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SS-MIX: A Ministry Project to Promote Standardized Healthcare Information Exchange
17 February 2010
accepted: 29 January 2010
18 January 2018 (online)
Objectives: To promote healthcare information exchange between providers and to allow hospital information systems (HIS) export information in standardized format (HL7 and DICOM) in an environment of widespread legacy systems, which only can export data in proprietary format.
Methods: Through the Shizuoka prefecture EMR project in 2004–2005, followed by the ministry’s SS-MIX project, many software products have been provided, which consist of 1) a standardized storage to receive HL7 v2.5 mes sages of patient demographics, prescription orders, laboratory results, and diagnostic disease in ICD-10, 2) a referral letter creation system, 3) a formatted document creation system, 4) a progress note/nursing record system, and 5) an archive/viewer to incorporate incoming healthcare data CD and allow users to view on HIS terminal. Meanwhile, other useful applications have been produced, such as adverse event reporting and clinical information retrieval. To achieve the above-mentioned objectives, these software products were created and propagated, because users can use these software products, provided that their HIS can export the above information to the standardized storage in HL7 v2.5 format.
Results: In 20 hospitals of Japan, the standardized storage has been installed and some applications have been used. As major HIS vendors are shipping HIS with HL7 export function since 2007, HIS of 594 hospitals in Japan became capable of exporting data in HL7 v2.5 format (as of March 2010).
Conclusions: In high CPOE installation rate (85% in 400+ bed hospitals), though most of them only capable of exporting data in proprietary format, prefecture and ministry projects were effective to promote healthcare information exchange between providers. The standardized storage became an infrastructure for many useful applications, and many hospitals started using them. Ministry designation of proposed healthcare standards was effective so as to allow vendors to conform their products, and users to install them.
- 1 Agarwal G, Crooks VA. The nature of informational continuity of care in general practice. Br J Gen Pract 2008; 58 556 e17-24.
- 2 Olola CH, Rowan B, Narus S, Hales J, Poynton M, Nebeker J, Evans RS. Enhancing continuity of care through an emergency medical card at Intermountain Healthcare: using Continuity of Care Record (CCR) standard. AMIA Annu Symp Proc 2007; 11: 1063.
- 3 Dolin RH, Giannone G, Schadow G. Enabling joint commission medication reconciliation objectives with the HL7/ASTM Continuity of Care Document standard. AMIA Annu Symp Proc 2007; 11: 186-190.
- 4 Campbell SL. HL7 (Health Level 7) – the future becomes a reality. Health Inform 1990; 7 (05) 24-26.
- 5 Wang Y, Best DE, Hoffman JG, Horii SC, Lehr JL, Lodwick GS, Morse RR, Murphy LL, Nelson OL, Perry J. ACR-NEMA digital imaging and communications standards: minimum requirements. Radiology 1988; 166 (02) 529-532.
- 6 Spilker C. The ACR-NEMA Digital Imaging and communications Standard: a nontechnical description. J Digit Imaging 1989; 2 (03) 127-131.
- 7 Kimura M, Ohyama N, Inamura K, Ando Y, Shigemura N, Shima Y, Saito T. IS&C (Image Save & Carry) standard: standardized exchange media for medical information. Proc MEDINFO-95 1995; 8 Pt (01) 207-211.
- 8 Kimura M. Role of standardization. Comput Meth Prog Bio 1994; 43 (01) 19-20.
- 9 Rishel W. Standards seen as a key to managing healthcare costs. Comput Healthc 1992; 13 (11) 23-24.
- 10 Kimura M, Tani S, Sakusabe T. Towards Japanese EHR; Shizuoka Style EMR Project, Deployment Stage, Proceedings of CJKMI2005, China-Japan-Korea Conference on Medical Informatics, Shenzhen, China, Nov. 10, 2005 pp 4-5.
- 11 Kimura M, Hirai M. HL7 Japan CDA Referral Document Deploys Nationwide. M2 Keynote, International HL7 Interoperability Conference IHIC 2006. Cologne, Germany, August 25, 2006
- 12 http://sciencelinks.jp/j-east/article/200122/000020012201A0334640.php or (in Japanese) Tsuchiya F. The future view and problems of standardization of drug code. Gekkan Yakuji 1998; 40 (11) 85-88
- 13 Kimura M, Kanno T, Tani S, Satomura T. Standardizations of clinical laboratory examinations in Japan. Int J Med Inform 1998; 48: 239-246. Or (in Japanese) Japanese Society of Laboratory Medicine. Laboratory test code, the 10th time revision. Rinshou Byouri Shuppan 1998 or http://www.jslm.org/ )
- 14 The Ministry of Health, Labour and Welfare standard EMR Promotion Committee final report. 2005 (See also: Shin-Iryo, 2005 July, pp 75-78. ) (in Japanese)
- 15 Kimura M, Ohe K, Yoshihara H, Ando Y, Kawamata F, Tsuchiya F, Furukawa H, Horiguchi S, Sakusabe T, Tani S, Akiyama M. MERIT-9: a patient information exchange guideline using MML, HL7 and DICOM. Int J Med. Inform 1998; 51: 59-68.
- 16 Schadow G, Russler DC, Mead CN, McDonald CJ. Integrating medical information and knowledge in the HL7 RIM. Proc AMIA Symp 2000 pp 764-768.
- 17 Lee CJ, Hornik RC. Physician trust moderates the Internet use and physician visit relationship. J Health Commun 2009; 14 (01) 70-76.
- 18 http://wiki.ihe.net/index.php?title=Portable_Data_for_Imaging
- 19 http://www.hci-bc.com/ss-mix/eng/index.html
- 20 Kimura M. General Purpose Portable Data: MERIT-9 Referral document conforming both HL7 CDA R2 and IHE PDI. (Portable Data for Image) in Shizuoka Prefecture EHR project. The 6th HL7 International Affiliates Meeting & The 4th Asia-Pacific HL7 Conference on Healthcare Information Standards, Taipei, Taiwan, July 21, 2005
- 21 Kimura M, Takenouchi K. Adverse Event Report on IHE RFD, (Retrieve Form for Data capture) with Japan’s Ministry Project SS-MIX. An HL7 Standardized HIS Data Export Promotion. Proc. of CDISC Interchange North America 2009, Baltimore, MD, November 12, 2009
- 22 Kimura M. et al. High-Speed Clinical Data Retrieval System with Event Time Sequence Feature. Methods Inf Med 2008; 47: 560-568.
- 23 Furuta T. et al. CYP2C19 genotype is associated with symptomatic recurrence of GERD during maintenance therapy with low-dose lansoprazole. Eur J Clin Pharmacol 2009; 65 (07) 693-698.
- 24 Kimura M. Genome Data into cloned Whole Clinical Database?. Quick and Safe Tool for Genomic Study. Proc of 2009 Summit on Translational Bioinformatics, American Medical Informatics Association, March, 2009
- 25 Kimura M. Study for Japanese version EHR realization, the opinion poll about the medical informatics among citizens. , the 2008 FY Ministry of Health, Labour and Welfare grant-in-aid scientific research report 2009 (in Japanese)
- 26 Morin RL. Outside images on CD: a management nightmare. J Am Coll Radiol 2005; 2 (11) 958.
- 27 ISO/IEC 18033-3: 2005 Information technology – Security techniques – 37 Encryption algorithms – Part 3: Block ciphers
- 28 http://wiki.ihe.net/index.php?title=Cross-Enterprise_Document_Sharing
- 29 Kimura M. Image Sharing, EHRs and IHE®: Specific IHE Profiles and Experiences from Around the World. RSNA2009 (Radiology Society of North America) session II42, December 3, 2009. Chicago, IL.:
- 30 Giokas D. Canada’s Interoperable EHR, Infoway chooses the more challenging path, the greater benefits. J AHIMA 2008; 79 (05) 56-57.
- 31 Becker MY. Information governance in NHS’s NPfIT: a case for policy specification. Int J Med Inform 2007; 76 5–6 432-437.
- 32 Jian WS, Hsu CY, Hao TH, Wen HC, Hsu MH, Lee YL, Li YC, Chang P. Building a portable data and information interoperability infrastructure framework for a standard Taiwan Electronic Medical Record Template. Comput Methods Prog Bio 2007; 88 (02) 102-111.
- 33 Kim Y. National Healthcare Information Network Development in Korea. Proc of APAMI 2006, Asia-Pacific Conference on Medical Informatics, 2006
- 34 Ammenwerth E, Schnell-Inderst P, Machan C, Siebert U. The Effect of Electronic Prescribing on Medication Errors and Adverse Drug Events: A Systematic Review. J Am Med Inform Assoc 2008; 15 (05) 585-600.
- 35 Kawazoe Y, Ohe K. An ontology-based mediator of clinical information for decision support systems: a prototype of a clinical alert system for prescription. Methods Inf Med 2008; 47 (06) 549-559.