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Title:
COAS Submission
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HBO & C. Philips Medical Systems. Protocol Systems. 10 June 1998. CORBAmed 98-06-10. 2 ... Early effort was to identify issues and usage scenarios ... – PowerPoint PPT presentation
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Title: COAS Submission
1
COAS Submission
- 3M
- Care Data Systems
- CareFlowNet
- HBO C
- Philips Medical Systems
- Protocol Systems
2
Supporters Contributors
3
Outline
- Overview
- Scope of COAS
- Background on the submitters
- Usage examples
- Issues list - status and discussion
4
History
- June, 1997 - RFI issued
- Aug Sept, 1997 - Responses were received
- Dec., 1997 - RFP issued
- March, 1998 - Submitters started discussions
(after HIMSS) - April, 1998 - LOI deadline
- May, 1998 - Submission deadline
- Submission caveats
- Early effort was to identify issues and usage
scenarios - Straw-man IDL was based on a Protocol
implementation to access vital signs.
5
Environment
Back-ends
Middleware
Lab results
User
Front-end
Reports
COAS interfaces? Middleware Server
Back-end Server Both
Images
6
Definitions
- Clinical Observations
- Any measurement, recording, or description
WHAT of the anatomical, physiological,
pathological, or psychological CLINICAL state
or history WHEN of a human being WHO and any
impressions, conclusions, or judgments made
WHAT regarding that individual within the
context of the current delivery of health care to
that individual." - Access Services Methods / functions that
- 1. Determine what observations are, or may be,
available - 2. Let the user to specify subsets of the
available observations - 3. Return to the client
- a link to the observation,
- context and meta- information about the
observation, - the observation itself.
7
Common Attributes of Observations
- Observations WHAT
- are made on a specific individual, the patient
WHO - represent a snap-shot of that individual in time,
either at a particular time, or over some
specified interval of time WHEN - are made, or recorded, by an instrument or a
health care professional in some clinical
context and - are given (either by the patient, the health care
institution, or society) some degree of
confidentiality.
8
Observation Objects
- At least two flavors of observation objects have
been identified - 1. Thin Objects i.e. the observations by
themselves, or with minimal context information. - 2. Complete Objects, containing
- - the observation itself
- - context information (including links to
supporting observations) - - methods for common operations.
9
Example
- struct Measurement
- QualifiedCode name
- MeasuredValue value
- QualifiedCode units
- TimeStamp timeStamp
- QualifiedCodeSeq flags
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Observation Classes and Uses
- Measurements past, current, and future - for
display, analysis, and alerts. - Laboratory results for display, analysis, and
alerts. - Images for display within the EPR.
- Captured speech for report transcription and
review, v-mail, etc. - Reports for editing, review, sign-off, and
display within the EPR. - Scanned documents for display within the EPR.
11
Request Filtering
- Simple queries on Who, When, and / or What.
- Who one or more PIDs, or dont-care
- When specific Date-Time, Time-Span, or
conceptual concept, e.g. Latest, Previous, - What LQS conceptCode for general or specific
observation type using HL7 or DICOM or some other
public and/or private lexicon.
12
Scope
- Explicit support for
- Measurements
- Generic support for
- Documents
- Images
- No support for
- Conversion between data formats
- May perform a subset of the envisioned RLS
functionality
13
Background of Submitters
14
Usage Examples (1)
- Client queries PIDS to retrieve the Patient Ids
and their related Id Domains - Client queries Trader to find the COAS servers
within those Id Domains - Client queries each COAS to find out what
information is available for the patient - Client accesses (requests) specific observations
from one or more COAS servers.
15
Usage Examples (2)
- A physician refers a patient for an imaging study
- The physician is notified when the imaging report
is available. - The physician
- logs onto a workstation,
- selects the patient's record, and
- requests the report.
- The report refers to visual features seen in the
images. - The physician
- requests non-diagnostic quality versions of the
images, and - views both the report and one or more images.
16
Usage Examples (3,...)
17
Open Issues
- Information model - we intend to define a model,
and have several to build on - Dynamic Discovery - Yes, but what and how?
- Value Domains - we need to clarify the
relationship between COAS and LQS. - Componentization - Similar to PIDS and LQS
- Publish/subscribe - Yes, but Event or
Notification? - Synchronous vs Asynch- Should we support both?
- Observation Confidentiality - Access control,
How?
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