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Simulated Hospital

github.com

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Re: Simulated Hospital

#51

Post by pskinner »

djfobbz wrote: post #49
ape4 wrote: post #22

When they say "Most EHRs use a message format called HL7v2, which is ugly and tedious to type." they aren't kidding, here's an example of it: MSH|^~\&|FROM_APP|FROM_FACILITY|TO_APP|TO_FACILITY|20180101000000||ADT^A01|20180101000000|P|2.5| EVN|A01|20110613083617| PID|1|843125^^^^MRN|21004053^^^^MRN~2269030303^^^^ORGNMBR||SULLY^BRIAN||19611209|M|||123 MAIN ST^^CITY^STATE^12345| PV1||I|H73 RM1^1^^HIGHWAY 01 CLINIC||||51…

This message object seems to be missing the HIPAA^ENCRYPTED field (pun intended)...I am assuming the encryption is implemented above this layer? Is there a standard for HL7v2 encryption?

HL7v2 is just the schema - the mechanism for sending these messages is normally something called MLLP which is just a simple framing protocol and has no built in security. It is possible to send/receive HL7v2 over other protocols, MLLP is the most common.

Its normal to secure the endpoints via network level security - ipsec etc. HL7v3 transformed into FHIR which is done over HTTPS instead.

Re: Simulated Hospital

#52

Post by kckljssyckyc »

djfobbz wrote: post #49
ape4 wrote: post #22

When they say "Most EHRs use a message format called HL7v2, which is ugly and tedious to type." they aren't kidding, here's an example of it: MSH|^~\&|FROM_APP|FROM_FACILITY|TO_APP|TO_FACILITY|20180101000000||ADT^A01|20180101000000|P|2.5| EVN|A01|20110613083617| PID|1|843125^^^^MRN|21004053^^^^MRN~2269030303^^^^ORGNMBR||SULLY^BRIAN||19611209|M|||123 MAIN ST^^CITY^STATE^12345| PV1||I|H73 RM1^1^^HIGHWAY 01 CLINIC||||51…

This message object seems to be missing the HIPAA^ENCRYPTED field (pun intended)...I am assuming the encryption is implemented above this layer? Is there a standard for HL7v2 encryption?

oh neat. i was aware of hl7, but didn't realize i'd seen it in the wild til today.

you can often find these messages flying unencrypted over flex pager channels in the us

Re: Simulated Hospital

#53

Post by kckljssyckyc »

pskinner wrote: post #51
djfobbz wrote: post #49

Earlier quoted context omitted.

This message object seems to be missing the HIPAA^ENCRYPTED field (pun intended)...I am assuming the encryption is implemented above this layer? Is there a standard for HL7v2 encryption?

HL7v2 is just the schema - the mechanism for sending these messages is normally something called MLLP which is just a simple framing protocol and has no built in security. It is possible to send/receive HL7v2 over other protocols, MLLP is the most common. Its normal to secure the endpoints via network level security - ipsec etc. HL7v3 transformed into FHIR which is done over HTTPS instead.

or, hear me out, you also blast it unencrypted to the flex pagers your employees don't even use anymore

Re: Simulated Hospital

#54

Post by stavros »

a_bonobo wrote: post #32
jenadine wrote: post #17

This has nothing to do with Theme Hospital https://en.wikipedia.org/wiki/Theme_Hospital

Fun link: Theme Hospital is the follow-up to Theme Park, Theme Park was co-created by Demis Hassabis, Demis Hassabis founded DeepMind, DeepMind was acquired by Google, DeepMind has been incorporated into Google Health, surely Simulated Hospital sits within Google Health.

Demis Hassabis wrote Theme Park? Wow, I did not expect that.

Re: Simulated Hospital

#56

Post by IG_Semmelweiss »

wilg wrote: post #27
IG_Semmelweiss wrote: post #13

Nice effort, and its something. But something may not be good enough to solve hard problems. Can simulated hospital simulate efforts by staff to quickly add into many charts a medication Rx - by taking one patient note and copying 1 note, then pasting that into several? Does it simulate staff forgetting the dosage was not edited after pasting into all those charts ? Or staff not logging out of their userID, to avoid…

In your view, what was the purpose of your comment? Who are you lecturing?

To warn developers of potential blind spots and wasting time, hoping this helps them contribute meaningfully to fix healthcate

Re: Simulated Hospital

#57

Post by brap »

Every time I dip a little into healthcare tech I want to throw up. It's so bizarre, and even offensive, how convoluted and outdated these systems are. It's patches on top of patches on top of patches for decades. To the brave engineers working on maintaining these systems, I salute you.

Hospitals, banks, government... just think of the tech these heavily regulated industries could have had, and how it could have improved our experience, if they actually had a strong incentive to improve. And it goes far beyond the tech stack.

In the long term, regulation often kills competition, which inevitably kills innovation.

Re: Simulated Hospital

#58

Post by chpatrick »

stavros wrote: post #54
a_bonobo wrote: post #32

Earlier quoted context omitted.

Fun link: Theme Hospital is the follow-up to Theme Park, Theme Park was co-created by Demis Hassabis, Demis Hassabis founded DeepMind, DeepMind was acquired by Google, DeepMind has been incorporated into Google Health, surely Simulated Hospital sits within Google Health.

Demis Hassabis wrote Theme Park? Wow, I did not expect that.

From what I've heard he had a small role in it.

Re: Simulated Hospital

#59

Post by Eumenes »

ape4 wrote: post #22

When they say "Most EHRs use a message format called HL7v2, which is ugly and tedious to type." they aren't kidding, here's an example of it: MSH|^~\&|FROM_APP|FROM_FACILITY|TO_APP|TO_FACILITY|20180101000000||ADT^A01|20180101000000|P|2.5| EVN|A01|20110613083617| PID|1|843125^^^^MRN|21004053^^^^MRN~2269030303^^^^ORGNMBR||SULLY^BRIAN||19611209|M|||123 MAIN ST^^CITY^STATE^12345| PV1||I|H73 RM1^1^^HIGHWAY 01 CLINIC||||51…

Seems readable to me

Re: Simulated Hospital

#60

Post by adolph »

brap wrote: post #57

Every time I dip a little into healthcare tech I want to throw up. It's so bizarre, and even offensive, how convoluted and outdated these systems are. It's patches on top of patches on top of patches for decades. To the brave engineers working on maintaining these systems, I salute you. Hospitals, banks, government... just think of the tech these heavily regulated industries could have had, and how it could have impr…

As someone working in this arena, I offer an alternative perspective for your consideration: healthcare was an early adopter of information technology and as a result many of its most core technologies come from a nearly unrecognizable time in computing. These systems are “outdated” as a result of success.

The current prevalence of these venerable technologies may be in part due to regulation, but more often has to do with their success.

HL7v2 is just token delimited ascii. Not unlike the similarly primitive but ubiquitous csv. The fields within it are defined by standards documents and once you use it a little, you can read enough to get the gist of most messages. As you might guess, modules in your language of choice are used to parse and compose HL7v2 so its detail isn’t that important.

[Edit: looks like the project has written Synthea out in favor of an integrated data generator]

Something I’d like to point out about Google Hospital is that under the hood it uses MITRE’s Synthea to generate synthetic patient data.

https://www.healthcareittoday.com/2017/09/13/open-source-too...

https://synthetichealth.github.io/synthea/

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