Daily Archives: April 13, 2017

FHIR

Fast Healthcare Interoperability Resources (FHIR) describes a set of standards that facilitate the transfer of healthcare information between electronic healthcare systems. The video above is from the QVera clips YouTube channel. FHIR has been developed by HL7.

HL7

HL7 is described in the NHS interoperability handbook as applying to the Interoperability Framework. HL7 is an organisation that develops a framework and standards for interoperability of health information systems. Their website can be found here and the organisation also has a well established social media presence.

Patient Records

Patient records are central to the delivery of healthcare and serve a number of functions including the recording of clinical assessments and interventions. Aggregated data is also utilised at a local and national level to inform commissioning.

Electronic Patient Records

The digitisation of patient records offers a number of advantages over paper based records. These advantages include automated backup of records, reduced use of physical storage space (since paper based notes are switched to servers), off-site access to records using mobile devices and the potential to develop analytical clinical support tools which use computers to process clinical data to help improve clinical decisions. Not all healthcare services have electronic patient records but most providers are moving in this direction.

Getting Electronic Patient Records to Talk to Each Other

When patients move between healthcare providers – for instance between primary care and the hospital – they may find that one provider does not have information that the other provider has. There are many providers and many electronic paper record systems. For two systems to talk to each other they have to solve a number of problems. When these problems are solved a patient can move between providers and healthcare information can be accessed by the different providers. A key solution to this problem of health information gaps is the Health Information Exchange (HIE).

The Health Information Exchange

There are many definitions of what a Health Information Exchange is. (Hersh et al, 2015) define a HIE as follows:

Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations’

Whilst this definition is simple, the process of sharing clinical information between healthcare organisations is technically complex and encompasses a range of software, hardware and governance issues. The process of helping systems to talk to each other is helped by the development of standards. A set of standards is outlined in the NHS interoperability framework.

The Interoperability Framework

A digital copy of the Interoperability Handbook can be found at the NHS England website (NHS England, 2017). The handbook explains how an interoperability framework can support an interoperability strategy. The Interoperability Framework has three layers – a governance layer, an exchange layer and an interpretation layer.

The Standards Applicable to the Interoperability Framework

Appendix A in the Interoperability Handbook shows how various standards map onto the Interoperability Framework (NHS England, 2017).

Citations

https://www.england.nhs.uk/digitaltechnology/info-revolution/interoperability/, accessed 8.4.17

There is also an NHS Digital Twitter account here.

Links to Other Posts in the Health Information Exchange Series

General Posts to Date on Health Information Exchanges

Posts on Examples of Health Information Exchanges

SNOMED CT®/ICD Mapping and Harmonisation Posts

SNOMED CT® Posts

ICD 1-10 Posts

ICD-11 Posts

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section

The Brain Hypometabolism Hypothesis Part 41: GLUT 14

glucose_2

GLUT 14

Professors Bernard Thorens and Mike Mueckler have written a review titled ‘Glucose Transporters in the 21st Century’. In terms of a Brain Hypometabolism Hypothesis, it is important to understand how Glucose is handled in the brain. Thorens and Mueckler reference 14 Glucose Transporters but not all of them are expressed in the brain.

In their paper, Professors Bernard Thorens and Mike Mueckler note that GLUT 14 is not primarily expressed in the brain and also that the role of GLUT 14 in glucose metabolism is not characterised.

What are the GLUT’s?

GLUT’s are short for Glucose Transporters. They constitute a set of molecules which transport substrates across cell membranes. They play a central role in Glucose transport and hence the name. However their role is not limited to the transport of Glucose.

 What is the Brain Hypometabolism Hypothesis?

The Brain Hypometabolism Hypothesis broadly states that

Hypometabolism in the brain leads to neuropathology

Human_Metabolism_-_Pathways

Human Metabolism by Evans Love (CC BY 4.0)

What is Metabolism?

Metabolism can be defined as the chemical processes that occur in living organisms. There are three types of metabolic processes

(a) Generation of energy

(b) Generation of basic chemicals including fatty acids, amino acids and sugars

(c) Elimination of Nitrogen waste products

Restating the Brain Hypometabolism Hypothesis

The Brain Hypometabolism Hypothesis focuses on energy metabolism. More specifically the hypothesis states that

Energy hypometabolism in the brain leads to neuropathology

Citations

Thorens B, Mueckler M. Glucose transporters in the 21st Century. American Journal of Physiology – Endocrinology and Metabolism. 2010;298(2):E141-E145. doi:10.1152/ajpendo.00712.2009.

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section