Technical aspects of interfaces
A functional interface between two health information systems can be difficult to design and implement. The interface specification system has no standard methodology to deal with, nor do the standard methods to determine how the interface can communicate with the CPOE system and pharmaceutical information system. The problem is exacerbated when systems like CPOE and pharmaceutical information systems are so complex. The data are not only more complex in this case, but a transmission of prescription order error can affect the patient’s treatment directly. As a result, the functional aspects of interface activity must be well understood.
Figure 1 illustrates the basic components of the interface of a CPOE with a pharmaceutical information system. Since the order data can also be transferred from the pharmaceutical system to the CPOE system in the case of bidirectional ordering interfaces ( BOIs), the main objective of the interface is to send a prescription order for processing and compliance from the CPOE system to the pharmaceutical information system. In the CPOE system information is stored in a format compatible with its data and application, whilst in a format compatible with its data set and application the pharmaceutical information system needs the same order data. To receive information from the CPOE system in the pharmacy information system, a translation of one system to another is required.
The interface between an IPOE system and a pharmacy information system has functional components (PIS). Health Level 7 stands for HL7.
Inbound and outbound messages to and from a required format or proprietary standard must be configured by translators on each supplier system according to the interface, for both cpoe and pharmacy information systems. An interface engine is received to send the message across the two systems. Health Level 7 is the most widely agreed framework for the exchange of information between the two translators via the routing motor (HL7). [two]
ISO is a global federation of national regulatory bodies dedicated to the promotion of standardisation and international trade promotion.
The American National Standards Institute is the United States’ national standards association at ISO (ANSI). HL7 is an ANSI developer responsible for developing and publishing standards for the interchange, integration, stocking and retrieval of health data between various data collection, processing, or management systems. Members of HL7 include payers, healthcare consulting firms in california suppliers, producers and others interested in creating and implementing standards for clinical data in the healthcare sector.
Many software providers in the industry have adopted HL7 specifications and implemented them as a messaging standard. Patient information, including insurance details, diagnostic data, allergy data, orders for any clinical departments, test results, and changes made to these data (patient name, address, close of kin, emergence contact information, date of birth, etc.) shall apply. The interface design uses HL7 specifications widely to increase the speed and accuracy of systems. The requirements for HL7 integration and its implementation are detailed and vendors and interface experts often tailor their applicability; therefore the HL7 standards are far from being discussed thoroughly. Readers should consult the HL7 standards for further details.
The CPOE method is assumed to be responsible for translating order details from a patent structure to the HL7 standard (see Figure 1). The Pharmacy Information System then translates the HL7 order message into the message standard required to process the order in the pharmacy information system. In the case of a BOI, each supplier framework must be able to move to and from the HL7 standard. The interface engine has no understanding of the content of the messages and aims solely to establish a communication link between the two systems for message transmission. Although interfaces are defined as unidirectional or bidirectional, a BOI is in effect two distinct and separate interfaces, one for sending and one for receiving messages from each vendor context.
There are a variety of ways to implement interfaces and, depending on software technologies, the interface design may differ greatly. The translators are separate components of the CPOE applications and the pharmaceutical information system, and as shown in figure 1, the interface engine is independent from the translators. Technologies also provide translation and transmission characteristics that are independent of clinical applications and do not require a translation to the HL7 standard. It should be noted that only one example is the interface architecture referred to in this article, with other interface models. This report does not cover the benefits and disadvantages of various motors for interfaces as well as the process of selecting one motor against another.
Once the interface type (unidirectional versus BOI) and the interface engine design are established, the CPOE development team, the pharmaceutique information system vendor team and the interface engine technical team must all agree on the exact mapping of the interface message construction. There are many segments in the HL7 interface message. These segments contain data from the field which can be found in a message. Table 1 shows some segments in a standard HL7 drug message. One section describes the patient, another section specifies the type of message that needs to be taken (pharmaceutical order versus laboratory result) (new order, discontinue order, change order, etc.). Table 2 shows the various steps in response to an order for pharmacies. These activities are carried out in such a way that the general workflow of order production and order processing is similar.
Table 3 provides an example of a typical patient identification section. Numerous fields of information can be described. Certain fields may be required for the sending system or receiving system, while others provide optional information. The mechanism through which both sellers agree to position data for each section in these areas is called mapping. The HL7 standard makes the mapping process work by ensuring that meaning exists in each of the segment areas. However, HL7 makes it possible to develop custom fields that meet the specific requirements of the sending or receiving system. The CPOE and pharmacy information system representatives shall agree upon the location of data in each field in each section. The accepting system must know, in order to use the details, where certain data should be stored in the message section.
Mapping is a time-consuming process, which involves writing detailed explanations of where the data comes from and where the message stream is going. By consistently placing data in the agreed sector, the message must be constructed by the transmitting vendor (CPOE system). The reception system (pharmacological information system) must decipher the messages and put data in the correct place in the pharmacological information system application in order to evoke the correct performance in the receiving system.
The mapping discussions result in a document which sets out how the interface works and how mapping takes place, the information found on messages, interface standards and other functionality specifications. This interface specification document is developed by the CPOE system vendor, the pharmacy information system vendor and the customer (ISD). The HL7 criteria will be noted by the ISD as well.