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HL7FHIR:AnupdateforCHIMADr.DavidHay,MBChB,June2015chinc.org.cnPage2•Copyright©2012OrionHealth™groupofcompanies•AllrightsreservedAboutMe个人简介•Name:Dr.DavidHay•Role:ProductStrategistatOrionHealth现任OrionHealth医疗产品战略专家•Background–Clinician临床医师–ClinicalApplicationsVendor临床应用供应商–InvolvedinFHIRalmostfrombeginning从一开始就参与FHIR–Co-ChairFHIRManagementGroupFHIR管理协会联合主席–ChairHL7NewZealand新西兰HL7主席–Blog:FHIRBlog.com博客chinc.org.cnPage3•Copyright©2012OrionHealth™groupofcompanies•AllrightsreservedFHIR(FastHealthcareInteroperabilityResources)快速医疗资源互通•DriversforFHIR动机•ThemainpartsofFHIR主要部件–Resources资源–ExchangingFHIR交换–API应用程序接口–Profiling分析•ImplementingFHIR实施DesiredoutcomeisthatyouwanttolearnmoreaboutFHIR!理想的结果是，你想更深入的了解FHIR！核心特征chinc.org.cnWhyFHIRchinc.org.cnPage5•Copyright©2012OrionHealth™groupofcompanies•AllrightsreservedDrivers动机•Interoperabilityrequirementincreasing互操作性要求的提高–Increasingcollaborativecare–needforco-ordination提高合作医疗–需要协调–ChangingPaymentmodels改变支付模式–ClinicalCaredeliverytoanagingpopulation人口老龄化的临床护理–Decisionsupport决策支持–Involvingthepatient–raisingthebar涉及病人-提高标准•Needforrealtimeaccess实时访问需要–Mobile手机–Connectedworld与世界接轨•Vastincreaseintheamount&typeofdata数据的数量与类型大量增加–Devices,Mobile移动设备–Genomics基因组学•Analytics,populationhealth分析，人口健康•Implementerexpectations实施者的期望–Expectamodernstandard期待一个现代标准Currentstandardsdon’tcutit-theseledtoFHIR…chinc.org.cnPage6•Copyright©2012OrionHealth™groupofcompanies•AllrightsreservedIssueswithotherstandards与其他标准的问题•HL7version2–Greatformessagingbetweensystems系统间的消息传递–But:•Oldtechnology过时的技术•Hardtocustomizeandextend不容易定制和不容易扩展•HL7version3–Definedcommonmodelforinteroperability定义了通用模型的互操作性–But:•Verylargeinstances实例庞大•Extremelycomplextoimplement实施非常复杂•CDA(version3)–Verysuccessful非常成功–But:•Documentsonly仅限于文档•Difficulttocommunicatecodeddata难以沟通的编码数据chinc.org.cnPage7•Copyright©2012OrionHealth™groupofcompanies•AllrightsreservedBusinessCaseforFHIR–I商业案例•Mobilefriendly支持移动设备–Concise,RESTAPI&JSON•Developerfriendly易于开发–Familiartooling&familiartechnologies–XML/JSON,HTTP,SSL,Oauth通晓的工具和技术–Librariesavailable–HAPI,referenceimplementation方便的标准库•Simpletounderstandandaccesswithexamples!简单的理解和使用的例子•PredefinedResources预定义的资源–Analysisalreadydone已提前分析•Allparadigms,AllArchitectures,AllClients所有的模式，所有的架构，所有客户–Thickclient,browser,mobile,devices胖客户端，浏览器，移动设备chinc.org.cnPage8•Copyright©2012OrionHealth™groupofcompanies•Allrightsreserved核心特征BusinessCaseforFHIR–II商业案例•Solvesthecommonproblems–canconcentrateonthetrickystuff解决常见问题–可以专注于棘手的东西–EgAPI/formatsaredefined•Don’tneedtounderstandHealthCaredomaintoimplement不需要了解医疗保健领域的实施–DevelopersorAnalysts开发者或分析师•Largecommunityforsupport支持大型社区•AlreadyinuseInternationally已经在国际上使用–70Organizations,20Countries,allContinents(exceptAntarctica)70组织，20个国家（地区），所有大洲(除了南极洲)–InterestfromProviders,Vendors,Payers,Governments医疗供应者，供应商，保险公司，政府都很有兴趣Resultsinfaster,cheaperdeploymentsthataremorere-usable结果是更快，更低成本的部署，更可重复使用chinc.org.cnPage9•Copyright©2012OrionHealth™groupofcompanies•AllrightsreservedFHIRTimeline时间轴20122016201420182020FirstDraft(草案)201120152013201720191stDSTU~2ndDSTU~1stNorm(标准).~2ndNorm(标准)....FreshLookchinc.org.cnPage10•Copyright©2012OrionHealth™groupofcompanies•AllrightsreservedFHIRManifesto宣言•FocusonImplementers聚焦于实施人员•Targetsupportforcommonscenarios常见方案的目标支持•Leveragecross-industrywebtechnologies借助跨行业的网络技术•Supporthumanreadabilityasbaselevelofinteroperability以支持人类对数据的阅读作为互操作性的基础•Supportmultipleparadigms&architectures支持多模式与架构•Makecontentfreelyavailable使内容免费•Demonstratebestpracticegovernance展示最佳实践下的管理chinc.org.cnResources资源chinc.org.cnPage12•Copyright©2012OrionHealth™groupofcompanies•AllrightsreservedResources资源•“Resources”are:–Smalllogicallydiscreteunitsofexchange小逻辑离散单元的交换–Definedbehaviourandmeaning定义行为和意义–Knownidentity/location已知身份/位置–Smallestunitoftransaction“ofinterest”tohealthcare最小交易单位“利益”的医疗保健–V2:SortoflikeSegments段–V3:SortoflikeCMETs•CanberepresentedinXMLorJSON•Canbeindividualorinbundles–Egmessages,documents核心特征chinc.org.cnPage13•Copyright©2012OrionHealth™groupofcompanies•AllrightsreservedResources资源chinc.org.cnPage14•Copyright©2012OrionHealth™groupofcompanies•AllrightsreservedResourceanatomy资源解剖DefinedStructuredData定义的结构化数据Extensions扩展Narrative叙述(text)Metadata元数据chinc.org.cnPage15•Copyright©2012OrionHealth™groupofcompanies•Allrightsreservedchinc.org.cnPage16•Copyright©2012OrionHealth™groupofcompanies•AllrightsreservedReferencesbetweenresources引用之间的资源核心特征chinc.org.cnExchangingFHIR交换FHIRchinc.org.cnPage18•Copyright©2012OrionHealth™groupofcompanies•AllrightsreservedParadigmsofInteroperability范式的互操作性RESTDocuments文档Messages消息Services服务(Operations)FHIRcansupportalloftheseFHIR支持以上所有chinc.org.cnPage19•Copyright©2012OrionHealth™groupofcompanies•AllrightsreservedFHIRRepositoryRegardlessofparadigm,thecontentisthesame无论范式，内容都是一样的LabSystemFHIRMessageFHIRDocumentNationalExchangeThesameresources同样的资源核心特征chinc.org.cnAPI(ApplicationsProgrammingInterface)应用程序接口chinc.org.cnPage21•Copyright©2012OrionHealth™groupofcompanies•AllrightsreservedAPI–REST&Services应用程序接口–REST和服务•Real-timeinteraction实时交互–A