Biomedical Engineering Reference
In-Depth Information
4. the observation has an associated code that indicates that the patient
contracts hives. CDA relies on external vocabularies for describing
specifi c medical concepts. This example is using a code from
SNOMED CT;
5. next, the CDA document describes why the patient gets hives. The
entryRelationship relates two entities, with the typeCode MFST
meaning manifestation;
6. another observation, this time of an adverse reaction;
7. fi nally, a name value pair indicating penicillin as the cause.
20.3 Mirth
With both HL7 V2 and V3, it is tempting to build individual scripts or
programs to handle each of the different interactions. There are open
source toolkits in a variety of languages for parsing and manipulating
HL7 messages. For example, the Perl HL7 toolkit [4] could be used to
write a script that reads an HL7 orders feed, processes it, and outputs the
results needed into an analytics database. The problem is that this sort of
solution is very diffi cult to scale out to meet the needs of a modern
hospital for the following reasons:
1. Large effort to write and maintain
■
Implementers should consider not only the time it takes to write
all of those scripts/programs but also maintaining the scripts.
This includes keeping some form of version control for each of
the scripts and updating them as applications change.
2. Duplication of effort
■
Implementers often spend a large amount of time on
'housekeeping' items such as fi le and database processing.
■
Many of the scripts/programs will be very similar with slight
differences in the business logic.
3. Fragility
■
Implementers have to account for connectivity and application
failures in each of the scripts/programs.
■
There will be no way to monitor all of the scripts/programs
for errors or failures unless a monitoring framework is
implemented.
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