Development Of Profiling Framework And Classification System For Traditional Chinese Medicine Informatics Standards

The importance of standardization of Health informatics is recognized by most countries in the world. There are two key problems in the informationization of Traditional Chinese Medicine (TCM):Firstly, a large amount of information which is valuable and has ’TCM characteristics’ can not be recorded and denoted sufficiently and effectively due to the defect of TCM informatics standards; secondly, the clinical information systems of TCM are incompatible with international standards, thus, there is no foundation for the information interchange between the clinical information systems of TCM and other health information systems. The solution is to plan the development of TCM informatics standards in order to ensure that the standards are systematic, practical and scienctific.Standardization in the field of information for health is to promote interoperability between independent systems, to enable compatibility and consistency for health information and data, as well as to reduce duplication of effort and redundancies. Framework and information model play important role in the development of standards. The trends of information standards development is from ’application driven’ method to ’information model driven’ method,viz., to construct framework and reference information model with Unified Modeling Language, to define the relationship between standards so that all the standards would be unified into organic, consistent system.Currently, the method for TCM informatics standards development lagged behind that for the international health informatics standards development. In order to ensure the TCM informatics standards to be systematic, practical and scienctific, framework and classification diagram for TCM informatics standard system should be established with international informatics framework methodology. The description of content and application purpose of TCM information standards would come to consencus and the relationship between TCM informatics stnadards and other health informatics standards would be set up, therefore, the coordinability and consistency of TCM informatics standards with international and national health informatics standards would be realized. In the study,Research Methodologies of framework and Classification diagram for Traditional Chinese Medicine(TCM) informatics standard system development were proposed based on the objective principle, systematic principle, scientific principle and practical principle. The methodologies include:Ⅰ. Framework for TCM informatics standard system development should be constructed based on ’top to bottom’-administration driven method.Ⅱ. TCM information conceptual model should be constructed on ’bottom to top’-business driven method.Ⅲ. Mapping with HL7CDA HD. Ⅳ. Standards Needs for TCM clinical practice should be analyzed according to the value set of data elements with TCM characteristics, thereby, the Classification diagram for TCM informatics standard system would be worked out. In addition, the research roadmap was traced out in order to provide a reference to the other health informatics standards development.There are mainly four parts in this dissertation.Part Ⅰ:Article Review.The current status of internation and national health informatics standards including ISO/TC215, health information interchange standards, clinical terminology was reviewed, and the status of framework and Classification diagram for other information fields as well.Part Ⅱ:preface.Problems and Potential effects were analyzed and the necessary route to solve these problems were addressed.Part Ⅲ:The main text.1. Based on ISO/TC215Health informatics profiling framework and Classification Matrix (HIPF) and categories of Health informatics standards of ISO/TC215,the framework and classification matrix for TCM was developed. The basic construct of the two-dimensional HIPF classification matrix including three rows of specificity and six columns of perspectives provides a means of identifying and classifying the content of a TCM informatics standards artifact. Levels of specificity provide differentiation of TCM informatics standards artefacts by defining levels that move from abstract to exact implementation specifications-Conceptual, logical and physical design levels. Levels of Perspectives was divided into data standards for TCM EMRs, TCM clinical terminologies, information system standards and medical devices communication standards for TCM. This framework provides great capacity and makes the standards artifacts related systematically. It will benefit for the planning, developing and generalizing of TCM informatics standards.2. In order to denote, define and confine the data structure of TCM medical records by computer, TCM clinical information conceptual model was constructed with four steps:①TCM clinical business was analyzed in this study, and business model was constructed based on literature investigation, expert consultation, meeting interview, site survey methods.TCM characteristic information flow includes four diagnostic check, physical pattern identification, disorders diagnosis, therapeutic principle and methods and TCM prescription Herbal drugs prescription, acupuncture prescription, moxibustion prescription, cupping prescription, electro-acupuncture prescription, tuina manipulation and et,al).②TCM clinical information descriptive module was set up based on the above information collection demands.③Data elements with TCM characteristics were abstracted based on the information flow.④TCM clinical information conceptual modeling.3. Mapping TCM data elements with HL7R-MIM data elements and verifying the applicability of representation of TCM information with HL7V3model. The demand for standards development was concluded by analyzing the classification and coding of value domain for TCM data elements. Meanwhile, the demand for standards development of TCM clinical information system and TCM diagnostic and therapeutic device information communication was studied.4. Clarifying the relationship between TCM clinical information data elements with HL7, health data elements and clinical terminological standards.5. The framework and Classification diagram for TCM was developed,and the statistical data for the international standards and industrial standards was provided. Part Ⅳ:appendix.Appendix A Example for ISO health informatics profiling framework.Appendix B List of the health informatics standards developed by ISO/TC215for capacity test.Appendix C Residency medical record (section)Appendix D Example for TCM prescriptionsAppendix E Data Structure of EMRAppendix F Data types of HL7V3Main innovative points1.Data elements with TCM characteristics were extracted based on TCM clinical business modeling and TCM clinical information conceptual modeling.2. Mapping TCM data elements with HL7R-MIM data elements based on HL7framework and verifying the applicability of representation of TCM information with HL7V3model.3. The principle,"modelling driven" methodology and research route of framework and Classification diagram for TCM were studied, and framework and Classification diagram for TCM was constructed.