1、,IT基础架构(PIX/PDQ/RID/CT),宫晓东,Copyright 2011 Neusoft Corporation,IT基础架构概述,IT基础架构技术框架(ITI TF,IHE IT Infrastructure Technical Framework),它定义了如何应用现有标准,以达到提供恰当的医疗信息共享,优化患者诊疗的集成目标。是整个IHE集成规范中重要的组成部分。,Copyright 2011 Neusoft Corporation,IT基础框架,Copyright 2011 Neusoft Corporation,PIX/PDQ/RID/CT,PIX介绍概述,组成和框架,事
2、务介绍,Case示例PDQ介绍 概述,组成和框架,事务介绍,Case示例RID介绍概述,组成和框架,事务介绍,Case示例CT介绍 概述,组成和框架,事务介绍测试技巧,PIX介绍,PIX的概述,PIX(Patient Identifier Cross-referencing)患者ID交叉索引,在多个系统中同一患者不同ID之间,提供一个患者标识的相互索引,一旦多个系统建立交叉索引,同一个患者即使在不同医疗域或多个信息系统中拥有不同的ID,也可以同时从多个系统中获取其相关信息.这样使用者(比如医生)就可以很方便的获取到患者更为完整的信息。,Copyright 2011 Neusoft Corpor
3、ation,PIX的组成,在 IHE 的PIX 集成规范中,定义了三个角色(Actors):Patient Identity Source(病人标识源)Patient Identifier Cross-reference Manager(病人标识交叉引用管理器)Patient Identifier Cross-reference Consumer(病人标识交叉引用使用者),Copyright 2011 Neusoft Corporation,PIX框架,Copyright 2011 Neusoft Corporation,PIX Transactions,PIX角色间共有三个事务进行交换信息,
4、分别是:Patient Identity Feed(ITI-8)ITI TF-Volume 2a(ITI TF-2a)Transactions Part A Sections 3.8 PIX Query(ITI-9)ITI TF-Volume 2a(ITI TF-2a)Transactions Part A Sections 3.9 PIX Update Notification(ITI-10)ITI TF-Volume 2a(ITI TF-2a)Transactions Part A Sections 3.10,Copyright 2011 Neusoft Corporation,PIX T
5、ransactions,Patient Identity Feed(ITI-8),Copyright 2011 Neusoft Corporation,HL7消息示例,ADTA01MSH|&|MESA_ADT|DOMAIN1_ADMITTING|MESA_XREF|HOSPITAL|200310011100 |ADTA01ADT_A01|10511102|P|2.3.1|EVN|200310011100|200310011043PID|ANDERS10511HIMSS2005&1.3.6.1.4.1.21367.2005.1.1&ISOPI|ANDERSMARIAN|19440404|F|WH
6、|444 Main St. Seattle, WA|10511-101|PV1|I|,Copyright 2011 Neusoft Corporation,.1病人病例号码,3.病人标识域,HL7消息示例,ADTA08MSH|&|MESA_ADT|DOMAIN1_ADMITTING|MESA_XREF|XYZ_HOSPITAL|200310011200|ADTA08|10501108|P|2.3.1|EVN|200310011200|200310011200PID|ABC10501HIMSS2005&1.3.6.1.4.1.21367.2005.1.1&ISOPI|EhrxyzmedicalM
7、ARION|19380224|M|BL|5 PINETREEWEBSTERMO63119|10501-102|PV1|O|,Copyright 2011 Neusoft Corporation,HL7消息示例,ADTA40MSH|&|MESA_ADT|DOMAIN1_ADMITTING|MESA_XREF|XYZ_HOSPITAL|200310011100|ADTA40ADT_A39|10514106|P|2.5|EVN|200310011100|200310011043PID|XYZ10506HIMSS2005&1.3.6.1.4.1.21367.2005.1.1&ISOPI|Ehrxyzm
8、edicalMARION|19720908|M|BL|5 PINETREEWEBSTERMO63119|10501-104|N|MRG|PIX10501HIMSS2005&1.3.6.1.4.1.21367.2005.1.1&ISOPI|MarionSingleton,Copyright 2011 Neusoft Corporation,PID-3New PatientID,PID-5 New PatientName,MRG-1 Old PatientID,MRG-6 Old PatientName,PIX Transactions,PIX Query(ITI-9),Copyright 201
9、1 Neusoft Corporation,HL7消息示例,QBPQ23(QPD-4为空,没有指定查询标志域)发送消息:MSH|&|MESA_PIX_CLIENT|MESA_DEPARTMENT|MESA_XREF|XYZ_HOSPITAL|200603121200|QBPQ23|10501108|P|2.5|QPD|QRY_1001Query for Corresponding IdentifiersIHEDEMO|QRY10501108|56321AWEST CLINIC|空|RCP|I|返回消息:MSH|&|HOSPMPI|HOSP|CLINREG|WESTCLIN|1999121211
10、35-0600|RSPK23RSP_K23|1|D|2.5|MSA|AA|QAK|111069|OK|Q23Get Corresponding IDsHL7nnnn|1|QPD|Q23Get Corresponding IDsHL7nnn|111069|112234METRO HOSPITAL|PID|66532SOUTH LAB112234METRO HOSPITAL|SmithJohn|19630423|M|C|N2378 South,QPD-4 为空 不指定要查询的标识域,QPD-3 指定已知的标示域的病人ID,注意:返回的PID-3不包括已知的标识域ID(56321AWEST CLIN
11、IC)。,HL7消息示例,QBPQ23(QPD-4不为空,指定查询标志域)发送消息:MSH|&|CLINREG|WESTCLIN|HOSPMPI|HOSP|199912121135-0600|QBPQ23QBP_Q21|1|D|2.3.1QPD|Q23Get Corresponding IDsHL7nnnn|111069|112234METRO HOSPITAL|WEST CLINICSOUTH LAB|RCP|I|返回消息:MSH|&|HOSPMPI|HOSP|CLINREG|WESTCLIN|199912121135-0600|RSPK23RSP_K23|1|D|2.3.1|MSA|AA|
12、QAK|111069|OK|Q23Get Corresponding IDsHL7nnnn|1|QPD|Q23Get Corresponding IDsHL7nnn|111069|112234METRO HOSPITAL|WEST CLINICSOUTH LAB|PID|56321AWEST CLINIC66532SOUTH LAB|SmithJohn|19630423|M|C|N2378 South,QPD-4不为空,指定要查询的标识域,PIX Transactions,PIX Update Notification(ITI-10),Copyright 2011 Neusoft Corpor
13、ation,HL7消息示例,ADTA31MSH|&|MESA_ADT|XYZ_ADMITTING|MESA_OP|XYZ_HOSPITAL|200511031045|ADTA31ADT_A05|12102104|P|2.3.1|EVN|200511031045|200511031045PID|PAM12102HIMSS2005&1.3.6.1.4.1.21367.2005.1.1&ISOPI|JACKSONSARAH|19601014|F|WH|14 WILLOWLADUEMO63124|(314)555-1234|(314)555-4444|12102-001|MODOTJ12102|Y|A
14、L|20051103|PV1|N|V12102ADT1|200511031045|V|,Copyright 2011 Neusoft Corporation,No Applicable,Case示例(PIX_FEED_Berlin),Case示例(PIX_FEED_Berlin),PDQ介绍,PDQ的概述,PDQ(Patient Demographics Query)病人信息查询。在一个机构内分布的多个医疗域可以使用特定的查询语法,向患者信息中心服务器查询患者信息,查询结果可以直接被使用者所使用,结果包括患者的人口学基本信息,甚至可以包括就诊相关信息.,Copyright 2011 Neuso
15、ft Corporation,PDQ的组成,在 IHE 的PDQ 集成规范中,定义了两个角色(Actors):Patient Demographics Supplier (患者基本信息提供者)Patient Demographics Consumer(患者基本信息使用者),Copyright 2011 Neusoft Corporation,PDQ框架,Copyright 2011 Neusoft Corporation,PDQ Transactions,PDQ角色间共有两个事务进行交换信息,分别是:Patient Demographics Query (ITI-21) ITI TF-Volu
16、me 2a(ITI TF-2a)Transactions Part A Sections 3.21Patient Demographics and Visit Query (ITI-22) ITI TF-Volume 2a(ITI TF-2a)Transactions Part A Sections 3.22,Copyright 2011 Neusoft Corporation,PDQ Transactions,Patient Demographics Query (ITI-21),Copyright 2011 Neusoft Corporation,HL7消息示例,QBPQ22发送消息:MS
17、H|&|CLINREG|WESTCLIN|HOSPMPI|HOSP|199912121135-0600|QBPQ22QBP_Q21|1|D|2.3.1QPD|Q22Find Candidates|111069|PID.5.1.1SMITHPID.5.1.2JOHN PID.8M|80|MATCHWARE|1.2|METRO HOSPITALSOUTH LAB|RCP|I|20RD, 查询条件,QPD-8 指定标识域,HL7消息示例,接收消息:MSH|&|HOSPMPI|HOSP|CLINREG|WESTCLIN|199912121135-0600|RSPK22RSP_K22|1|D|2.3.1
18、|MSA|AA|8699|QAK|111069|OK|Q22Find CandidatesHL7nnnn|3|QPD|Q22Find CandidatesHL7nnn|111069|PID.5.1SMITH PID.5.2JOHNPID.8M|80|MATCHWARE|1.2|METRO HOSPITALSOUTH LAB|PID|66785METRO HOSPITAL66532SOUTH LAB|SmithJohn|19630423|M|C|N2378 South StreetMadisonWI53711|QRI|95|MATCHWARE 1.2|PID|87443METRO HOSPITA
19、L651189SOUTH LAB|SmithJon|19470606|M|C|124 Second StreetMadisonWI53711|QRI|90|MATCHWARE 1.2|PID|43266METRO HOSPITAL81209SOUTH LAB|SmithyJohn|19901210|M|C|W11234 Bay DriveLodiWI53555|QRI|85|MATCHWARE 1.2|,HL7消息示例,QBPQ22必需支持的查询条件:,Copyright 2011 Neusoft Corporation,HL7消息示例,补充:除了文档中规定的要支持的查询条件外,在IHE测试的
20、case中还要支持以下几个查询条件:PID.6 Mothers Maiden Name PID.13 Home Phone Number,Copyright 2011 Neusoft Corporation,PDQ Transactions,Patient Demographics and Visit Query (ITI-22),Copyright 2011 Neusoft Corporation,HL7消息注意事项,QBPZV1发送消息:MSH|&|IBMPixSource|IBM|XDSDEMO_ADT|XDSDEMO|20060615212219-0800|QBPZV1QBP_Q21|
21、3484497703508759719|P|2.3.1QPD|Q22Find CandidatesHL7|2646139448179905807900228792293|PID.5.1TRENTONPV1.2ORCP|I,Copyright 2011 Neusoft Corporation,病人就诊查询条件,HL7消息示例,接收消息:MSH|&|RSPZV2|20120131102736HL7Event_ZV1|P|2.3.1|MSA|AA|20120131102731HL7Event_ZV1|QPD|CREALIFE_PDQ|QRY123456|PV1.2I|QAK|QRY123456|OK
22、|CREALIFE_PDQ|2|PID|Lalainne1.1HIMSS2009&1.3.6.1.4.1.21367.2009.1.2.300&ISOPI|TRENTONLalainne|BrownBonnie|20030103|F|515 ASTER STEscondidoCA92135|555-123-4567|Y|1|20030130|23PV1|I|PID|CREALIFEIHENA&1.3.6.1.4.1.21367.2009.1.2.300&ISOPI|TRENTONJAY|19240202|F|343-12-2216 111 MICHIGAN AVE. CHICAGOIL6050
23、1|10501-102|PV1|I|nnnnaa|tttqq|sssss|dddd|,HL7消息示例,Copyright 2011 Neusoft Corporation,Case示例(PDQ_Multiple_Query),Case示例(PDQ_Multiple_Query),双胞胎测试数据,RID介绍,RID的概述,RID(Retrieve Information for Display)通过一种简单快捷的只读方式获取必要的患者信息,这些信息对于患者提供更好的医疗服务是很重要的,RID支持HL7-CDA,PDF,JEPG等主流的文档格式。同时,为了临床需要,该规范还支持读取某些以病人为中心
24、的关键信息,促进了工作流程的自动化,使之更为流畅。,Copyright 2011 Neusoft Corporation,RID的组成,在 IHE 的RID 集成规范中,定义了两个角色(Actors):Display(显示)Information Source(信息源),Copyright 2011 Neusoft Corporation,RID框架,Copyright 2011 Neusoft Corporation,RID Transactions,RID角色间共有两个事务进行交换信息,分别是:Retrieve Specific Information for Display ITI-11
25、 ITI TF-Volume 2a(ITI TF-2a)Transactions Part A Sections 3.11Retrieve Document for Display ITI-12 ITI TF-Volume 2a(ITI TF-2a)Transactions Part A Sections 3.12,Copyright 2011 Neusoft Corporation,RID Transactions,Retrieve Specific Information for Display ITI-11,Copyright 2011 Neusoft Corporation,RID请求
26、示例,Copyright 2011 Neusoft Corporation,RID请求示例,Copyright 2011 Neusoft Corporation,RID请求示例,http:/IHERetrieveSummaryInfo?requestType=SUMMARY&patientID=99998410%%26DNS &lowerDateTime=2003-01-01T00:00:00&upperDateTime=2003-01-01T23:59:59&mostRecentResults=1,Copyright 2011 Neusoft Corporation,RID Transact
27、ions,Retrieve Document for Display ITI-12,Copyright 2011 Neusoft Corporation,RID请求示例,Copyright 2011 Neusoft Corporation,RID请求示例,http:/IHERetrieveDocument?requestType=DOCUMENT&documentUID=1.2.3&preferredContentType=application%2fpdf,Copyright 2011 Neusoft Corporation,RID 模式,RID共有三种交互模式,分别是:Retrieve S
28、pecific Information for Display Process Flow Retrieve a Document Process FlowRetrieve Summary Information for Display and Retrieve several Documents Process Flow,Copyright 2011 Neusoft Corporation,RID模式一,Copyright 2011 Neusoft Corporation,RID模式二,Copyright 2011 Neusoft Corporation,RID模式三,Copyright 20
29、11 Neusoft Corporation,Case示例(Query_with_summary _request),Case示例(Query_with_summary _request),CT介绍,CT的概述,CT(Consistent Time )集成规范是一种使网络中的多台电脑之间保证时间一致的方法,本规范使多台电脑的中位时间差小于1。,Copyright 2011 Neusoft Corporation,CT的组成,在 IHE 的CT 集成规范中,定义了两个角色(Actors):Time Server(时间服务器)Time Client(时间客户端),Copyright 2011 Ne
30、usoft Corporation,CT框架,Copyright 2011 Neusoft Corporation,CT Transactions,CT角色间使用一个事务进行交换信息,是:Maintain TimeITI-1 ITI TF-Volume 2a(ITI TF-2a)Transactions Part A Sections 3.1,Copyright 2011 Neusoft Corporation,CT Transactions,Maintain TimeITI-11,Copyright 2011 Neusoft Corporation,CT Transactions,Copyright 2011 Neusoft Corporation,测试技巧,测试技巧,1.测试开始阶段,迅速设置网络环境,调试程序。确保参测程序自身运行流畅。2.将测试case中需要的数据提前录入到数据库中。如双胞胎数据信息等。3.联系合作厂商,交换设置参数。如IP,端口,标识域,交换飞秋等。4.与合作厂商进行测试联调。测试中后期注意保存相关日志。5.积极联系督察,验证case.,Copyright 2011 Neusoft Corporation,Copyright 2011 Neusoft Corporation,