Metadata Power Team

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Saúde e medicina

HIT Standards Committee Metadata Analysis Power Team Stan Huff, Chair June 22, 2011

Power Team Members ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Power Team Charge ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Patient Identity Summary ,[object Object],Metadata Elements Rationale Additional Suggestions Standard ,[object Object],[object Object],[object Object],[object Object],[object Object],Represent the minimum elements that are required to uniquely select a patient from a population with a guaranteed degree of accuracy ,[object Object],[object Object],Use the HL7 CDA R2 header format. XML based format for describing generic clinical documents can best accommodate international representation of names.

Provenance Summary ,[object Object],Metadata Elements Rationale Additional Suggestions Standard ,[object Object],[object Object],[object Object],[object Object],[object Object],Envelope will provide information permitting the recipient to judge whether a trusted source sent the data, when it was packaged, and whether any content tampering took place. ,[object Object],Metadata elements be expressed using the HL7 CDA R2 format.

PRIVACY

Use Cases from PCAST Analysis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Privacy - Sensitive Information Model ,[object Object],Yes No ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Can the envelope contain sensitive information? Yes No ,[object Object]

Privacy - Rationale for Suggested Metadata ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Out of Scope Infeasible

[object Object],[object Object],[object Object],[object Object],[object Object],Privacy - Suggested Metadata Elements

Privacy Suggestions – Metadata Elements ,[object Object],[object Object],[object Object],[object Object]

Privacy - Standards Comparison

[object Object],[object Object],[object Object],[object Object],[object Object],Privacy - Analyzed Standards Built for online businesses; no capture of content metadata MITRE suggestions : Suggestion Rationale Modify CDA CDA already includes datatype information (using HL7 class codes and document type codes) and sensitivity tags (using confidentiality codes). Modify XDS XDS allows new tags and values to easily be added. Create a new standard ,[object Object],[object Object],[object Object]

Privacy - Use Case Example CDA <?xml version="1.0" encoding="UTF-8"?> <ClinicalDocument xmlns = "urn:hl7-org:v3" classCode = "DGIMG" > <realmCode code = "US" > <typeId root = "2.16.840.1.113883.1.3" extension = "09230” /> <confidentialityCode value = "SDV" /> <code code="34788-0" displayName= "Psychiatric Consult note" codeSystemName="LOINC"/> </ClinicalDocument> IHE XDS <rim:Name> <rim:LocalizedString xml:lang = "en-us" charset = "UTF-8" value = "Generic Image" > </rim:Name> <rim:Name> <rim:LocalizedString xml:lang = "en-us" charset = "UTF-8" value = "Restricted" > </rim:Name> Generic format relies on context to find relevant fields Legitimate values defined by an Affinity Domain Relies on HL7 class hierarchy Limited set of confidentiality codes

Privacy Suggestions - Standards ,[object Object],[object Object],[object Object],[object Object]

Privacy Suggestions - Standard ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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12. Privacy - Standards Comparison

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14. Privacy - Use Case Example CDA <?xml version="1.0" encoding="UTF-8"?> <ClinicalDocument xmlns = "urn:hl7-org:v3" classCode = "DGIMG" > <realmCode code = "US" > <typeId root = "2.16.840.1.113883.1.3" extension = "09230” /> <confidentialityCode value = "SDV" /> <code code="34788-0" displayName= "Psychiatric Consult note" codeSystemName="LOINC"/> </ClinicalDocument> IHE XDS <rim:Name> <rim:LocalizedString xml:lang = "en-us" charset = "UTF-8" value = "Generic Image" > </rim:Name> <rim:Name> <rim:LocalizedString xml:lang = "en-us" charset = "UTF-8" value = "Restricted" > </rim:Name> Generic format relies on context to find relevant fields Legitimate values defined by an Affinity Domain Relies on HL7 class hierarchy Limited set of confidentiality codes

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