Modelagem do padrão TISS por meio do enfoque dual da Fundação openEHR

• Autor(a) principal: Dias, Rigoleta Dutra Mediano
• Data de Publicação: 2011
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/8568
• topic: Electronic health record; Health informatics standards. TISS standard. DualModel; Archetypes; Informática médica; Agência Nacional de Saúde Suplementar; Registro eletrônico de saúde; Sistemas computadorizados de registros médicos; Indicadores de saúde; Registro Eletrônico de Saúde; Padrões de informática em saúde; Padrão TISS; Modelo Dual; Arquétipos.; CNPQ::CIENCIAS EXATAS E DA TERRA::CIENCIA DA COMPUTACAO::METODOLOGIA E TECNICAS DA COMPUTACAO::SISTEMAS DE INFORMACAO

In 2005 the Brazilian National Healthcare Agency (Agência Nacional de Saúde Suplementar (ANS), in Portuguese) published the TISS standard, a mandatory electronic exchange claims between the health insurance (approximately 1500 registered at ANS) and healthcare providers (approximately 200 000) about the healthcare events provided to the beneficiaries. The TISS standard was developed following the structure of the ISO/TC215 Committee for Health Informatics and is divided into four parts: data structure that encompasses the forms; semantic content that refers to the vocabularies and terminologies; data interchange that includes the electronic messages; and security issues in healthcare information following a recommendation of the Federal Council of Medicine (Conselho Federal de Medicina (CFM), in Portuguese). To improve the TISS standard s evolution, this study analyses the levels of interoperability in accordance with ISO 20514 (ISO 20514, 2005) and the dual model of the openEHR Foundation, which proposes open standards for Electronic Health Records (EHR) architecture and healthcare information. The dual model of the openEHR Foundation specifications is composed, on the first level, by a generic reference model and on the second by an archetype model that details the concepts and attributes. Two studies were conducted in this thesis: the first one refers to a set of demographic archetypes developed as a proposal representation of the demographic information, based on the reference model of the openEHR Foundation. The second study proposes a generic reference model, as an improvement of the openEHR specifications, to represent the concept of submission of claims, as well as a set of archetypes. Finally, a new architecture for building the TISS standard is proposed based on the dual model of the openEHR Foundation and envisioning a patient-centered EHR