Ringholm Whitepapers

Latest whitepapers
History of the HL7 RIM The history of the RIM goes back to the MEDIX organization (1986) who introduced the concept of a common healthcare data model. this paper covers the major steps in the development of the HL7 RIM as we know it today. Intended audience: general.	English/HTML
New features of HL7 2.7 This document provides an overview of the of the additional functionality as offered by the HL7 2.7 standard when compared to HL7 2.6. Intended audience: implementers.	English/HTML
An explanation of HL7 version 3 in terms of HL7 version 2 HL7 version 3 is an entirely new standard - this paper aims to explain some of the features of HL7 version 3 using HL7 version 2 terminology. The reader is assumed to be familiar with HL7 version 2. Intended audience: standard users.	English/HTML

Integration strategies and technologies

AORTA, the Dutch national infrastructure AORTA is the Dutch national infrastructure for the exchange of data between healthcare providers. The focus of this program is to facilitate the realization of a national "continuity of care" oriented EPR. AORTA uses HL7 version 3 messages and documents as its core mechanism for information exchange. This whitepaper describes the key components of the infrastructure. Intended audience: Analysts.	English/HTML
Implementing Web Services in Dutch Healthcare Healthcare in the Netherlands is moving rapidly towards an infrastructure where XML data will be exchanged over the Internet. This whitepaper discusses the implementation issues and pitfalls discovered during the implementation of web services, and more specifically SOAP and WSDL, in this large and complex environment. Intended audience: integration analysts.	English/HTML
The NPfIT Spine, an English national programme This document describes the architecture of the English NPfIT Spine (the national IT infrastructure for healthcare). Its aim is to provide a commonly accessible patient based resource, making information from multiple sources available to all those with a legitimate care relationship to the patient. The architecture of the Spine is based on a centralized partial care record, supported by directory services and HL7 version 3 messaging. Intended audience: Analysts.	English/HTML
Creating a messaging interface This paper discusses the integration issues a vendor has to deal with during the process of developing a messaging interface for an application. Intended audience: Software development managers, Integration engineers.	English/HTML
Act Reference Registries This document provides an overview of the Act Reference Registry (Dutch: verwijsindex), part of the planned Dutch national infrastructure. The Act Reference Registry contains a set of metadata which supports the retrieval process of care related data from various systems when required by a healthcare provider. Intended audience: General.	English/HTML Dutch/HTML
Message Brokers This document provides an overview of the role of a Message Broker in a systems integration project. Intended audience: IT management.	English/HTML  German/HTML  German/PDF

IHE (Integrating the Healthcare Enterprise)

An implementation framework based on messaging standards This paper provides a high-level overview of the IHE framework and some of the results of the European connectathon held in Padova in March 2004. Intended audience: IT management, standard developers, integration analysts.

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DICOM Imaging

The DICOM standard, overview and characteristics This paper provides a high-level overview of the characteristic elements of the Digital Imaging and Communications in Medicine (DICOM) imaging standard. Intended audience: IT management, integration analysts.	English/HTML
The seven levels of PACS integration This document describes seven different levels of PACS integration, ranging from No Integration up to API Level Integration. The current trend seems to gravitate towards the use of messaging standards (e.g. DICOM) and integration profiles (e.g. IHE). All integration levels have their advantages and disadvantages. Intended audience: General.	English/HTML
Structured Reporting, a Powerful DICOM mechanism This paper contains a description of the structure and the usage areas of DICOM Structured Reporting (SR). Intended audience: Integration analysts.	English/HTML

HL7 Modeling

History of the HL7 RIM The history of the RIM goes back to the MEDIX organization (1986) who introduced the concept of a common healthcare data model. this paper covers the major steps in the development of the HL7 RIM as we know it today. Intended audience: general.	English/HTML
An explanation of HL7 version 3 in terms of HL7 version 2 HL7 version 3 is an entirely new standard - this paper aims to explain some of the features of HL7 version 3 using HL7 version 2 terminology. The reader is assumed to be familiar with HL7 version 2. Intended audience: standard users.	English/HTML
The HL7 MIF - Model Interchange Format The Model Interchange Format (MIF) is a set of XML formats used to support the storage and exchange of HL7 version 3 artefacts as part of the HL7 Development Framework. It is the pre-publication format of HL7 v3 artefacts used by tooling. It is also the formal definition of the HL7 metamodel. The MIF can be transformed -to a certain degree- into UML/XMI. Intended audience: standard implementers, standard developers.	English/HTML
HL7 v3 RIM Act Essentials: moodCode The semantic interpretation of the Act class in the HL7 version 3 RIM heaviliy relies on one of its properties: its mood. This whitepaper attempts to explain the concept of mood - a lot of examples are provided in the process. Related concepts such as the ActClass, ActStatus and the impact of the NegationIndicator are also covered. Intended audience: standard users.	English/HTML
Common issues found in implementations of the HL7 Clinical Document Architecture (CDA) A large number of XML instances of HL7's CDA R2 standard were examined in detail. Two different tools, based on the CDA R2 XML schema and the CDA R2 MIF, were used to identify issues and errors. The issues identified are mainly related to the intent of the CDA standard and to misinterpretations of the underlying data type standard. The paper contains recommendations as to how these issues could have been detected and avoided. The reader is assumed to be familiar with the CDA R2 standard. Intended audience: standards implementers.	English/HTML
The RIMBAA Technology Matrix An increasing number of software implementations in healthcare use a HL7 version 3 RIM based application architecture (RIMBAA). The subject of this whitepaper, the RIMBAA Technology Matrix, was created in order to be able to identify the architectural choices used by the designers of these applications in a technology independent fashion. This in order to determine a set of generic approaches and best practices related to the use of HL7 version 3 RIM-based models for purposes other than messaging. Intended audience: Software Architects	English/HTML
An Overview of OIDs used in European HL7 Artefacts This document provides an overview of the of OIDs (Object Identifiers) assigned by the European HL7 affiliates. Intended audience: HL7 version 3 implementers.	English/HTML
HL7 version 3: Messages or CDA Documents? HL7 creates open standards for the exchange, management and integration of electronic healthcare related data. Its standards are both based on the messaging (HL7 v2.x, HL7 v3 messaging) as well as on the document (HL7 v3 documents – CDA) paradigm. Given the choice: what should one use given a particular use-case? Intended audience: Analysts.	English/HTML

HL7 Messaging

New features of HL7 2.7 This document provides an overview of the of the additional functionality as offered by the HL7 2.7 standard when compared to HL7 2.6. Intended audience: implementers.	English/HTML
SAP IS-H Interfacing capabilities What interfacing capabilities does the SAP IS-H application have, and how do I support HL7 interfaces? That question is at the heart of this whitepaper. It describes the three interfacing options and how those can be used to import and export data. Intended audience: implementers.	English/HTML
HL7 Message examples: version 2 and version 3 This whitepaper contains 2 use case descriptions. Each use case could be supported by either the HL7 v2.x or the HL7 v3 messaging standard. Each example use case has two example messages associated with it: a HL7 v2.x message, and its functional equivalent in v3. The whitepaper aims to show some the differences as well as similarities between example v2.x and v3 message instances. Intended audience: standards implementers.	English/HTML
New features of HL7 2.6 This document provides an overview of the of the additional functionality as offered by the HL7 2.6 standard when compared to HL7 2.5. Intended audience: implementers.	German/HTML English/HTML
Navigating the pitfalls: Implementing HL7 version 3 The amount of implementations of the HL7 Version 3 standard, whether in the form of HL7 messages or the HL7 Clinical Document Architectures (CDA), is steadily increasing. This whitepaper contains a number of recommendations for implementers of HL7 version 3 artefacts. It is based on the experiences of other implementers. Intended audience: standards implementers, product architects.	English/HTML
HL7 ADT Messages HL7 ADT messages (Admission, Discharge and Transfer) are a group of messages as defined in the HL7 version 2.x messaging standard. The focus of ADT messages is to convey data related to patient demographics and/or to healthcare encounters (visits). ADT messages are implemented by almost all software applications in a hospital setting. Intended audience: general.	English/HTML
Query messages: the next step in German systems integration ? This paper describes the query-response messaging mechanism in general and lists the main categories of query messages; its aim is to promote the use of query messages in Germany. Intended audience: Integration analists, Integration engineers.	English/HTML  German/HTML  German/PDF
Act Reference Registries This document provides an overview of the Act Reference Registry (Dutch: verwijsindex), part of the planned Dutch national infrastructure. The Act Reference Registry contains a set of metadata which supports the retrieval process of care related data from various systems when required by a healthcare provider. Intended audience: General.	Dutch/HTML
Registries and Master Files The data as contained in healthcare IT applications is synchronized by the exchange of HL7 messages. These messages will refer to the identifiers of commonly used objects such as locations, physicians and laboratory tests. A Registry maintains the identifiers of certain objects. This whitepaper describes HL7 Master Files and Registries. Intended audience: integration analysts.	English/HTML
New features of HL7 2.5 This document provides an overview of the of the additional functionality as offered by the HL7 2.5 standard when compared to HL7 2.4. Intended audience: implementers.	German/HTML English/HTML
The HL7 CX Datatype and the German insurance card The specification of datatypes has been updated in version 2.5 of the HL7 standard. Table 0203 "Identifier Type Code" has been updated and expanded. With the aid of some of the new values in this table the data present on the German insurance card (German: KV-Karte) can now be encoded using the CX datatype. Intended audience: integration analysts.	German/HTML
Role Agents This paper discusses some of the integration issues that have been highlighted by the introduction of the new HL7 version 3 standard. These are identified, and can be covered by a new type of middleware product: a Role Agent. Intended audience: Integration analists.	English/HTML
Historic Movements in HL7 This document provides an overview of how movements are used in HL7. Intended audience: standard developers.	English/HTML
New features of HL7 2.4 This document provides an overview of the of the additional functionality as offered by the HL7 2.4 standard when compared to HL7 2.3.1. Intended audience: implementers.	German/HTML
HL7 Query/Response Conformance Statements This document provides an overview of Query/Response Conformance Statements to be used for HL7 2.x based query and response messages. Intended audience: implementers.	English/HTML