mohh – models submission
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MOHH – Models Submission
Dr Linda Bird9th August 2012
Strategic vision of patients moving seamlessly across the
healthcare system, receiving coordinated patient-centric care
at the most appropriate settings.
RH
CHNHPolyclinics
FPs Home Care
Rehab & support services
Screening & Prevention
Palliative Care
RH
CHNHPolyclinics
FPs Home Care
Rehab & support services
Screening & Prevention
Palliative Care
RH
CHNHPolyclinics
FPs Home Care
Rehab & support services
Screening & Prevention
Palliative Care
RH
CHNHPolyclinics
FPs Home Care
Rehab & support services
Screening & Prevention
Palliative Care
RH
CHNHPolyclinics
FPs Home Care
Rehab & support services
Screening & Prevention
Palliative Care
RH
CHNHPolyclinics
FPs Home Care
Rehab & support services
Screening & Prevention
Palliative Care
Enabled by the National
Electronic Health Record
(EHR)
Singapore’s Future Healthcare Landscape
Standards Products• Diagnosis - SNOMED CT and
Singapore Extension (SE)• Drugs - Singapore Drug Dictionary
(SDD)• Allergic Reactions– SNOMED CT +
SE • Allergens - SNOMED CT + SDD• Laboratory Results – LOINC• Data Dictionary – MOHH Data
Dictionary• Procedures - TBD• Reason for visit - SNOMED CT• Symptoms and Problems - SNOMED
CT and Singapore Extension• Laboratory Reports – Smart SNOMED
CT• Laboratory Orders – SNOMED CT• Radiology Orders - SNOMED CT
LIM Development Process
Requirements
Clinician Verification
Graphical Represent-
ationsClinician Input
Clinical Modelling Framework
Singapore Logical
Information Model
Clinical Modelling Language
(LOM)
Logical Reference Model(ISO13606+21090)
Computable Implementation
Specification
Cons
train
Inst
ance
of
Terminology Server
References
Terminology Ontology
Bind
va
lues
Bind
sem
antic
s
Store
Generate
Lim Repository
Store representation
Refe
renc
es
Input
Generate
Clinician Validation of the LIM
LIM ID LIM Name
LIM Cardinality
LIM Definition LIM Example (for Exchange)
LIM Example (for Display)
Laboratory Test Item 1 A class describing the laboratory test that was
performed.
Test Name 1 The name of the laboratory test within a panel of tests.
("xxx", "LDH measurement")("xxx", "Blood sodium measurement")
"LDH measurement""Blood sodium measurement"
Sequence Number 0..1 A number that identifies and sequences this
laboratory test item within a given panel."1""2"
"1""2"
Additional Description 0..1
A descriptor used in combination with the Test Name to fully define the description of the laboratory test.
POCT Indicator 0..1 The POCT (Point-of-care Testing) indicator at the
laboratory test item level.("xx, "Point of Care Test")
"Point of Care Test"
Type 0..1 The type of the test.
WYSIWYG
NDDS snippet
NXDS LXML XSD
NXDS LXML Instance
IsoSemantic Models – Example of Problem
e.g. “Suspected Lung Cancer”
IsoSemantic Models – Example Instances
e.g. “Suspected Lung Cancer”
IsoSemantic Models – Compositional Grammar
Problem Diagnosis = $ProblemDiagnosisName: 246090004|associated_finding|= (404684003|clinical_finding|:
63698007|finding_site|=($BodySite: 272741003|laterality|=$Laterality), 246112005|severity|=$Severity),
408729009|finding_context|=$FindingContext
IsoSemantic Models – Equivalence Testing
Problem Diagnosis = $ProblemDiagnosisName: 246090004 |associated finding| = (404684003|Clinical Finding|:
363698007 | finding site | = ($BodySite: 272741003|laterality| = $Laterality),
246112005 | severity| = $Severity), 408729009 | finding context | = $FindingContext
GP Problem Diagnosis = 86049000|Cancer| : 246090004 |associated finding| = (404684003|Clinical Finding| :
363698007 | finding site | = 39607008|Lung|), 408729009 | finding context | = 415684004|Suspected|
Polyclinic Problem Diagnosis = 162572001 |Suspected cancer|: 246090004 |associated finding| = (404684003|Clinical Finding|:
363698007 | finding site | = 39607008|Lung|)
RH Problem Diagnosis = 86049000|Suspected lung cancer|
Bi-directional Semantic Interoperability
NEHR
Prob/Dx :”Osteoarthritis”
Severity : “Severe”
Location : “Knee Joint”
Side : “Left”
Source Data
Prob/Dx :”Osteoarthritis”
Severity : “Severe”
Location : “Knee Joint”
Side : “Left”
GP - Source Data
Design Patterns - Diagnosis
DP-based GP - Source Data
National Term
Research Semantics
Problem/Diagnosis : “Severe
osteoarthitis of the left knee”
Transformed GP - Source Data in RH format
Diagnosis : ”Osteoarthritis
of the left knee”
Degree : “Severe”
Transformed GP - Source Data in Polyclinic format
Maps In
Maps out
Severe osteoarthritis of the left knee
• ENTRY– Observation Entry (Observable Name/Value)
• Heart Rate/ Blood Pressure / Blood Glucose– Clinical Finding
• Problem Diagnosis Entry• Adverse Reaction Entry• Alert Entry
– Activity• Pharmacy Activity Entry
– Pharmacy Order Entry– Pharmacy Dispense Entry– Pharmacy Administration Entry
• Investigation Activity Entry– Investigation Order Entry– Investigation Result Entry
• Procedure Entry (Reference Pattern)• CLUSTER
– Pharmacy Item / Investigation Test Item
Submission Overview
This material contains information that is confidential to MOH Holdings Pte Ltd (MOHH) and should not be circulated beyond MOHH without permission.© All Rights Reserved
Thank You
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