Inter-Installation record retrieval and update

[Alec Bickerton]

I'd like to suggest a feature to allow multiple installation to share records in a secure manner. I've not found if this has already been discussed previously, If it has, please be gentle.

Some scenarios...

Scenario 1 : Ambulance first contact

1. An ambulance crew responds to an emergency call, The find patient that can only provide their name & address.
2. The crew request an summary of known conditions & allergies from their local health authority. They will in turn:
   
1. Find the patients health authority (Could be a broadcast to a JMS topic)
   
2. Each health authority ask all it's doctors office to determine which has the record for the patient (Could be a broadcast to a JMS topic)
3. Only the responsible office(s) respond.
   
1. If multiple the most recent is preferred.
   
3. The health authority queries the known conditions & allergies from the responding doctors office.
4. The response is sent to the ambulance crew via the appropriate authority. No direct contact between doctors office and ambulance should be needed.
   

Scenario 2 : Hospital treatment

1. An ambulance brings in a patient from scenario 1
2. The hospital books them in and provides treatment.
3. The patient record at the Doctors office should be updated to reflect the treatment in the hospital.
1. Find the patients health authority (Could be a broadcast to a JMS topic)
2. Each health authority ask all it's doctors office to determine which has the record for the patient (Could be a broadcast to a JMS topic)
3. Only the responsible office(s) respond.
4. Hospital sends doctors office the treatment event to be added to the record

How it could be done. While keeping down costs.

• Provide a JMS bus for inter-health authority queries. (National queries)
• Hospital -> Ha -> Ha2 ->Doctors office
• Ambulance -> Ha -> Ha2 ->Doctors office
• Provide another bus for intra-health authority queries.(regional)
• Hospital -> Ha -> Doctors office
• Ha ->Ambulance
  
• Define a message specification for common requests
• Find patient record
• Retrieve summary record
• Add treatment
• etc ...
  

The above example is based on the UK NHS as I understand it. I'm a developer, not a healthcare professional, so it's likely to be over simplified.

WDYT?

[Burke Mamlin]

Welcome Alec,

Have you looked at the OpenHIE architecture?  What you describe sounds much like their Health Interoperability Layer, which I believe is Mirth-based.

Cheers,

-Burke

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