HIE and Health Data Standards Development in Thailand and Asia

Boonchai Kijsanayotin M.D., Ph.D.(Health Informatics)

Chair: Asia eHealth Information Network (AeHIN)

Manager: Thai health Information Standards Development Center (THIS), HSRI

IHE AsiaPac Summit 2019, Bangkok in conjunction with HIMSS AsiaPac19

Centara Grand & Bangkok Convention Centre - 7th October 2019

Asia eHealth Information Network (AeHIN)

enable good governance, policy, oversight,proedures, and controls to ensure eHealth success

capture user input to plan, design, and deploybetter eHealth solutions one step at a time

activate interoperability layer with registriesfor clients, providers, and facilities

manage digital health projects, changes, and risks

engage multiple sectors and develop eHealthstrategy aligned with health sector priorities

apply data/IT standards for betterquality and use of information

continually optimizeDigital health services

evaluation & strategic reuse

sustainability

universality

scalability

interoperability

institutional readiness

leadership

Principles in Practice

Best Practices, Guidance, Standards, Certification Programs

WHO-ITU eHealthStrategy Toolkit

National Digital Health Strategy & Action Plan

Digital HealthGovernance Framework

Digital Health Architecture Blueprint

Health Information Exchange (HIE)

Interoperability Profiles, Terminology Services

Management Plans, Policies, and Procedures

Digital HealthService Agreements

NationalDigital HealthCapacity Roadmap

AeHIN' s Community of Interoperability Labs (COIL)

AeHIN Working Council

& members

Regional

Enterprise

Architecture

Council for

Health

(REACH)

Community of

Interoperability

Labs

(COIL)

SIL-T SIL-P SIL-IRef. Lab

(SIL-A)

SIL= Standards & Interoperability Lab

T = Thailand, P = Philippine

I = Indonesia, V = Vietnam, A =Asia

SL = Sri Lanka, Ref.= Reference

SIL-TStandards and

Interoperability Lab Thailand

SIL-V SIL-SL

OpenHIE Architectural Principals

A. "Standards-based“

B. "Adaptable" / "implementable“

C. "Interchangeability" / "Swappable"

https://wiki.ohie.org/display/resources/Architectural+Principals

OpenHIE

Architecture

Specification

Version 2

Interoperability Layer

Provider Registry

Facility Registry

Client Registry

HMIS/Claims

EMRsHospital Systems

mHealth Applications

Inventory

Supply Chain Applications

HMISs

Indicators

Thailand Approach to Health Data Standards

Insurance Claim

Citizen IDs

Health

Facility IDs

Coding & Terminology

ICD -10

CGD code

DRG

TMT

12 Files

18 Files

43 Files

LOINC

SNOMED

National

Provider

IDs

Referral

Docs.

National

Product

Catalogue

CGD = Comptroller General Department, TMT = Thai Medicines Terminology, DRG = Diagnosis Related Group, HMIS = Health

Management Information System, FHIR = Fast Health Interoperability Resource IHE = Integrating the Healthcare Enterprise,

HL7 FHIR, IHE, CDA, NDID, Authentication, Mapping services etc.

Landscape of Health Data Standards

From: Standards – Yesterday, Today and Tomorrow: Integrating the Standards for Healthcare presentation

, Ken Lunn, 17 October 2011

Categories of Health Information Standards

HL

7 F

HIR

Level of Interoperability & Standards

•Clinical Practice Guideline, Similar Claim Rules (DRG), HIPAA rules

Process/Service

•Health ID, ICD 10, Drug Code (TMT), LOINC, SNOMED-CT etc.

Semantic

• HL7 V2 ,HL7 CDA, DICOM etc. Syntactic

• Standards Dataset : Discharge Summary, Prescription etc.

Structure

• Oauth2, JSON, XML, PKI, SSL , Web Service (API) etc.

Technical

Adapted :1) Benson T: Principles of Health Interoperability HL7 and SNOMED. 2nd ed. 2012. Springer; 2012., 2) Bobel B: Making Hospital IT Interoperable Hospital Information Technology Europe 2008

Fas

t H

ealt

h In

tero

per

abili

ty R

eso

urc

es

CENTRAL

POPULATION

DATABASE

From paper records to digital records 1982-1988

Digitizing over 60 million records from paper

“60 Million records over 5 Years”

Content Standards

(Standard Data Set)

Standard Data set for health insurance (12 files) 1996

Health Center standard data set (18 files) 2002

Semantic Standards

(Standards Vocabularies)

Safety

Drug interaction

Pharm. Class (ATC)

บญัชยีาหลกั (ED/NED)

ADR

Bio

Equivalent

Quality

Public

InformPrescription

Dispensing, Price,

eGP,

reimbursement

Cost Control

Reimbursed Price

Inventory

Logistic (GS1)

Safety

Drug interaction

Thai Medicines Terminology

TMT

พฒันาแลว้

และใชอ้ยู่ใน

ระบบเบกิจา่ย

คา่

รกัษาพยาบา

ล และ eGP

TPU

Trade Product

Use

TPP

Trade Product

Pack

GP

Generic

Product

TP

Trade Product

GPU

Generic

Product Use

VTMVirtual Therapeutic

Moiety

GPP

Generic Product

Pack

SUBS

Substance

Groupers

Continuum of Health Vocabularies

Nomenclature-Highly detail descriptions (SNOMED-

CT)

Classification-organized aggregation of descriptions

into rubric (ICDs)

Groupings-High level categories of rubrics (DRGs)

Nomenclatures Classification Groups

Aggregation

Details SNOMED-CT ICD DRG Grouped