journal of biomedical informatics
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Surveillance system using HL7 CDA in Korea

Author(s): Jong-Ho Lim, Jun-Hyun Song, Sung-Hyun Lee, Il-Kon Kim, Byoung-Kee Yi, Sun-Hee Park

Objective: The current process for reporting infectious disease in Korea is a complex workow based on manual entry and verication of data and requires transmission of report via obsolete technologies such as FAX. As such, it incurs unnecessary time and eort that hinder real time monitoring of epidemic outbreak. Further, the lack of standardized coding of data in the report makes it dicult to manage and analyze the data from dierent sources. We propose an interoperable infectious disease reporting system based on HL7 standards that simplies the reporting workow and enables near real time reporting in Korea.

Method: We rst analyze the current process of infectious disease reporting in Korea and identify its shortcomings in detail. Next we analyze KRFID (Korea Report Form of Infectious Disease) and related regulations to draw a data architecture design. Finally we take existing HL7 CDA implementation guides such as PHIN and Healthcare Associated Infection (HAI) Reports Template and conduct a comparative analysis to derive our design of CDA.

Result: The nal design of CDA consists of Patient and Infection sections. The Patient section includes 4 entries and the Patient section has 6 entries. KRFID is composed of 24 data items, of which 14 are included in the CDA header and the other in the body. The value of each entry is encoded using either SNOMED-CT or LOINC.

Conclusion: The system we developed enables fast reporting by eliminating unnecessary workload and delays. In the reporting process, the steps for manual entry, printing a form, and sending it via FAX at healthcare providers can be omitted and the procedure in which employees at Regional Health Centers manually enter data through KCDC web portal can also be removed. The system also oers interoperability by using international standards. Specically, we adopted HL7 CDA for the report form and LOINC and SNOMED-CT for encoding data. Finally, due to the regulatory requirement that all infectious disease reports should be documented and archived, the adoption of CDA as the electronic format of KRFID satises the regulation as well as the need for real time monitoring of infectious diseases in Korea.