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Standards em Informática na Saúde

Nesta página você encontrará referências para as mais importantes Organizações de Desenvolvimento de Standards para a área de Informática na Saúde. 
  1. Classificação dos Standards quanto a o que Padronizam
  2. Principais Standards e sua Classificação Funcional
  3. ISO/TC 215
  4. CEN/TC 251
  5. ABNT/CB-26
  6. Links para Recursos Adicionais
  7. Exemplos
    1. Descritor MeSH em XML
    2. Mensagem HL7 ver.2.5 (não-XML)


Classificação dos Standards quanto a o que Padronizam

Podemos classificar os Standards em:

  1. (MSG) Padrões de Mensagem - definem um conjunto de mensagens e sua sintaxe, como por exemplo "Cadastro de um Novo Paciente", "Dados da Reserva da Sala de Cirurgia #2 para o Paciente 12.034-X", "Dados da Reserva do Leito 2 do Apartamento 304 para o Paciente 12.034-X".
  2. (SRV) Padrões de Serviços - definem um Protocolo de Serviços que especifica como duas entidades (dois equipamentos, um computador e um equipamento, dois computadores, dois programas diferentes em um mesmo computador) em conformidade com o Protocolo interagem entre si e quais são os serviços que uma entidade pode prestar para a outra. Por exemplo: um software cliente de balcão de um hospital pode requisitar ao servidor de prontuário eletrônico do hospital que execute o serviço de Registrar_Um_Novo_Paciente. Em outro exemplo, uma workstation radiológica pode requistar ao aparelho de tomografia que diga Quais_Exames_Estão_Armazenados. Um bom protocolo de serviços está associado a um conjunto bem definido de mensagens, onde a cada serviço é associado um conjunto delimitado de mensagens que são trocadas entre as duas entidades durante a "negociação" do serviço. 
  3. (STR) Documentos Estruturados - Definem uma filosofia e uma sintaxe de organização da informação em um Documento Clínico que permita: (a) sua migração entre sistemas, de forma que o prontuário de um paciente possa acompanhar o paciente, indo do PEP de um hospital para outro; (b) uma sintaxe que permita organizar a informação contida no documento em uma estrutura hierárquica que reflita o Protocolo Clínico (Algoritmo Médico) associado ao Ato Médico que gerou este documento, retirando o documento do domínio de texto puro e passando-o para o domínio das Estruturas de Dados e (c) associe aos principais termos médicos e seus modificadores códigos de alguma Terminologia Controlada de forma que os principais apsectos do conteúdo do documento sejam independentes de língua e possas sofrer tradução automática de uma língua para outra. O exemplo clássico de documento estruturado é o DICOM Structured Report criado pelo Colégio Americano de Radiologia.
  4. (TRM) Terminologias Controladas. Controlam o léxico utilizado para designar fenômenos e entidades da prática médica de forma a evitar mal entendidos e interpretações ambíguas e associam códigos a termos médicos de forma a tornar partes de um documento passíveis de interpretação eletrônica e independentes de lingua. Terminologias controladas costumam possuir vários Eixos de Classificação, como por exemplo Anatomia, Patologia, Processo Clínico, Farmacologia, etc. A terminologia controlada mais conhecida é o Código Internacional de Doenças (CID ver.10), que no entanto é uma terminologia extremaemnte simples pois somente apresenta um eixo de classificação, o de Patologia/Conclusão. 
  5. (PRF) Padrões de Profilização. Tentam estandardizar os processos clínicos e organizacionais dos hospitais, definindo Workflows e Protocolos Clínicos (Algoritmos Médicos) padronizados e codificando-os, de forma a possibilitar a integração de entidades de atenção à saúde de forma a permitir que um paciente possa iniciar tratamento em um local e continuar noutro. 
É importante notar que no caso da interdependência Protocolo de Serviços X Especificação de Mensgaens nem todos os standards que usam mensageamento definem um protocolo claro de serviços e que nem todos os protocolos de serviços se baseiam em um conjunto claro e bem definido de mesagens. Se você for ter de optar por um protocolo, escolha um onde estas duas coisas estejam bem claramente definidas.

Standards e sua Classificação Funcional

Abaixo vai uma Lista não exaustiva dos Standards Médicos e uma associação dos mesmos a classificações de funcionalidade:

  1. ASTM (STR)
  2. CEN TC 251 / ISO TC 215 (MSG,SRV,STR,TRM). Veja também: Enterprise Workspace - ISO/TC 215 "Health informatics" onde você vai encontrar as entradas de todos os Working Groups descritos na figura abaixo. 
  3. DeCS- Descritores em Ciências da Saúde (TRM). O vocabulário estruturado e trilingüe DeCS - Descritores em Ciências da Saúde foi criado pela BIREME para uso na indexação de artigos de revistas científicas, livros, anais de congressos, relatórios técnicos, e outros tipos de materiais, assim como para ser usado na pesquisa e recuperação de assuntos da literatura científica nas bases de dados LILACS, MEDLINE  e outras.
  4. DICOM - Digital Image Communication in Medicine (MSG,SRV,STR)
  5. HL7 - Health Level Seven (MSG,SRV,STR,TRM)
  6. IHE - Integrating the Health Enterprise (PRF)
  7. ICD/CID - Código Internacional de Doenças (TRM)
  8. LOINC - Logical Observation Identifiers Names and Codes (TRM). The purpose of the LOINC database is to facilitate the exchange and pooling of results, such as blood hemoglobin, serum potassium, or vital signs, for clinical care, outcomes management, and research. 
  9. MESH - Medical Subject Headings (TRM). MeSH thesaurus is a controlled vocabulary produced by the National Library of Medicine and used for indexing, cataloging, and searching for biomedical and health-related information and documents. The 2006 issue of MeSH is the printed listing of subject descriptors appearing in MEDLINE, PubMed, the NLM catalog database, and other NLM databases.
  10. NCPDP (MSG)
  11. OMG CORBAMed Medical Transcript Management (SRV) CORBA Healthcare Domain Task Force.
  12. RxNorm (TRM). Provides standard names for clinical drugs (active ingredient + strength + dose form) and for dose forms as administered to a patient.
  13. SNOMED - Sistematic Nomenclature of Medicine (TRM)
  14. UMLS -  Unified Medical Language System (STR,TRM). The purpose of NLM's UMLS is to facilitate the development of computer systems that behave as if they "understand" the meaning of the language of biomedicine and health.


As iniciativas de normatização ISO/TC215 e CEN/TC251 estão intimamente ligadas e são com certeza as mais importantes para nós no Brasil, visto que as normas ida Organização Internacional de Padronização - ISO tem sido em geral adotadas no Brasil pela Associação Brasileira de Normas Técnicas - ABNT após uma adaptação às necessidades e características nacionais. 

ISO TC 215 

Abaixo temos uma tabela com as normas já publicadas, os subcomitês técnicos responsáveis, a data de publicação e um link para a página da norma, a qual geralmente cotém um resumode seu conteúdo.
 
 
Lista de Comitês Técnicos - ISO 215 - Health Informatics
À direita de cada documento a data de publicação.
ISO/IEEE 11073-10101:2004 Health informatics -- Point-of-care medical device communication -- Part 10101: Nomenclature
ISO/IEEE 11073-10201:2004 Health informatics -- Point-of-care medical device communication -- Part 10201: Domain information model
ISO/IEEE 11073-20101:2004 Health informatics -- Point-of-care medical device communication -- Part 20101: Application profiles -- Base standard
ISO/IEEE 11073-30200:2004 Health informatics -- Point-of-care medical device communication -- Part 30200: Transport profile -- Cable connected
ISO/IEEE 11073-30300:2004 Health informatics -- Point-of-care medical device communication -- Part 30300: Transport profile -- Infrared wireless
ISO/TR 16056-1:2004 Health informatics -- Interoperability of telehealth systems and networks -- Part 1: Introduction and definitions
ISO/TR 16056-2:2004 Health informatics -- Interoperability of telehealth systems and networks -- Part 2: Real-time systems
ISO/TS 16058:2004 Health informatics -- Interoperability of telelearning systems
ISO/TS 17090-1:2002 Health informatics -- Public key infrastructure -- Part 1: Framework and overview
ISO/TS 17090-2:2002 Health informatics -- Public key infrastructure -- Part 2: Certificate profile
ISO/TS 17090-3:2002 Health informatics -- Public key infrastructure -- Part 3: Policy management of certification authority
ISO/TS 17117:2002 Health informatics -- Controlled health terminology -- Structure and high-level indicators
ISO/TR 17119:2005 Health informatics - Health informatics profiling framework
ISO/TS 17120:2004 Health informatics -- Country identifier standards
ISO 17432:2004 Health informatics -- Messages and communication -- Web access to DICOM persistent objects
ISO 18104:2003 Health informatics -- Integration of a reference terminology model for nursing
ISO/TR 18307:2001 Health informatics -- Interoperability and compatibility in messaging and communication standards -- Key characteristics
ISO/TS 18308:2004 Health informatics -- Requirements for an electronic health record architecture
ISO 18812:2003 Health informatics -- Clinical analyser interfaces to laboratory information systems -- Use profiles
ISO/TR 20514:2005 Health informatics -- Electronic health record -- Definition, scope and context
ISO/TR 21089:2004 Health informatics -- Trusted end-to-end information flows
ISO/TS 21091:2005 Health informatics -- Directory services for security, communications and identification of professionals and patients
ISO 21549-1:2004 Health informatics -- Patient healthcard data -- Part 1: General structure
ISO 21549-2:2004 Health informatics -- Patient healthcard data -- Part 2: Common objects
ISO 21549-3:2004 Health informatics -- Patient healthcard data -- Part 3: Limited clinical data
ISO/TS 21667:2004 Health informatics -- Health indicators conceptual framework
ISO/TR 21730:2005 Health informatics -- Use of mobile wireless communication and computing technology in healthcare facilities -- Recommendations for the management of unintentional electromagnetic interference with medical devices
ISO 22857:2004 Health informatics -- Guidelines on data protection to facilitate trans-border flows of personal health information


Organização dos Working Groups do Comitê Técnico ISO 215 numa visão de Audrey Dickerson  adickerson@himss.org

CEN TC 251


O Comité Européen de Normalisation (CEN - European Committee for Standardization) é interessante pois é um órgão supranacional vinculado à União Européia que "contributes to the objectives of the European Union and European Economic Area with voluntary technical standards which promote free trade, the safety of workers and consumers, interoperability of networks, environmental protection, exploitation of research and development programmes, and public procurement. CEN was founded in 1961 by the national standards bodies in the European Economic Community and EFTA countries." [retirado do Scope Statement]

CEN/TC 251 Health Informatics é anterior ao Comitê ISO 215, tendo-o inspirado, e foi um comitê técnico do CEN criado para promover  "standardization in the field of Health Information and Communications Technology (ICT) to achieve compatibility and interoperability between independent systems and to enable modularity. This includes requirements on health information structure to support clinical and administrative procedures, technical methods to support interoperable systems as well as requirements regarding safety, security and quality." [retirado do Scope Statement]

CEN/TC 251 é dividido, da mesma forma que o ISO/TC 215, em Grupos de Trabalho, listados abaixo:

  1. WG I, Modelos de Informação: "An important area of WG I work is standards for the Electronic Healthcare Record. These will include a record architecture establishing the principles for representing the information content and record structure, a set of concepts and terms for record components, and rules and mechanisms for sharing and exchanging records. A domain model representing a formal description of the context within which the healthcare records are used, will be established to document requirements for these standards. Another important area of WG I work is that of standards for messages to meet specific healthcare business needs for the communication of healthcare information. While some messages may have a broad initial scope, WG I will also validate, refine and profile these and other messages to ensure they are applicable to specialist domains with particular requirements. WG I will also address the maintenance, revision and harmonisation of existing message standards. In addition, WG I will address standards for the information requirements that may be applicable to other media for the storage and transfer of healthcare information, including patient data cards."
  2. WG II, Terminologia e Representação do Conhecimento: "The objectives of CEN/TC 251 WGII are the semantic organisation of information and knowledge so as to make it of practical use in the domains of health informatics and telematics and the provision of information and criteria to support harmonisation. This encompasses clinical, managerial and operational aspects of the medical record and enabling access to other knowledge."
  3. WG III, Segurança, Confiabilidade e Qualidade: "Major pan-European documents that provide a basis for CEN/TC 251 are the recommendations from the Council of Europe which apply to all CEN nations and the European Union Data Protection Directive finally adopted in 1995 to be implemented in the member states by October 1998. Specifications include: Secure User Identification for Healthcare — Strong Authentication using microprocessor cards; Security for Healthcare Communication; Security requirements for intermittently connected devices; Safety and Security Related Software Quality Standards for Healthcare; Framework for formal modelling of healthcare security policies; Safety procedures for identification of persons and related objects."
  4. WG IV, Tecnologia para Interoperabilidade: "The aim of this WG is to develop and promote standards that enable the interoperability of devices and information systems in health informatics. The scope covers three main areas: (1) Intercommunication of data between devices and information systems; (2) Integration of data for multimedia representation; (3) Communication of such data between source departments and other legitimate users elsewhere in the healthcare sector, in order to facilitate electronic healthcare record provision"
Além de Grupos de Trabalho, o CEN possui Forças-Tarefa para implementar ações específicas. As CEN/TC 251 Task Forces são:
  • Task Force Cards: Health Cards. Revision of ENV 12018 together with ISO/TC 215 (Frans Van Bommel)
  • Task Force HISA, Revision of ENV 12967: Health informatics — Service architecture. Part 1: Enterprise viewpoint; Part 2: Information viewpoint; Part 3: Computational viewpoint. (Gunnar Klein)
  • Task Force EHRcom, Revision of ENV 13606: .Electronic Health Record Communication. Part 1: Extended architecture; Part 2: Domain termlist; Part 3: Distribution rules; Part 4: Message for the exchange of information
Os times de projeto do CEN/TC 251 atualmente (Março,2006) em operação são:
  • PT-26 Electronic Healthcare Record Communication - Part 1: Extended Architecture and Domain Model (Stephen Kay)
  • PT-27 Electronic Healthcare Record Communication - Part 2: Domain Termlist (Angelo Rossi Mori)
  • PT-28 Electronic Healthcare Record Communication - Part 3: Distribution Rules (Robin Hopkins)
  • PT-29 Electronic Healthcare Record Communication -Part 4: Messages for the exchange of information (David Markwell)
  • PT-30 System of Concepts to Support Continuity of Care (Francois Mennerat)
  • PT-31 Messages for the Exchange of Information on Drug Prescription (Jesper Theilgaard)
  • PT-32 Blood Transfusion Related Messages (Christian Desaint)
  • PT-33 Messages for Maintenance of Supporting Information in Healthcare Systems (Niels Jørgen Christensen
  • PT-34 Interoperability of Healthcare Multimedia Report Systems (Nicholas Brown)
  • PT-35 Interoperability of Medical Devices within Acute Care Units (Paul Woolman)
  • PT-36 Instrument Interfaces to Laboratory Information Systems (Richard Hayes)
  • PT-37 Secure User Identification for Healthcare — Strong Authentication using Microprocessor Cards (Lionel Moss)
  • PT-38 Safety and Security related Software Quality Standards (Paul Wardman)
  • PT-39 Security for Healthcare Communication (Tor Olav Grøtan)
  • PT-40 File exchange format for Vital Signs (Alpo Värri)
  • PT-41 General Purpose Information Components (Gunnar Klein)
  • PT-42 Service Request and Report Messages (Edgar Gl|ck)

    • PT-44 Mapping of Hierarchical Message Descriptions to XML (Yves Mounier)
Abaixo uma lista de padrões já publicados pelo CEN/TEC 251.  Uma lista atualizada pode ser encontrada aqui.

Observe que não existe uma relação 1-a-1 com os standards publicados pela ISO, apesar de haver muito trabalho conjunto. Existe uma lista de padrões em elaboração cuja versão atualizada pode ser obtida no site de Comitês Técnicos da CEN. 
Referência no Standard Título
CEN/TR 15253:2005  Health informatics - Quality of service requirements for health information interchange 
CEN/TS 14271:2003  Health informatics - File exchange format for vital signs 
CEN/TS 14463:2003  Health informatics - A syntax to represent the content of medical classification systems (CIaML) 
CEN/TS 14796:2004  Health Informatics - Data Types 
CEN/TS 14822-4:2005  Health informatics - General purpose information components - Part 4: Message headers 
CEN/TS 15127-1:2005  Health informatics - Testing of physiological measurement software - Part 1: General 
CR 12069:1995  Profiles for medical image interchange 
CR 12161:1995  A method for defining profiles for healthcare 
CR 12587:1996  Medical Informatics - Methodology for the development of healthcare messages 
CR 12700:1997  Supporting document to ENV 1613:1994 - Messages for Exchange of Laboratory Information 
CR 1350:1993  Investigation of syntaxes for existing interchange formats to be used in health care 
CR 13694:1999  Health Informatics - Safety and Security Related Software Quality Standards for Healthcare (SSQS) 
CR 14300:2002  Health Informatics - Interoperability of healthcare multimedia report systems 
CR 14301:2002  Health informatics - Framework for security protection of healthcare communication 
CR 14302:2002  Health informatics - Framework for security requirements for intermittently connected devices 
EN 1064:2005  Health informatics - Standard communication protocol - Computer-assisted electrocardiography 
EN 1068:2005  Health informatics - Registration of coding systems 
EN 12052:2004  Health informatics - Digital imaging - Communication, workflow and data management 
EN 12251:2004  Health informatics - Secure User Identification for Health Care - Management and Security of Authentication by Passwords 
EN 12264:2005  Health informatics - Categorial structures for systems of concepts 
EN 12381:2005  Health informatics - Time standards for healthcare specific problems 
EN 12435:2006  Health informatics - Expression of results of measurements in health sciences 
EN 13609-1:2005  Health informatics - Messages for maintenance of supporting information in healthcare systems - Part 1: Updating of coding schemes 
EN 14484:2003  Health informatics - International transfer of personal health data covered by the EU data protection directive - High level security policy 
EN 14485:2003  Health informatics - Guidance for handling personal health data in international applications in the context of the EU data protection directive 
EN 14720-1:2005  Health informatics - Service request and report messages - Part 1: Basic services including referral and discharge 
EN 14822-1:2005  Health informatics - General purpose information components - Part 1: Overview 
EN 14822-2:2005  Health informatics - General purpose information components - Part 2: Non-clinical 
EN 14822-3:2005  Health informatics - General purpose information components - Part 3: Clinical 
EN 1828:2002  Health informatics - Categorial structure for classifications and coding systems of surgical procedures 
EN ISO 11073-10101:2005  Health informatics - Point-of-care medical device communication - Part 10101: Nomenclature (ISO/IEEE 11073-10101:2004) 
EN ISO 11073-10201:2005  Health informatics - Point-of-care medical device communication - Part 10201: Domain information model (ISO/IEEE 11073-10201:2004) 
EN ISO 11073-20101:2005  Health informatics - Point-of-care medical device communication - Part 20101: Application profiles - Base standard (ISO/IEEE 11073-20101:2004) 
EN ISO 11073-30200:2005  Health informatics - Point-of-care medical device communication - Part 30200: Transport profile - Cable connected (ISO/IEEE 11073-30200:2004) 
EN ISO 11073-30300:2005  Health informatics - Point-of-care medical device communication - Part 30300: Transport profile - Infrared wireless (ISO/IEEE 11073-30300:2004) 
EN ISO 18104:2003  Health Informatics - Integration of a reference terminology model for nursing (ISO 18104:2003) 
EN ISO 18812:2003  Health informatics - Clinical analyser interfaces to laboratry information systems - Use profiles (ISO 18812:2003) 
EN ISO 21549-1:2004  Health informatics - Patient healthcard data - Part 1: General structure (ISO 21549-1:2004) 
EN ISO 21549-2:2004  Health informatics - Patient healthcard data - Part 2: Common objects (ISO 21549-2:2004) 
EN ISO 21549-3:2004  Health informatics - Patient healthcard data - Part 3: Limited clinical data (ISO 21549-3:2004) 
ENV 12017:1997  Medical Informatics - Medical Informatics Vocabulary (MIVoc) 
ENV 12018:1997  Identification, administrative, and common clinical data structure for Intermittently Connected Devices used in healthcare (including machine readable cards) 
ENV 12388:1996  Medical Informatics - Algorithm for Digital Signature Services in Health Care 
ENV 12443:1999  Medical Informatics - Healthcare Information Framework (HIF) 
ENV 12537-1:1997  Medical informatics - Registration of information objects used for EDI in healthcare - Part 1: The Register 
ENV 12537-2:1997  Medical informatics - Registration of information objects used for EDI in healthcare - Part 2: Procedures for the registration of information objects used for electronic data interchange (EDI) in healthcare 
ENV 12610:1997  Medical informatics - Medicinal product identification 
ENV 12611:1997  Medical informatics - Categorial structure of systems of concepts - Medical devices 
ENV 12612:1997  Medical informatics - Messages for the exchange of healthcare administrative information 
ENV 12924:1997  Medical Informatics - Security Categorisation and Protection for Healthcare Information Systems 
ENV 12967-1:1998  Medical informatics - Healthcare Information System Architecture (HISA) - Part 1: Healthcare Middleware Layer 
ENV 13606-1:2000  Health informatics - Electronic healthcare record communication - Part 1: Extended architecture 
ENV 13606-2:2000  Health informatics - Electronic healthcare record communication - Part 2: Domain term list 
ENV 13606-3:2000  Health informatics - Electronic healthcare record communication - Part 3: Distribution rules 
ENV 13606-4:2000  Health informatics - Electronic healthcare record communication - Part 4: Messages for the exchange of information 
ENV 13607:2000  Health informatics - Messages for the exchange of information on medicine prescriptions 
ENV 13608-1:2000  Health informatics - Security for healthcare communication - Part 1: Concepts and terminology 
ENV 13608-2:2000  Health informatics - Security for healthcare communication - Part 2: Secure data objects 
ENV 13608-3:2000  Health informatics - Security for healthcare communication - Part 3: Secure data channels 
ENV 13609-2:2000  Health informatics - Messages for maintenance of supporting information in healthcare systems - Part 2: Updating of medical laboratory-specific information 
ENV 13729:2000  Health informatics - Secure user identification - Strong authentication using microprocessor cards 
ENV 13730-1:2001  Health informatics - Blood transfusion related messages - Part 1: Subject of care related messages 
ENV 13730-2:2002  Healthcare Informatics - Blood transfusion related messages - Part 2: Production related messages (BTR-PROD) 
ENV 13734:2000  Health informatics - Vital signs information representation 
ENV 13735:2000  Health informatics - Interoperability of patient connected medical devices 
ENV 13940:2001  Health Informatics - System of concepts to support continuity of care 
ENV 1614:1995  Healthcare informatics - Structure for nomenclature, classification, and coding of properties in clinical laboratory sciences 
 

ABNT - Associação Brasileira de Normas Técnicas 

A ABNT é o órgão oficial de normatização no Brasil. Todo o trabalho realizado pela ABNT nos Comitês Brasileiros e Organismos de Normalização Setorial é orientado para atender ao desenvolvimento da tecnologia e participação efetiva na normalização internacional e regional. A Comissão de Estudo Especial Temporária (CEET) da ABNT é uma Comissão de Estudo vinculada à Gerência do Processo de Normalizacão da ABNT, com objetivo e prazo determinados, para tratar do assunto não coberto pelo âmbito de atuação dos Comitês Técnicos. O Comitê Brasileiro (ABNT/CB) é um órgão da estrutura da ABNT com Superintendente eleito pelos sócios da ABNT, nele inscritos, com mandato de 2 anos, permitidas duas reeleições. 

A ABNT possui atualmente 53 Comitês e 3 Organismos de Normalização Setorial. Na área da Saúde temos o Comitê ABNT/CB-26 - Odonto Médico Hospitalar atuando nas seguintes áreas: Normalização no campo odonto-médico-hospitalar compreendendo produtos correlatos de saúde tais como: materiais, artigos, aparelhos, dispositivos, instrumentos e acessórios cujo uso ou aplicação na prática médica, hospitalar, odontológica e de laboratório estejam associados às ações e serviços de saúde, no que concerne a
terminologia, requisitos, métodos de ensaio e generalidades. Excluindo-se a normalização de radiação não-ionizante que é de responsabilidade do ABNT/CB-20.  Na área da Informática Médica ainda (Março de 2006) não existem Comitês atuantes no Brasil, isso podendo ser observado ao ser analisar de quais comitês ISO o CB-26 participa. 

Superintendenter: Luiz Fernando de Andrade Viotti 
Secretaria Técnica: ABIMO - Associação Brasileira da Indústria de
Artigos e Equipamentos Médicos, Odontológicos, Hospitalares e
de Laboratórios
Chefe de Secretaria: Rita de Cássia Cação
Av. Paulista, 1313 - 8º andar - Sala 806
Cep: 01311-923 - São Paulo - SP
Fone: (11) 3285-0155 ramal 32
Fax: (11) 3285-0155 ramal 30
E-mail: cb26@abnt.org.br 

Comitês ISO/TC relacionados: 

Categoria: O - membro observador | P - membro participante 

  • Membro - P: ISO/TC 76, ISO/TC 84, ISO/TC 121, ISO/TC 150, ISO/TC 157, ISO/TC 194, ISO/TC 198 
  • Membro - O: ISO/TC 106, ISO/TC 168, ISO/TC 170, ISO/TC 173 
Links para Recursos Adicionais Exemplos

1) Entrada de um Descritor MeSH em XML

<?xml version="1.0"?>
<!DOCTYPE DescriptorRecordSet SYSTEM "desc2006.dtd">
<DescriptorRecordSet>
<DescriptorRecord DescriptorClass = "1">
  <DescriptorUI>D000001</DescriptorUI>
  <DescriptorName>
   <String>Calcimycin</String>
  </DescriptorName>
  <DateCreated>
   <Year>1974</Year>
   <Month>11</Month>
   <Day>19</Day>
  </DateCreated>
  <DateRevised>
   <Year>2003</Year>
   <Month>07</Month>
   <Day>30</Day>
  </DateRevised>
  <DateEstablished>
   <Year>1984</Year>
   <Month>01</Month>
   <Day>01</Day>
  </DateEstablished>
  <ActiveMeSHYearList>
   <Year>2004</Year>
   <Year>2005</Year>
   <Year>2006</Year>
  </ActiveMeSHYearList>
  <AllowableQualifiersList>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000008</QualifierUI>
      <QualifierName>
      <String>administration &amp; dosage</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>AD</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000009</QualifierUI>
      <QualifierName>
      <String>adverse effects</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>AE</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000031</QualifierUI>
      <QualifierName>
      <String>analogs &amp; derivatives</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>AA</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000032</QualifierUI>
      <QualifierName>
      <String>analysis</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>AN</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000037</QualifierUI>
      <QualifierName>
      <String>antagonists &amp; inhibitors</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>AI</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000096</QualifierUI>
      <QualifierName>
      <String>biosynthesis</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>BI</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000097</QualifierUI>
      <QualifierName>
      <String>blood</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>BL</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000134</QualifierUI>
      <QualifierName>
      <String>cerebrospinal fluid</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>CF</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000138</QualifierUI>
      <QualifierName>
      <String>chemical synthesis</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>CS</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000145</QualifierUI>
      <QualifierName>
      <String>classification</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>CL</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000176</QualifierUI>
      <QualifierName>
      <String>diagnostic use</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>DU</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000191</QualifierUI>
      <QualifierName>
      <String>economics</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>EC</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000266</QualifierUI>
      <QualifierName>
      <String>history</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>HI</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000276</QualifierUI>
      <QualifierName>
      <String>immunology</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>IM</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000302</QualifierUI>
      <QualifierName>
      <String>isolation &amp; purification</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>IP</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000378</QualifierUI>
      <QualifierName>
      <String>metabolism</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>ME</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000493</QualifierUI>
      <QualifierName>
      <String>pharmacokinetics</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>PK</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000494</QualifierUI>
      <QualifierName>
      <String>pharmacology</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>PD</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000506</QualifierUI>
      <QualifierName>
      <String>poisoning</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>PO</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000528</QualifierUI>
      <QualifierName>
      <String>radiation effects</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>RE</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000592</QualifierUI>
      <QualifierName>
      <String>standards</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>ST</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000600</QualifierUI>
      <QualifierName>
      <String>supply &amp; distribution</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>SD</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000627</QualifierUI>
      <QualifierName>
      <String>therapeutic use</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>TU</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000633</QualifierUI>
      <QualifierName>
      <String>toxicity</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>TO</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000652</QualifierUI>
      <QualifierName>
      <String>urine</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>UR</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000737</QualifierUI>
      <QualifierName>
      <String>chemistry</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>CH</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000744</QualifierUI>
      <QualifierName>
      <String>contraindications</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>CT</Abbreviation>
   </AllowableQualifier>
   <AllowableQualifier>
    <QualifierReferredTo>
     <QualifierUI>Q000819</QualifierUI>
      <QualifierName>
      <String>agonists</String>
      </QualifierName>
    </QualifierReferredTo>
    <Abbreviation>AG</Abbreviation>
   </AllowableQualifier>
  </AllowableQualifiersList>
  <HistoryNote>91(75); was A 23187 1975-90 (see under ANTIBIOTICS 1975-83)
  </HistoryNote>
  <OnlineNote>use CALCIMYCIN to search A 23187 1975-90
  </OnlineNote>
  <PublicMeSHNote>91; was A 23187 1975-90 (see under ANTIBIOTICS 1975-83)
  </PublicMeSHNote>
  <PreviousIndexingList>
   <PreviousIndexing>Antibiotics (1973-1974)</PreviousIndexing>
   <PreviousIndexing>Carboxylic Acids (1973-1974)</PreviousIndexing>
  </PreviousIndexingList>
  <TreeNumberList>
   <TreeNumber>D03.438.221.173</TreeNumber>
  </TreeNumberList>
  <RecordOriginatorsList>
   <RecordOriginator>NLM</RecordOriginator>
   <RecordMaintainer>SYSTEM</RecordMaintainer>
   <RecordAuthorizer>NLM</RecordAuthorizer>
  </RecordOriginatorsList>
  <ConceptList>
   <Concept PreferredConceptYN="Y">
    <ConceptUI>M0000001</ConceptUI>
    <ConceptName>
     <String>Calcimycin</String>
    </ConceptName>
    <ConceptUMLSUI>C0000699</ConceptUMLSUI>
    <CASN1Name>4-Benzoxazolecarboxylic acid, 5-(methylamino)-2-
((3,9,11-trimethyl-8-(1-methyl-2-oxo-2-
(1H-pyrrol-2-yl)ethyl)-1,7-dioxaspiro(5.5)undec-2-yl)methyl)-, (6S-(6alpha(2S*,3S*),8beta(R*),9beta,11alpha))-</CASN1Name>
    <RegistryNumber>52665-69-7</RegistryNumber>
    <ScopeNote>An ionophorous, polyether antibiotic from Streptomyces chartreusensis. It binds and transports cations across membranes and uncouples oxidative phosphorylation while inhibiting ATPase of rat liver mitochondria. The substance is used mostly as a biochemical tool to study the role of divalent cations in various biological systems.
    </ScopeNote>
    <SemanticTypeList>
     <SemanticType>
      <SemanticTypeUI>T109</SemanticTypeUI>
      <SemanticTypeName>Organic Chemical</SemanticTypeName>
     </SemanticType>
     <SemanticType>
      <SemanticTypeUI>T195</SemanticTypeUI>
      <SemanticTypeName>Antibiotic</SemanticTypeName>
     </SemanticType>
    </SemanticTypeList>
    <PharmacologicalActionList>
     <PharmacologicalAction>
      <DescriptorReferredTo>
       <DescriptorUI>D000900</DescriptorUI>
        <DescriptorName>
         <String>Anti-Bacterial Agents</String>
        </DescriptorName>
      </DescriptorReferredTo>
     </PharmacologicalAction>
     <PharmacologicalAction>
      <DescriptorReferredTo>
       <DescriptorUI>D007476</DescriptorUI>
        <DescriptorName>
         <String>Ionophores</String>
        </DescriptorName>
      </DescriptorReferredTo>
     </PharmacologicalAction>
    </PharmacologicalActionList>
    <ConceptRelationList>
     <ConceptRelation RelationName="NRW">
     <Concept1UI>M0000001</Concept1UI>
     <Concept2UI>M0353609</Concept2UI>
     </ConceptRelation>
    </ConceptRelationList>
    <TermList>
     <Term  ConceptPreferredTermYN="Y"  IsPermutedTermYN="N"  LexicalTag="NON"  PrintFlagYN="Y"  RecordPreferredTermYN="Y">
      <TermUI>T000002</TermUI>
      <String>Calcimycin</String>
      <DateCreated>
       <Year>1999</Year>
       <Month>01</Month>
       <Day>01</Day>
      </DateCreated>
      <ThesaurusIDlist>
       <ThesaurusID>NLM (1975)</ThesaurusID>
      </ThesaurusIDlist>
     </Term>
    </TermList>
   </Concept>
   <Concept PreferredConceptYN="N">

    <ConceptUI>M0353609</ConceptUI>
    <ConceptName>
     <String>A-23187</String>
    </ConceptName>
    <ConceptUMLSUI>C0878412</ConceptUMLSUI>
    <RegistryNumber>0</RegistryNumber>
    <SemanticTypeList>
     <SemanticType>
      <SemanticTypeUI>T109</SemanticTypeUI>
      <SemanticTypeName>Organic Chemical</SemanticTypeName>
     </SemanticType>
     <SemanticType>
      <SemanticTypeUI>T195</SemanticTypeUI>
      <SemanticTypeName>Antibiotic</SemanticTypeName>
     </SemanticType>
    </SemanticTypeList>
    <ConceptRelationList>
     <ConceptRelation RelationName="NRW">
     <Concept1UI>M0000001</Concept1UI>
     <Concept2UI>M0353609</Concept2UI>
     </ConceptRelation>
    </ConceptRelationList>
    <TermList>
     <Term  ConceptPreferredTermYN="Y"  IsPermutedTermYN="N"  LexicalTag="LAB"  PrintFlagYN="N"  RecordPreferredTermYN="N">
      <TermUI>T000001</TermUI>
      <String>A-23187</String>
      <DateCreated>
       <Year>1990</Year>
       <Month>03</Month>
       <Day>08</Day>
      </DateCreated>
      <SortVersion>A A 23187</SortVersion>
      <ThesaurusIDlist>
       <ThesaurusID>NLM (1991)</ThesaurusID>
      </ThesaurusIDlist>
     </Term>
     <Term  IsPermutedTermYN="Y"  LexicalTag="LAB">
      <TermUI>T000001</TermUI>
      <String>A 23187</String>
     </Term>
     <Term  ConceptPreferredTermYN="N"  IsPermutedTermYN="N"  LexicalTag="NON"  PrintFlagYN="N"  RecordPreferredTermYN="N">
      <TermUI>T000003</TermUI>
      <String>Antibiotic A23187</String>
      <DateCreated>
       <Year>1990</Year>
       <Month>03</Month>
       <Day>08</Day>
      </DateCreated>
      <ThesaurusIDlist>
       <ThesaurusID>NLM (1991)</ThesaurusID>
      </ThesaurusIDlist>
     </Term>
     <Term  IsPermutedTermYN="Y"  LexicalTag="NON">
      <TermUI>T000003</TermUI>
      <String>A23187, Antibiotic</String>
     </Term>
     <Term  ConceptPreferredTermYN="N"  IsPermutedTermYN="N"  LexicalTag="LAB"  PrintFlagYN="N"  RecordPreferredTermYN="N">
      <TermUI>T000004</TermUI>
      <String>A23187</String>
      <DateCreated>
       <Year>1974</Year>
       <Month>11</Month>
       <Day>11</Day>
      </DateCreated>
      <ThesaurusIDlist>
       <ThesaurusID>UNK (19XX)</ThesaurusID>
      </ThesaurusIDlist>
     </Term>
    </TermList>
   </Concept>
  </ConceptList>
 </DescriptorRecord>
</DescriptorRecordSet>

2. Mensagem em HL7 ver. 2.5

Uma mensagem de Registro de Paciente completa em HL7 (Exemplo de Kenneth S. Rubin)

MSH|^~\&|REGADT|MCM|IFENG||199112311501||ADT^A04|000001|P|2.4|||
EVN|A04|199901101500|199901101400|01||199901101410
PID|||191919^^^GENHOS^MR~371-66-9256^^^USSSA^SS|253763|MASSIE^JAMES^A||
19560129|M|||171 ZOBERLEIN^^ISHPEMING^MI^49849^""^||(900)485-5344|(900)485-5344||S|C|
10199925^^^GENHOS^AN|371-66-9256||
NK1|1|MASSIE^ELLEN|SPOUSE|171 ZOBERLEIN^^ISHPEMING^MI^49849^""^|
(900)485-5344|(900)545-1234~(900)545-1200|
EC1^FIRST EMERGENCY CONTACT
NK1|2|MASSIE^MARYLOU|MOTHER|300 ZOBERLEIN^^ISHPEMING^MI^49849^""^|(900)485-5344|(900)545-1234~(900)545-1200|
EC2^SECOND EMERGENCY CONTACT
PV1||O|O/R||||0148^ADDISON,JAMES|0148^ADDISON,JAMES|0148^ADDISON,JAMES|AMB||
|||||0148^ADDISON,JAMES|S|1400|A|||||||||||||||||||GENHOS|||||199501101410|
PV2||||||||199901101400||||||||||||||||||||||||||199901101400
OBX||ST|1010.1^BODY WEIGHT||62|kg|||||F
OBX||ST|1010.1^HEIGHT||190|cm|||||F
DG1|1|19||BIOPSY||00|
GT1|1||MASSIE^JAMES^""^""^""^""^||171 ZOBERLEIN^^ISHPEMING^MI^49849^""^|
(900)485-5344|(900)485-5344
||||SE^SELF|371-66-925||||MOOSES AUTO CLINIC|171 ZOBERLEIN^^ISHPEMING^MI^49849^""|
(900)485-5344|
IN1|0|0|BC1|BLUE CROSS|171 ZOBERLEIN^^ISHPEMING^M149849^""^||
(900)485-5344|90||||||50 OK|

Abaixo repetimos a mesma mensagem, agora comentada:

Cabeçalho e descritor de evento
MSH|^~\&|REGADT|MCM|IFENG||199112311501||ADT^A04|000001|P|2.4|||<cr>
EVN|A04|199901101500|199901101400|01||199901101410<cr>
Identificador do Paciente
PID|||191919^^^GENHOS^MR~371-66-9256^^^USSSA^SS|253763|MASSIE^JAMES^A||19560129|
M|||171 ZOBERLEIN^^ISHPEMING^MI^49849^""^||(900)485-5344|(900)485-5344||S|C|
10199925^^^GENHOS^AN|371-66-9256||<cr>
Dados de Parentes Próximos
NK1|1|MASSIE^ELLEN|SPOUSE|171 ZOBERLEIN^^ISHPEMING^MI^49849^""^|(900)485-5344
|(900)545-1234~(900)545-1200|EC1^FIRST EMERGENCY CONTACT<cr>
NK1|2|MASSIE^MARYLOU|MOTHER|300 ZOBERLEIN^^ISHPEMING^MI^49849^""^|(900)485-5344
|(900)545-1234~(900)545-1200|EC2^SECOND EMERGENCY CONTACT<cr>
Informação sobre a Consulta
PV1||O|O/R||||0148^ADDISON,JAMES|0148^ADDISON,JAMES|0148^ADDISON,JAMES|AMB|
||||||0148^ADDISON,JAMES|S|1400|A|||||||||||||||||||GENHOS|||||199501101410|<cr>
PV2||||||||199901101400||||||||||||||||||||||||||199901101400<cr>
Dados biométricos
OBX||ST|1010.1^BODY WEIGHT||62|kg|||||F<cr>
OBX||ST|1010.1^HEIGHT||190|cm|||||F<cr>
Diagnostico
DG1|1|19||BIOPSY||00|<cr>
Plano de Saúde
GT1|1||MASSIE^JAMES^""^""^""^""^||171 ZOBERLEIN^^ISHPEMING^MI^49849^""^|(900)485-5344|(900)485-5344||||SE^SELF|
371-66-925||||MOOSES AUTO CLINIC|171 ZOBERLEIN^^ISHPEMING^MI^49849^""|(900)485-5344|<cr>
IN1|0|0|BC1|BLUE CROSS|171 ZOBERLEIN^^ISHPEMING^M149849^""^||
(900)485-5344|90||||||50 OK|<cr>