Electronic Healthcare Record and clinical research in cardiovascular radiology. HL7 CDA and CDISC ODM interoperability

Abstract

Integrating clinical research data entry with patient care data entry is a challenging issue. At the G. Pompidou European Hospital (HEGP), cardiovascular radiology reports are captured twice, first in the Electronic Health Record (EHR) and then in a national clinical research server. Informatics standards are different for EHR (HL7 CDA) and clinical research (CDISC ODM). The objective of this work is to feed both the EHR and a Clinical Research Data Management System (CDMS) from a single multipurpose form. We adopted and compared two approaches. First approach consists in implementing the single "care-research" form within the EHR and aligning XML structures of HL7 CDA document and CDISC ODM message to export relevant data from EHR to CDMS. Second approach consists in displaying a single "care-research" XForms form within the EHR and generating both HL7 CDA document and CDISC message to feed both EHR and CDMS. The solution based on XForms avoids overloading both EHR and CDMS with irrelevant information. Beyond syntactic interoperability, a perspective is to address the issue of semantic interoperability between both domains.

Figure 1

The single multipurpose «Care-Research CV report» is the union of the DxCare «CV radiology report» and the AOL «General form» and «Procedure form»

Figure 2

Alignment between HL7/CDA sections and CDISC/ODM forms structures

Figure 3

Production of a CDISC ODM message from a HL7 CDA document, using a mapping file.

Figure 4

Production of a HL7 CDA document and a CDISC ODM message from a Xforms form