1、 I n t e r n a t i o n a l T e l e c o m m u n i c a t i o n U n i o n ITU-T H.860 TELECOMMUNICATION STANDARDIZATION SECTOR OF ITU (04/2014) SERIES H: AUDIOVISUAL AND MULTIMEDIA SYSTEMS E-health multimedia services and applications Multimedia e-health data exchange services Multimedia e-health data
2、exchange services: Data schema and supporting services Recommendation ITU-T H.860 ITU-T H-SERIES RECOMMENDATIONS AUDIOVISUAL AND MULTIMEDIA SYSTEMS CHARACTERISTICS OF VISUAL TELEPHONE SYSTEMS H.100H.199 INFRASTRUCTURE OF AUDIOVISUAL SERVICES General H.200H.219 Transmission multiplexing and synchroni
3、zation H.220H.229 Systems aspects H.230H.239 Communication procedures H.240H.259 Coding of moving video H.260H.279 Related systems aspects H.280H.299 Systems and terminal equipment for audiovisual services H.300H.349 Directory services architecture for audiovisual and multimedia services H.350H.359
4、Quality of service architecture for audiovisual and multimedia services H.360H.369 Supplementary services for multimedia H.450H.499 MOBILITY AND COLLABORATION PROCEDURES Overview of Mobility and Collaboration, definitions, protocols and procedures H.500H.509 Mobility for H-Series multimedia systems
5、and services H.510H.519 Mobile multimedia collaboration applications and services H.520H.529 Security for mobile multimedia systems and services H.530H.539 Security for mobile multimedia collaboration applications and services H.540H.549 Mobility interworking procedures H.550H.559 Mobile multimedia
6、collaboration inter-working procedures H.560H.569 BROADBAND, TRIPLE-PLAY AND ADVANCED MULTIMEDIA SERVICES Broadband multimedia services over VDSL H.610H.619 Advanced multimedia services and applications H.620H.629 Ubiquitous sensor network applications and Internet of Things H.640H.649 IPTV MULTIMED
7、IA SERVICES AND APPLICATIONS FOR IPTV General aspects H.700H.719 IPTV terminal devices H.720H.729 IPTV middleware H.730H.739 IPTV application event handling H.740H.749 IPTV metadata H.750H.759 IPTV multimedia application frameworks H.760H.769 IPTV service discovery up to consumption H.770H.779 Digit
8、al Signage H.780H.789 E-HEALTH MULTIMEDIA SERVICES AND APPLICATIONS Interoperability compliance testing of personal health systems (HRN, PAN, LAN and WAN) H.820H.849 Multimedia e-health data exchange services H.860H.869 For further details, please refer to the list of ITU-T Recommendations. Rec. ITU
9、-T H.860 (04/2014) i Recommendation ITU-T H.860 Multimedia e-health data exchange services: Data schema and supporting services Summary Recommendation ITU-T H.860 specifies a common health schema applicable to a wide range of health systems e.g., clinical and wellness and describes the supporting se
10、rvices and systems architecture for a health data exchange that allows an exchange of multimedia health data between a health provider, a controlling function and a patient. The services this Recommendation describes include both point-of-care and personal healthcare services. History Edition Recomm
11、endation Approval Study Group Unique ID* 1.0 ITU-T H.860 2014-04-13 16 11.1002/1000/12163 Keywords Architecture, data dictionary, e-health, schema. _ * To access the Recommendation, type the URL http:/handle.itu.int/ in the address field of your web browser, followed by the Recommendations unique ID
12、. For example, http:/handle.itu.int/11.1002/1000/11830-en. ii Rec. ITU-T H.860 (04/2014) FOREWORD The International Telecommunication Union (ITU) is the United Nations specialized agency in the field of telecommunications, information and communication technologies (ICTs). The ITU Telecommunication
13、Standardization Sector (ITU-T) is a permanent organ of ITU. ITU-T is responsible for studying technical, operating and tariff questions and issuing Recommendations on them with a view to standardizing telecommunications on a worldwide basis. The World Telecommunication Standardization Assembly (WTSA
14、), which meets every four years, establishes the topics for study by the ITU-T study groups which, in turn, produce Recommendations on these topics. The approval of ITU-T Recommendations is covered by the procedure laid down in WTSA Resolution 1. In some areas of information technology which fall wi
15、thin ITU-Ts purview, the necessary standards are prepared on a collaborative basis with ISO and IEC. NOTE In this Recommendation, the expression “Administration“ is used for conciseness to indicate both a telecommunication administration and a recognized operating agency. Compliance with this Recomm
16、endation is voluntary. However, the Recommendation may contain certain mandatory provisions (to ensure, e.g., interoperability or applicability) and compliance with the Recommendation is achieved when all of these mandatory provisions are met. The words “shall“ or some other obligatory language such
17、 as “must“ and the negative equivalents are used to express requirements. The use of such words does not suggest that compliance with the Recommendation is required of any party. INTELLECTUAL PROPERTY RIGHTSITU draws attention to the possibility that the practice or implementation of this Recommenda
18、tion may involve the use of a claimed Intellectual Property Right. ITU takes no position concerning the evidence, validity or applicability of claimed Intellectual Property Rights, whether asserted by ITU members or others outside of the Recommendation development process. As of the date of approval
19、 of this Recommendation, ITU had not received notice of intellectual property, protected by patents, which may be required to implement this Recommendation. However, implementers are cautioned that this may not represent the latest information and are therefore strongly urged to consult the TSB pate
20、nt database at http:/www.itu.int/ITU-T/ipr/. ITU 2015 All rights reserved. No part of this publication may be reproduced, by any means whatsoever, without the prior written permission of ITU. Rec. ITU-T H.860 (04/2014) iii Table of Contents Page 1 Scope . 1 2 References . 1 3 Definitions 1 3.1 Terms
21、 defined elsewhere 1 3.2 Terms defined in this Recommendation . 1 4 Abbreviations and acronyms 2 5 Conventions 3 6 Overview of the current data standard challenges in healthcare 3 6.1 Health data transactions 5 6.2 Common health data schema 5 6.3 Service architecture 6 6.4 Collaborative development
22、process 6 7 Systems overview . 7 7.1 Participants . 7 7.2 Transaction types 8 7.3 Transmission . 8 7.4 Validation and storage 8 7.5 Analysis 8 7.6 Statistics and insights . 8 7.7 Governance . 9 8 Common health data schema 9 9 Health transactions 11 10 Health transactions transmission 11 11 Validatio
23、n . 12 Annex A Common health data schema . 13 Annex B Health transactions. 20 Annex C Validation rules definition . 23 Appendix I Illustrative governance model 33 I.1 Collaborative development framework 33 Appendix II Health transactions XML 35 II.1 ClaimSubmission 35 II.2 Remittance.Advice . 36 II.
24、3 DataSubmission 36 Appendix III Web services definition . 40 III.1 UploadTransaction . 40 III.2 GetNewTransactions 40 III.3 DownloadTransaction . 40 iv Rec. ITU-T H.860 (04/2014) Page III.4 SetTransactionDownloaded 41 III.5 CheckNewPriorAuthorizationTransactions 41 III.6 GetNewPriorAuthorizationTra
25、nsactions 41 III.7 GetPrescriptions . 41 III.8 SearchTransactions . 42 III.9 Web services returned values . 43 III.10 XML format 43 Appendix IV Illustrative use case . 44 Appendix V Illustrative implementation architecture . 48 V.1 Centralized health exchange . 48 V.2 Peer-to-peer health exchange .
26、48 Appendix VI Data standards for national workflow and low resource settings . 50 VI.1 National workflow in a high resource setting . 52 VI.2 National workflow in a low resource setting 52 Appendix VII Continua Design Guidelines Illustrative use case 54 VII.1 Continua pulse oximeter reading 55 VII.
27、2 Continua thermometer reading . 61 Bibliography. 66 Rec. ITU-T H.860 (04/2014) 1 Recommendation ITU-T H.860 Multimedia e-health data exchange services: Data schema and supporting services 1 Scope This Recommendation defines the following for health data exchange: A common health data schema to form
28、 a common language, for all participants in the health system, to exchange health information. Formats and mechanisms for exchanging health information. 2 References The following ITU-T Recommendations and other references contain provisions which, through reference in this text, constitute provisio
29、ns of this Recommendation. At the time of publication, the editions indicated were valid. All Recommendations and other references are subject to revision; users of this Recommendation are therefore encouraged to investigate the possibility of applying the most recent edition of the Recommendations
30、and other references listed below. A list of the currently valid ITU-T Recommendations is regularly published. The reference to a document within this Recommendation does not give it, as a stand-alone document, the status of a Recommendation. ISO 3166-1 ISO 3166-1 (2013), Codes for the representatio
31、n of names of countries and their subdivisions Part 1: Country codes. ISO 4217 ISO 4217 (2008), Codes for the representation of currencies and funds. 3 Definitions 3.1 Terms defined elsewhere None. 3.2 Terms defined in this Recommendation This Recommendation defines the following terms: 3.2.1 e-clai
32、m: A digital representation of a medical bill generated by a health provider for submission using telecommunications to a controlling function. 3.2.2 prior request: A process initiated by a health provider to obtain permission from a controlling function prior to providing service to a patient. 3.2.
33、3 prior authorization: An approval provided by a controlling function to a health provider to provide service to a patient. 3.2.4 remittance advice: An explanation of payment provided by the controlling function, which provides details about the health providers e-claim payment. A denied e-claim wou
34、ld contain the required explanations for denial. 2 Rec. ITU-T H.860 (04/2014) 4 Abbreviations and acronyms This Recommendation uses the following abbreviations and acronyms: API Application Programming Interface APR-DRG All Patient Refined Diagnosis Related Group AR-DRG Australian Refined Diagnosis
35、Related Group ASN.1 Abstract Syntax Notation One CCAM Common Classification of Medical Procedures CCI Cardiovascular Credentialing International CEN/TC 251 Comit Europen de Normalisation Technical Committee 251 CHDS Common Health Data Schema CMS Care Management System CPT-4 Current Procedural Termin
36、ology (4th Edition) CPT-5 Current Procedural Terminology (5th Edition) DICOM Digital Imaging and Communications in Medicine DRG Diagnosis Related Group EHR Electronic Health Record ESB Enterprise Service Bus e-Health Electronic Health e-Prescription Electronic Prescription GO Gebhrenordnung fr rzte
37、(fees for doctors (medical fee schedule) HCPCS Healthcare Common Procedure Coding System HIE Health Information Exchange HIPPA Health Insurance Portability and Accountability Act HIS Hospital Information System HL7 Health Level Seven International HTTPS Hypertext Transfer Protocol Secure ICD Interna
38、tional Classification of Diseases ICD-9 International Classification of Diseases, 9th Edition ICD-9-CM International Classification of Diseases, 9th Edition, Clinical Modification ICD-10 International Classification of Diseases, 10th Edition ICD-10-PCS International Classification of Diseases, 10th
39、Edition Procedure Coding System ICD-11 International Classification of Diseases, 11th Edition ICPC-2 International Classification of Primary Care, Second edition ID Identifier IEEE Institute of Electrical and Electronics Engineers Rec. ITU-T H.860 (04/2014) 3 IHE Integrating the Healthcare Enterpris
40、e IR-DRG International-Refined Diagnostic Related Group ISO International Organization for Standardization ISO/TC 215 ISO/Technical Committee 215 Health informatics LOINC Logical Observation Identifiers Names and Codes m-Health mobile Health MS-DRG Medicare Severity Diagnosis Related Group NCD Non C
41、ommunicable Disease NGO Non-Governmental Organization NHS National Health Service NOMESCO Nordic Medico- Statistical Committee OPS-301 Operationen und Prozedurenschlssel 301 SGB V OPCS-4.6 Office of Population Censuses and Surveys Classification of Interventions and Procedures RIM Reference Informat
42、ion Model SMS Short Message Services SSL Secure Socket Layer Swiss-DRG Swiss Diagnosis Related Group TARMED Tarif Mdical (medical fee) WHO World Health Organization XML Extensible Markup Language 5 Conventions In this Recommendation: The expression “is required to“ indicates a requirement which must
43、 be strictly followed and from which no deviation is permitted if conformance to this Recommendation is to be claimed. The expression “is recommended to“ indicates a requirement which is recommended but which is not absolutely required. Thus this requirement need not be present to claim conformance.
44、 The expression “can optionally“ indicates an optional requirement which is permissible, without implying any sense of being recommended. 6 Overview of the current data standard challenges in healthcare Worldwide, healthcare outputs are flattening while costs continue to increase. It is widely accep
45、ted that electronic health (e-health) systems hold great promise, in a broad range of health systems worldwide, for improving global access to healthcare services, improving health system performance and improving health outcomes. And yet, technological obstacles continue to hinder the promise of e-
46、health systems; these include the lack of global interoperability standards for e-health and technical 4 Rec. ITU-T H.860 (04/2014) infrastructure barriers b-ITU-T TWR-EH-2011. In the interests of addressing these technological obstacles, this Recommendation proposes an additional global interoperab
47、ility standard for e-health. There is already a rich ecosystem of standards for e-health, including telecommunications and messaging standards (e.g., short message service (SMS) and extensible markup language (XML) b-W3C XML 1.0), specific health code sets (e.g., for diagnosis, clinical treatment an
48、d clinical observations), and e-health standards including digital imaging and communications in medicine (DICOM), Comit Europen de Normalisation Technical Committee 251 (CEN/TC 251), Health Level Seven International (HL7), Integrating the Healthcare Enterprise (IHE), ISO/Technical Committee 215 Hea
49、lth informatics (ISO/TC 215), ISO/IEEE 11073 b-ISO/IEEE 11073 and ITU-T technology watch report b-ITU-T TWR-EH-2012. One prominent and widely adopted set of standards are those developed by HL7 b-HL7-RIM. “Open integration“ models (such as those developed by HL7) allow for a broad range of data to be transmitted (e.g., messages, documents, services) under the definition of the standard. However, there remains scope for difference
