ehr systems use and quality in ehr systems use and quality in austria ehr systems quality labelling...
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EHR EHR SSystems ystems UUsese and and QQualityuality in in Austria
EHR Systems Quality Labelling and Certification21 - 22 November 2011, Belgrade
FH-Prof. DI Dr. Stefan Sauermann
UAS Technikum WienProgram Director, Biomedical Engineering Sciences ProRec Austria
Myself: Myself:
Communications engineer, ◦ 15 years MedUni Vienna, BME
Head of national CEN ISO mirror „Medical Informatics“
Founding member of IHE AustriaConsulting ELGA
◦ CDA harmonisation of the Lab ReportResearch project in personal healthcare
◦ www.healthy-interoperability.at
EHR Systems Quality Labelling and Certification21 - 22 November 2011, Belgrade
Health Care in AustriaHealth Care in Austria
Insurance based system◦~25 public insurances
15000 GPs◦many with social security contracts
Hospitals: mostly provincial holdings◦Additional private hospital groups
Many legacy IT systems◦Big and small
EHR Systems Quality Labelling and Certification21 - 22 November 2011, Belgrade
EHR EHR systemsystems:s: market (estimates) market (estimates)
Software use◦ 80-90% of GPs use software
◦ Nearly all hospitals use EHRs
Number of products◦ Many GP systems! (> 100 vendors)
◦ >10 hospital products (>10 vendors)
Market shares◦ 4 GP software vendors cover 60% of market
◦ 4 Hospital products cover 75% of market
market stable over last five years
EHR Systems Quality Labelling and Certification21 - 22 November 2011, Belgrade
Existing law: enables treatmentExisting law: enables treatment
Laws for the medical professions
eGovernment law
Data protection law
Enables point-to-point data exchange
Not suited for single access all data for one
patient
EHR Systems Quality Labelling and Certification21 - 22 November 2011, Belgrade
National EHR lawNational EHR law: : expected within months expected within months
Enables sharing of patient related data
Data protection is primary concern
◦Access only in context of treatment
◦Patients have control on who may access what
Storage
◦What, how long
...
EHR Systems Quality Labelling and Certification21 - 22 November 2011, Belgrade
EHR systemsEHR systems:: quality assessment quality assessment
Existing GP software certification (in discussion)
◦ Approval of reimbursement for treatment (eCard)
◦ Reimbursement (Social insurance)
◦ Standardised data export (Chamber of doctors)
No incentive for using quality assessed / certified
EHR systems
EHR Systems Quality Labelling and Certification21 - 22 November 2011, Belgrade
„Affinity domain“ (Build by HCP or vendor)
Local Document Registries with
Repositories
National EHR National EHR ELGAELGA: : growing!growing!
Follows IHE IT Infrastructure (XDS, ATNA, BPC, ... )
EHR Systems Quality Labelling and Certification21 - 22 November 2011, Belgrade
Central components (Built by ELGA)
Master Patient Index
Healthcare Provider Index
GP SWCIS
GP SWCIS
GP SWCISGP SW,
CIS
Domain …Domain B
ELGA Timeline (roughly)ELGA Timeline (roughly)
Master patient, HCP index availableHarmonised CDA availableeMedication in pilotSecurity system in procurementConformant affinity domains existing
◦ Reference domain in procurement
Reference domain go live expected 2012/13All hospitals integrated 2014GPs integration in full swing 2015
EHR Systems Quality Labelling and Certification21 - 22 November 2011, Belgrade
Highlight: Clinical Documents Highlight: Clinical Documents (Real beauties!!)(Real beauties!!)
http://www.elga.gv.at/index.php?id=28
Discharge informationRadiology and Lab
reports◦ HL7 CDA
Content harmonized ◦ >120 medical experts◦ Implementations already
available
Usability guided design
EHR Systems Quality Labelling and Certification21 - 22 November 2011, Belgrade
„Affinity domain“ (Build by HCP or vendor)
Local Document Registries with
Repositories
Possible steps Possible steps to certificationto certification
Security first? Then affinity domain connection? Then GP/CIS connection?
EHR Systems Quality Labelling and Certification21 - 22 November 2011, Belgrade
Central components (Built by ELGA)
Master Patient Index
Healthcare Provider Index
GP SWCIS
GP SWCIS
GP SWCISGP SW,
CIS
Domain …Domain B
Certification prioritiesCertification priorities
Without access rights /security there is no data exchange
This is a task in Europe
May this be a first „eHealth Certificate“ on European level?
EHR Systems Quality Labelling and Certification21 - 22 November 2011, Belgrade
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