HL7 and/or DICOM Worklist discussion

[Jodin]

As a developer of medical solutions we are familiar with and practice HIPAA compliant practices in our applications. But we also desire to connect with other hospital databases through either HL7 and/or DICOM. I was wondering if anyone else has researched such connectivity through FM7 and would like to discuss it in this thread.

[dkemme]

This is my next problem as well. I know of no ready to go solutions for connectivity in HL7 for FM.

[Jodin]

Yeah, this could be a huge market for FMI if they address healthcare issues. They like to talk about it and market it but there's been no movement in the developer community to get together healthcare-related plug-ins, code, and practices (such as HL7, PACS integration, and DICOM). Of course FMP can be used in a healthcare environment but it's generally kept away from critical data in larger departments because of security issues or it's dirt-slow ODBC.

[thomi]

i'm a dev on 4D, i've tested a plug-in from "Escape" (nothing for FMP), they propose a toolkit:

"DTk: Escape's QuickTime-based DICOM Imaging toolkit"

http://www.escape.gr/dicom/developer/index.html

i'm also looking for an easier solution because i'm newbie on FMP .

[Brian C]

I dont know much about HL7 or PACS, but when you speak of attempting to connect to these other systems, are you talking about periodic synchronization thru import/export files or actually talking directly to these systems to do direct queries?

[dkemme]

HL7 to my very basic understanding is a superset of HTTP to allow presenting and sharing of results from medical systems. For FMP to read a file presented in HL7 or to export a result to HL7, a text file would be created with the tags for identification of patient and then results in the HL7 format.

[Brian C]

Could you provide a sample of the data format for download so i can get a more practical look at the formatting of the file?

[Tim Griffith]

I am currently developing in FMP11 an HL7/RIM model based EHR/HL7 transmission/Claims filing, EHR and Practice Management solution. Our base target demographic is small to medium Health Providers up to FMSA recommendation of 250 seats. The idea of HL7 in FMP is very workable.

I would disagree with the comment that HL7 is in anyway derived from HTML, it was an industry (non)standard developed over a long period of time until someone realized it was getting out of control (and proprietary), so then someone decided to create a model that HL7 was resembling- the RIM model- and then successive generations of HL7 began to conform and level itself.

It uses a hierarchical structure method, that at the top level classes itself well, but at the lower levels becomes incredibly nebulous, unnecessarily recursive (due to its out of control phase just before the advent of the RIM model)- and just a jumble of not well thought out add ons to an otherwise elegant structure.

In our solution we are strictly adhering to the RIM class model of how EHR data is structured- this makes the generating/sending and receiving of HL7 less logic-reliant, more friendly for method/scripting, and effortlessly extensible.

Definitely a separation model project- not one relation, validation, etc. in the table files. The HL7 standards change very rapidly. A new version appears about every 18 to 24 months. Our separation model uses three levels, table, data definition (the codified HL7 structure), and GUI. Almost all logical, evaluative and assumptive actions rely on data and data properties. Thus, new incarnations of HL7 v2.x will require only modified data in the data definition layer- no table changes, and very little changes to the GUI.

By the time we are ready to present product, scheduled for June of this year, we will have also adopted the XML transmission capabilities for v2.x, and incorporated v3 (exclusively XML) capabilities. Version 3.x will be industry standard by 2016.

Here's a helpful hint if you are venturing to develop anything HL7 based... Segment details run the entire logical process. Segment details lie in the middle of the hierarchical structure.

I am living in the one place you can starve being a FMP developer. St. Louis Missouri. I've been developing FM for 3 different companies for the past 18 years- the last being a large genetic seed manufacturing company headquartered in this area. My project with them ended last April. While looking for employment, I teamed up with a programmer and together we launched this endeavor.

I know that I'd fare better in Chicago, or the coasts, but, although long single, I want to remain near my children, at least until the youngest one heads to college.

[James Gill]

I have successfully tested FMP and HL7 integration using a suite of programs from InterfaceWare (http://www.interfaceware.com) called Chameleon and Iguana. Once you get to know how their tools work it is very easy to get integrated in to FMP and Filemaker Server. I had some issues with their ODBC driver for Mac OS X Server but I got the whole suite working in a Virtual box running Windows XP.

Ultimately we didn't end up buying the program since our HL7 needs weren't properly analyzed but the InterfaceWare engineers were very helpful in troubleshooting Mac OS X issues. They also have an entire walkthrough and instructions available on their website on how to integrate Iguana and Filemaker Pro. Overall it's a very easy (but a little pricey) product to use.

They also have a very informational section on their website that explains exactly how HL7 works and what each message segment does.