aplicaţii informatice, experţi tehnici. 
•Nume consacrate din industria IT medical din Romania 
•Dosarul Electronic al Pacientului dezvoltat de UTI bazat pe HL7 
•Oferirea de cursuri HL7 in colaborare cu HL7 International si organizarea de examene de certificare 
•Cursul HL7 Fundamental este un curs complet online, supervizat de tutori din SUA 
•Presedinte: prof. Florica MOLDOVEANU 
•Presedinte onorific: dr. Nicolae GOGA n.goga@rug.nl
Noi paradigme in asigurarea sanatatii 
•"pay for performance“ - cost control 
•"personalized medicine“ , "evidence-based medicine“ - quality of services 
•"patient-centered care”- “The right care in the right way at the right time” 
•"patient empowerment" Nothing about me without me” 
•ICT joaca un rol fundamental in schimbarea paradigmei prin sustinerea procesului de inovare al proceselor business in sanatate, sustinerea re-inginerizarii domeniului sanatatii
Trenduri in e-health 
•E-health “an emerging field in the intersection of medical informatics, public health and business” 
•Dosarul longitudinal al pacientului 
•Interoperabilitate semantica si organizationala 
–Interconnecting health 
•Sisteme de sanatate interconectate national si regional 
•Aplicatii dependente de context
Patient 
summaries 
Clinical Pathways 
* 
Workflow 
Engine 
Care Plan 
Drug and lab test prescriptions 
Medical image and report 
Lab test results 
Discharge Summary 
Emergency Summary 
Vital Sign Progress Report 
Sickness Prevalence 
Demographics 
Trends in 
Episodes of Care 
Patient 
Notification 
/Alarm 
Clinical Event 
Notification 
Clinical Event 
Notification 
Clinical 
documents 
Contacts 
Home Recovery 
Hospitalization 
Emergency 
Observations 
Therapy 
Medication 
GP Encounter 
CAT analysis 
Knowledge Base 
• Ontology 
• Clinical guidelines 
• Process Templates 
• Service & Metadata Registry 
• Clinical Document 
Repository 
Proc 
ess 
Inst 
anc 
e 
Security & Privacy 
Repositories 
• Care consumers 
• Care providers 
• Care organizations 
• Role profiles 
Clinical Event 
Notification 
Clinical Event 
Notification 
Past medical 
history 
Current 
health status 
Ongoing 
treatments 
Clinical Trial 
Evaluation Report 
Health 
conditions 
L.D.Serbanati, F.Ricci, G.Mercurio, A.Vasilateanu, Steps towards a digital health ecosystem, J Biomed Inform, Elsevier, 2011
Standarde informatica medicala 
•Interoperabilitate sintactica si semantica 
•Metodologie de analiza si proiectare a domeniului de interes
Standarde si specificatii HL7 
•Health Level 7, nivelul aplicatiilor din OSI 
•Specificatii mesaje versiunea 2.x si 3.x 
•Reprezentarea cunostiintelor si suportul deciziei (Sintaxa Arden) 
•Standardizarea documentelor clinice (CDA) 
•Vocabulare clinice 
•Standarde, metodologii si servicii legate de dosare electronice de sanatate
HL7 vers 3 Reference Information Model
Metodologia HL7 V3 
•Definirea aplicatiilor si problemelor din interfatare 
•Definirea informatiei care trebuie comunicata intre aplicatii : definitie, format, relatii 
•Evenimente care initiaza comunicarea 
•Structurarea si distribuirea pe pachete a informatiei
Example 
Restrict 
Restrict 
Restrict 
RIM 
D-MIM 
R-MIM 
HMD 
Message 
Type 
Storyboard 
Storyboard 
Example 
Application 
Role 
Trigger 
Event 
Interaction 
Instantiate 
Sender Receiver 
Triggers 
Content 
References 
Use Case Modeling 
Information Modeling 
Interaction Modeling 
Message Design
Analiza domeniului LUMIR
Ecosistemul digital al sanatatii 
EHR 
Infrastructure 
Digital Healthcare Ecosystem 
Patient 
GP Office 
e 
E 
Shared Resources 
Medical 
Ontology 
Clinical 
Guidelines 
Research Laboratory 
PHR 
GP’s EMR 
Mandate-based 
Organization 
An ad-hoc 
Organization 
Regional Health 
Organization 
Organization 
Business’s Rules 
GP's Virtual 
Avatar 
Virtual Team Care 
Organization 
Organizational Structure 
Healthcare Ecosystem 
Government 
Organizational 
Mediator 
Measurement 
device 
POS 
Organization’s 
Roles 
e 
E 
e-CRFs 
e 
E 
Reports 
Gov. Agency's 
Virtual Entity 
VHR's Virtual 
Entity 
Researcher's 
Avatar 
Supervisor 
Home 
GP 
Hospital EMR Hospital's 
Virtual Entity 
Hospital 
Researcher 
Governmental 
Agency 
Patient's 
Avatar 
HIS 
Virtual 
Health 
Record
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Perspective naționale și internaționale ale informaticii și standardelor medicale

  • 1. Perspective naționale și internaționale ale informaticii și standardelor medicale Dr. ing. Andrei VASILATEANU Universitatea POLITEHNICA Bucuresti
  • 2. Cuprins •Introducere, HL7 Romania •Noi paradigme in asigurarea sanatatii •Evolutia sistemelor informatice in sanatate •Standardul HL7, RIM •Metodologie •Modelul domeniului LUMIR •Catre ecosisteme digitale de sanatate
  • 3. HL7 Romania •Afiliata HL7 International •Include furnizori şi beneficiari de servicii medicale, dezvoltatori de aplicaţii informatice, experţi tehnici. •Nume consacrate din industria IT medical din Romania •Dosarul Electronic al Pacientului dezvoltat de UTI bazat pe HL7 •Oferirea de cursuri HL7 in colaborare cu HL7 International si organizarea de examene de certificare •Cursul HL7 Fundamental este un curs complet online, supervizat de tutori din SUA •Presedinte: prof. Florica MOLDOVEANU •Presedinte onorific: dr. Nicolae GOGA n.goga@rug.nl
  • 4. Noi paradigme in asigurarea sanatatii •"pay for performance“ - cost control •"personalized medicine“ , "evidence-based medicine“ - quality of services •"patient-centered care”- “The right care in the right way at the right time” •"patient empowerment" Nothing about me without me” •ICT joaca un rol fundamental in schimbarea paradigmei prin sustinerea procesului de inovare al proceselor business in sanatate, sustinerea re-inginerizarii domeniului sanatatii
  • 5. Trenduri in e-health •E-health “an emerging field in the intersection of medical informatics, public health and business” •Dosarul longitudinal al pacientului •Interoperabilitate semantica si organizationala –Interconnecting health •Sisteme de sanatate interconectate national si regional •Aplicatii dependente de context
  • 6. Patient summaries Clinical Pathways * Workflow Engine Care Plan Drug and lab test prescriptions Medical image and report Lab test results Discharge Summary Emergency Summary Vital Sign Progress Report Sickness Prevalence Demographics Trends in Episodes of Care Patient Notification /Alarm Clinical Event Notification Clinical Event Notification Clinical documents Contacts Home Recovery Hospitalization Emergency Observations Therapy Medication GP Encounter CAT analysis Knowledge Base • Ontology • Clinical guidelines • Process Templates • Service & Metadata Registry • Clinical Document Repository Proc ess Inst anc e Security & Privacy Repositories • Care consumers • Care providers • Care organizations • Role profiles Clinical Event Notification Clinical Event Notification Past medical history Current health status Ongoing treatments Clinical Trial Evaluation Report Health conditions L.D.Serbanati, F.Ricci, G.Mercurio, A.Vasilateanu, Steps towards a digital health ecosystem, J Biomed Inform, Elsevier, 2011
  • 7. Standarde informatica medicala •Interoperabilitate sintactica si semantica •Metodologie de analiza si proiectare a domeniului de interes
  • 8. Standarde si specificatii HL7 •Health Level 7, nivelul aplicatiilor din OSI •Specificatii mesaje versiunea 2.x si 3.x •Reprezentarea cunostiintelor si suportul deciziei (Sintaxa Arden) •Standardizarea documentelor clinice (CDA) •Vocabulare clinice •Standarde, metodologii si servicii legate de dosare electronice de sanatate
  • 9. HL7 vers 3 Reference Information Model
  • 10. Metodologia HL7 V3 •Definirea aplicatiilor si problemelor din interfatare •Definirea informatiei care trebuie comunicata intre aplicatii : definitie, format, relatii •Evenimente care initiaza comunicarea •Structurarea si distribuirea pe pachete a informatiei
  • 11. Example Restrict Restrict Restrict RIM D-MIM R-MIM HMD Message Type Storyboard Storyboard Example Application Role Trigger Event Interaction Instantiate Sender Receiver Triggers Content References Use Case Modeling Information Modeling Interaction Modeling Message Design
  • 13. Ecosistemul digital al sanatatii EHR Infrastructure Digital Healthcare Ecosystem Patient GP Office e E Shared Resources Medical Ontology Clinical Guidelines Research Laboratory PHR GP’s EMR Mandate-based Organization An ad-hoc Organization Regional Health Organization Organization Business’s Rules GP's Virtual Avatar Virtual Team Care Organization Organizational Structure Healthcare Ecosystem Government Organizational Mediator Measurement device POS Organization’s Roles e E e-CRFs e E Reports Gov. Agency's Virtual Entity VHR's Virtual Entity Researcher's Avatar Supervisor Home GP Hospital EMR Hospital's Virtual Entity Hospital Researcher Governmental Agency Patient's Avatar HIS Virtual Health Record
  • 14. Va multumesc pentru atentie! Intrebari?