AHIMA ICD-10 ICD-11 switch to ICD-10-CM in the USA;
Imr V3
1. WHO Indicator and Measurement Registry (IMR)
SDMX-HD Summary Data Format
Patrick Whitaker
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2. Definitions
M&E – Monitoring and Evaluation
Summary data – Data summarized from raw, e.g. clinical, data
Indicator – An indicator quantifies and simplifies phenomena and helps us
understand complex realities. Indicators are aggregates of raw and
processed data but they can be further aggregated to form complex indices.
International Institute for Sustainable Development (IISD)
IMR – WHO Indicator and Measurement Registry
SDMX – Statistical Data and Metadata Exchange(ISO/TS 17369:2005)
SDMX-HD – WHO implementation of SDMX for the health domain
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3. Human Nature?
Content Systems
Computers are dumb and precise.
People are brilliant and less precise.
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5. Issues Impacting Interoperability
Multitude of guidelines documents.
Insufficient metadata in indicator definitions.
Competing organizational standards.
Weak harmonization processes.
Lack of a global repository for indicator (and clinical concept) definitions.
Lack of a standard exchange format for summary data.
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6. Focus of Presentation
Message Format Content Reference Model
Individual Data HIC HL7, XML SNOMED-CT, LOINC, ICD HL7 V3, ISO 13606 (OpenEHR)
LIC CCR, CCD, HSR SNOMED-CT, LOINC, ICD HL7 V3, ISO 13606 (OpenEHR)
Summary Data SDMX-HD IMR, SDMX MCV, ISO SDMX
CCD HL7 CCR-based Clinical Document Architecture Continuity of Care Document
CCR ASTM Continuity of Care Record (XML)
DCM ISO Detailed Clinical Model
HIC High Income Country
HL7 Health Level Seven
HSR Health Summary Record
ICD WHO International Classification of Diseases
ISO equal', International Organization for Standardization
IMR WHO Indicator and Measurement Registry
LIC Low Income Country
LOINC Logical Observation Identifiers Names and Codes
RIM Reference Information Model
SDMX Statistical Data and Metadata Exchange
SDMX MCV Metadata Common Vocabulary
SDMX-HD WHO Statistical Data and Metadata Exchange – Health Domain
SNOMED-CT Systematized Nomenclature of Medicine – Clinical Terms
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7. Problems
Varying indicator and measurement definitions.
Solution: WHO Indicator and Measurement Registry (IMR)
Interoperability of computer systems (summary data).
Solution: SDMX-HD data exchange format
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9. Inconsistent and Incomplete Definitions
Source Indicator Name
UNSD Men 15-24 years old with comprehensive correct knowledge of HIV/AIDS, percentage
Percentage of young people aged 15–24 who both correctly identify ways of preventing the sexual
UNAIDS
transmission of HIV and who reject major misconceptions about HIV transmission
Percentage of young women and men aged 15–24 who both correctly identify ways of preventing the sexual
PEPFAR
transmission of HIV and who reject major misconceptions about HIV transmission
Percentage of young women and men aged 15–24 years who both correctly identify ways of preventing the
GFATM
sexual transmission of HIV and who reject the major misconceptions about HIV transmission
WHO Proportion of population aged 15-24 years with comprehensive correct knowledge of HIV/AIDS (%)
Indicator Sources:
UNSD mdgs.un.org/unsd/mdg/Metadata.aspx
UNAIDS data.unaids.org/pub/manual/2009/jc1676_core_indicators_2009_en.pdf
PEPFAR www.pepfar.gov/documents/organization/81097.pdf
GFATM www.theglobalfund.org/en/me/guidelines_tools/?lang=en#toolkit
WHO apps.who.int/gho/indicatorregistry/App_Main/browse_indicators.aspx
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11. IMR
WHO Indicator and Measurement Registry
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12. Indicator and Measurement Registry (IMR)
Definition, management, and harmonization of indicator definitions by WHO and
partners.
Incorporation of international standards.
Human and computer readable definitions.
Global definition distribution.
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17. Harmonization
Establishment of processes to reconcile country and organizational
differences in indicator definitions without duplication.
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24. SDMX History
Evolved from work on GESMES/TS in Central Banking community.
Developed in ISO Technical Committee (TC)154 - Processes, data
elements and documents in commerce, industry and administration.
Note that the version 1.0 of SDMX is ISO Technical Specification (TS)
17369.
Current SDMX version is 2.1.
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25. ISO/TS 17369:2005
Statistical data and metadata exchange (SDMX)
SDMX 2.1 Technical Specification
Section 1 – Framework. Introduces the documents and the content of the revised Version 2.1
Section 2 – Information Model. UML model and functional description, definition of classes, associations and
attributes
Section 3A – SDMX_ML. Specifies and documents the XML formats for describing structure, data, reference
metadata, and interfaces to the registry
Section 3B – SDMX-ML. XML schemas, samples, WADL and WSDL (update: 12 May 2011)
Section 4 – SDMX-EDI. Specifies and documents the UN/EDIFACT format for describing structure and data.
Section 5 – Registry Specification – Logical Interfaces. Provides the specification for the logical registry
interfaces, including subscription/notification, registration of data and metadata, submission of structural
metadata, and querying
Section 6 – Technical Notes. Provides some technical information which may be useful for the
implementation (this was called “Implementor’s Guide” in the 2.0 release)
Section 7 – Web Services Guidelines. Provides guidelines for using SDMX standards to promote
interoperability among SDMX web services
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26. Data exchange standard for summary data.
Defines structure and content of data.
Attributes
– Common
• Interoperability
• Documentation
– Custom
• Local customization
• Harmonization, i.e. support for current definition
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27. XML
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28. SDMX-HD Use
Public Domain Applications
M&E/Surveillance
– DHIS2
– CRIS (planned)
HR
– iHRIS
Clinical
– OSHIP
– OpenMRS
Logistics
– OpenLMIS
Lab
– OpenELIS
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29. SDMX-HD Use
Governments
Implemented
– Sierra Leone
– India
– Netherlands
• National Institute for Public Health and the Environment (RIVM)
• Netherlands Institute for Health Services Research (NIVEL)
In process
– Philippines
Planned
– Viet Nam
– Fiji
– Tonga
– Thailand
– Bangladesh
– China
– WHO Regional Offices
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31. Links
WHO Indicator and Measurement Registry
– Public: www.who.int/gho/indicatorregistry
– Public with write access: extranet.who.int/IndicatorRegistry
Request extranet account from: extranet.who.int/ads
– Web Service www.who.int/gho/indicatorregistryservice
SDMX: www.sdmx.org
SDMX-HD: www.sdmx-hd.org
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