Developing a standard protocol for clinical data exchange and analysis

Clinical data exchange across organisational boundary is essential but not straightforward, since it involves a diverse range of systems that maintain not just incompatible data formats but also their autonomy. This is barrier of substantial significance not only to improved care for individuals whereas data sharing is essential to clinical decisions, but also administrative strategies and resource allocation for an entire population whereas datasets need to be aggregated. The Hubei Provincial Department of Health recently launched an initiative of a province-wide data exchange standard. Under investigation by the authors, the standard will guide vendors to implement a set of hierarchical platforms at various administrative levels, and connect clinical information systems to them and join the data exchange network. In this paper, we will describe the data exchange requirements in the province, the design of a service paradigm and specification of Clinical Document Architecture (CDA), as well as governing protocols towards the goal. A case study on patients with hypertension, from detection, diagnosis, referral, treatment, onwards to follow-up will be used for illustration. The work contributes a semantic and functional data exchange model, and will further support data analysis to both clinical and administrative decision-making in this province.