Healthcare standards for hospital pharmacists
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Ma présentation au séminaire 12 du Congrès EAHP de Genève le 24 mars 2006
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Healthcare standards for hospital pharmacists
- 1. 1/ 27 11th Congress of the EAHP Palexpo Congress Centre, Geneva, Switzerland, 22-24 March 2006 Simon Letellier, Hospital pharmacist, medical informatics MD CHS de la Sarthe, Le Mans, France simon.letellier@phast.fr Context :Context : 11stst aspect :aspect : International PlayersInternational Players in Health Care Standardsin Health Care Standards 22ndnd aspect :aspect : Communication processCommunication process for interoperabilityfor interoperability
- 2. 2/ 27 International PlayersInternational Players in Health Care Standardsin Health Care Standards 11stst aspect :aspect :
- 3. 3/ 27 Who are the InternationalWho are the International Players in Health CarePlayers in Health Care Standards?Standards? Technical committee 215 Health Informatics Technical committee 251 Health Informatics Health Care Messaging Standards Health Level Seven European Committee for Standardization
- 4. 4/ 27 Making World Health CareHealth Care Standards TC 215 AFNORDIN National levelNational level European levelEuropean level Worldwide levelWorldwide level
- 5. 5/ 27 • WG1 :WG1 : Health RecordsHealth Records • WG2 :WG2 : Messaging and CommunicationMessaging and Communication ArchitectureArchitecture • WG3 :WG3 : TerminologyTerminology • WG4 :WG4 : SecuritySecurity • WG5 :WG5 : Smart CardsSmart Cards • WG6 :WG6 : e-pharmacye-pharmacy Technical Committee 215
- 6. 6/ 27 // • cen : « academic » view work on standard as norm • HL7 : « pragmatic » view work on functional standard
- 7. 7/ 27 • Technical Board of CEN decided in 1990 that many of the issues that needed standards for health informatics would best be solved on a European scaleEuropean scale rather than national and created the TC 251. • That position now seems to be changing with the creation of ISO TC 215 and the emergence of HL7 as an international standard. • CEN has moved to a position of sharingsharing and cooperationcooperation in the international community.
- 8. 8/ 27 • WG1 :WG1 : Information models • WG2 :WG2 : Terminologies • WG3 :WG3 : Security, safety, and quality • WG4 :WG4 : Technology for interoperability Nothing specially dedicated to Pharmacy.
- 9. 9/ 27 BSI SAI ON IBN BASMP ABNT CSSN DPS ANSI CSNI IRAM INTECO ICONTEC KATS AFNOR SFS EOS INEN DS DZNM MSZT BSN NSAI STIR BIS IDHKSAR KEBS JISC UNI SIIELOT DIN BPS INDECOPI DGSM NSF SNZ NNI SNIMA MOLDST DGN DSM SEE LST AENOR SMIS UNMS PSB SASO GOST-R IPQ FONDONORMA TCVN UNIT SSUAE TSE TTBS TISI SNV SIS SLSI SCC EVS CSM LVS MSA PKN SZS DSTU ASRO DIN National Standardization Bodies NEN SIST SUTN ASRO IST CNI CYS
- 10. 10/ 27 International AffiliatesInternational Affiliates • JapanJapan • KoreaKorea • LithuaniaLithuania • New ZealandNew Zealand • South AfricaSouth Africa • SwitzerlandSwitzerland • TaiwanTaiwan • The NetherlandsThe Netherlands • TurkeyTurkey • United KingdomUnited Kingdom • and more ...and more ... • ArgentinaArgentina • AustraliaAustralia • BrazilBrazil • CanadaCanada • ChinaChina • Czech RepublicCzech Republic • DenmarkDenmark • FinlandFinland • FranceFrance • GermanyGermany • IndiaIndia
- 11. 11/ 27 France 2004 Italy 2003 Spain 2003 Denmark 2003 Germany 1995 Netherland s 1996 Ireland 2003 UK 2000 Bulgaria 2005 Poland 2003 Finland 1996 Croatia 2001 Portugal 2006 ? Switzerland 2000 Austria 2006 ? Czech Republic 2001 Lithuania 2002 Latvia 2006 ? Sweden 2006 ? affiliates in Europeaffiliates in Europe
- 12. 12/ 27 Is there anything about pharmaceutical standards ? • cen : [ENV« EuroNorm Vornorm » draft standard] – ENV 13607:2000 messages on medicine prescriptions – ENV 12610:1997 pharmaceutical product identification • HL7 v3 : [From Draft Standard to Normative state] – Pharmacy domain process and messages – Medication domain pharmaceutical product identification
- 13. 13/ 27 Communication processCommunication process for computer interoperabilityfor computer interoperability 2nd aspect :2nd aspect :
- 14. 14/ 27 Semantic interoperability Functional interoperability What is computerWhat is computer interoperability?interoperability? • Although an intuitive answer is easy, a specific response is more complex “The ability of two or more systems or components to exchange information and to use the information that has been exchanged.” [IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries, IEEE, 1990]
- 15. 15/ 27 The Semiotic TriangleThe Semiotic Triangle C.K Ogden and I. A. Richards. The Meaning of Meaning. “Drug” Concept Referent Symbol SymbolizesRefers to Stands for
- 16. 16/ 27 From humans to computersFrom humans to computers I dispense a drug
- 17. 17/ 27 The Communication ProcessThe Communication Process Concept Referent Refers to Symbolizes Stands for Refers toSymbolizes Stands for Concept Symbol Symbol Semantics I dispense a drug Referent“Drug” “Drug”
- 18. 18/ 27 The Communication ProcessThe Communication Process Concept Referent Refers to Symbolizes Stands for Refers toSymbolizes Stands for Concept Symbol Symbol Semantics I dispense a drug Referent Syntax “Drug” “Drug”
- 19. 19/ 27 The Communication ProcessThe Communication Process Concept Referent Refers to Symbolizes Stands for “Drug” Refers toSymbolizes Stands for “Drug” Concept Symbol Symbol Semantics I dispense a drug Referent Syntax Shared Context ContextContext ContextContext
- 20. 20/ 27 From humans to computersFrom humans to computers Je dispense un médicament I dispense a drug Translator
- 21. 21/ 27 Je dispense un médicament EAI: «translator» server No brain , no cognition. I dispense a drug From humans to computersFrom humans to computers [EAI: Enterprise Application Integration, the integration of data between applications in a company.]
- 22. 22/ 27 ? I dispense a drug No brain , no cognition. From humans to computersFrom humans to computers
- 23. 23/ 27 The Communication Process Information Model / Data Model Shared Context Concept Refers to Symbolizes Stands for “Drug” Refers toSymbolizes Stands for “Drug” Concept Symbol Symbol I dispense a drug Lexicon (dictionary) ContextContext ContextContext Referent Referent
- 24. 24/ 27 The Communication Process Information Model / Data Model Concept Refers to Symbolizes Stands for Refers toSymboliszs Stands for Concept Symbol Symbol I dispense a drug Lexicon (dictionary) ContextContext ContextContext Formal Shared Context Terminologies Terminologies Referent “Drug” “Drug” Referent
- 25. 25/ 27 How to improve communication ? Define 2 elements : – Semantics / Vocabulary : definition from a dictionary • Ex: dispense blue pharmacist tablet – Syntax / Grammar : structure for the message/sentence • Ex: subject-verb-complement-adjectivesubject-verb-complement-adjective Define the [global english] globish language for pharmaceutical softwares (Formal Shared Context) : HL7-speak “Pharmacist” “dispense” “blue” “tablet”
- 26. 26/ 27 Messages : communication and information • Vocabulary for content : CIOsp (Fr) / DM+D (UK) / G-standaard (NL) – Description of medication content (and model) • Grammar for structure: XML & PN13/HL7v2 – Born with WebPages (HTML), XML defines (only) structure inside messages. – Description of messages in pharmaceutical process
- 27. 27/ 27 Story-boards of our pharmaceutical practices European best practices Seamless computer communication In conclusion … Shared Context