ehr certification, semantic interoperability and the link to clinical research

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G. De Moor, MD, PhD, EuroRec, Belgium Barcelona, 17 March 2010 Prof. Georges De Moor President, EuroRec University of Gent, Belgium [email protected] Parallel Session 25, Wednesday 17 March, 13:30-14:45

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EHR Certification, Semantic Interoperability and the Link to Clinical Research. Moor G. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

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Page 1: EHR Certification, Semantic Interoperability and the Link to Clinical Research

G. De Moor, MD, PhD, EuroRec, Belgium Barcelona, 17 March 2010

Prof. Georges De Moor

President, EuroRec

University of Gent, Belgium

[email protected]

Parallel Session 25, Wednesday 17 March, 13:30-14:45

Page 2: EHR Certification, Semantic Interoperability and the Link to Clinical Research

G. De Moor, MD, PhD, EuroRec, Belgium Barcelona, 17 March 2010

EHR-Certification, Semantic Interoperability and the

Link to Clinical Research

Georges De Moor, EuroRec, Belgium

The Role of Clinicians in Clinical Concept Modelling

Dipak Kalra, Univ. College London, U.K.

Different Interoperability Needs for Clinical Research

Mats Sundgren, Astra Zeneca, Sweden

Parallel Session 25

Page 3: EHR Certification, Semantic Interoperability and the Link to Clinical Research

G. De Moor, MD, PhD, EuroRec, Belgium Barcelona, 17 March 2010

EuroRec

The EuroRec Institute is an independent not-for-profitorganisation established in 2003.

Its main mission is to promote - as a federation of nationalProRec centres (17 member countries and 6 new applicants)- the use of high-quality Electronic Health Record systems(EHRs) in Europe.

It therefore also supports certification by defining qualitycriteria.

Page 4: EHR Certification, Semantic Interoperability and the Link to Clinical Research

G. De Moor, MD, PhD, EuroRec, Belgium Barcelona, 17 March 2010

Quality Criteria

EuroRec has installed a central repository of +1600 indexed,

validated and translated quality criteria and has developed

tools that can be used to harmonise certification, product

documentation and procurement specification of EHR

systems.

Existing criteria and tools are now being validated and tested

in 25 Member States through an ongoing project: EHR-Q-TN.

Harmonisation of the certification will favour harmonisation of

products.

Cf. the EuroRec seal:

Page 5: EHR Certification, Semantic Interoperability and the Link to Clinical Research

G. De Moor, MD, PhD, EuroRec, Belgium Barcelona, 17 March 2010

New Areas of Interest

- Semantic Interoperability (EHR-content, archetypes)

- Personal Health Records (and their interactions)

- Re-use of Electronic Health Record data for Research

- EHRs and Pre-emptive care: genetic data, individual risk

- EHRs and Cloud Computing

- Accreditation of Health IT Professionals

- Collaboration at global level: e.g. with the US

-…

Page 6: EHR Certification, Semantic Interoperability and the Link to Clinical Research

G. De Moor, MD, PhD, EuroRec, Belgium Barcelona, 17 March 2010

Re-Use of data

Clinician

Clinical Trials& Research

Safety and Adverse

Event Registers

EHR (EMR, EPR…)

DecisionSupport

Systems

Marketing

Billing

KnowledgeMgmt

Platforms

Privacy Enhancing Techniques

Patient

PHR

TRUST

HealthcareManagement

Page 7: EHR Certification, Semantic Interoperability and the Link to Clinical Research

G. De Moor, MD, PhD, EuroRec, Belgium Barcelona, 17 March 2010

EHRs can support Research:

- Reduce redundant data capture

- Provide a better understanding of real patient populations

- Hypothesis testing

- Clinical trial feasibility checking

- Population screening

- Patient recruitment!

- Early detection of safety risks

- Treatment effectiveness and outcomes

- Post-marketing monitoring and long term surveillance

- Line extensions

Page 8: EHR Certification, Semantic Interoperability and the Link to Clinical Research

G. De Moor, MD, PhD, EuroRec, Belgium Barcelona, 17 March 2010

The EHRCR Profile: a first step

The EHRCR profile is a profile of eClinical Forum endorsed by

EuroRec and HL7 with research-specific quality criteria in

order to certify EHR systems as suitable for use in the Clinical

Research environment.

Page 9: EHR Certification, Semantic Interoperability and the Link to Clinical Research

G. De Moor, MD, PhD, EuroRec, Belgium Barcelona, 17 March 2010

Main obstacle

The ultimate stumbling block is the problem of semantic

interoperability. For a system to adequately integrate data

between clinical care and research it is necessary to be able

to go beyond the simple coding of data in each type of system

and to enhance the capture of meaning between

communicating systems.

A further critical challenge is that clinical meaning in an EHR

is not limited to the interpretation of individual terms but also

to the context in which those terms have been entered.

Page 10: EHR Certification, Semantic Interoperability and the Link to Clinical Research

G. De Moor, MD, PhD, EuroRec, Belgium Barcelona, 17 March 2010

Response

EuroRec has - because of the problem of semantic

interoperability - a strategic interest in:

Promoting quality criteria not only related to EHR “business-”

functions but also related to “content”;

Validating clinical archetypes;

Involving the clinicians and their representative organisations

in its future projects and activities.

Page 11: EHR Certification, Semantic Interoperability and the Link to Clinical Research

G. De Moor, MD, PhD, EuroRec, Belgium Barcelona, 17 March 2010

Other challenges

Data quality is another important challenge when dealing with

the re-use of EHR data for research: consistency, correctness

and completeness (data integrity) are important in research.

Privacy protection (cf. use of P.E.T.s and role of T.T.P.s).

Ethical issues (e.g. data mining prior to obtaining consent).

... all these requirements need to be reflected in the functional

and content-related characteristics of an EHR system in order

to be considered as a reliable source of data for e.g. regulated

clinical trials.

Page 12: EHR Certification, Semantic Interoperability and the Link to Clinical Research

G. De Moor, MD, PhD, EuroRec, Belgium Barcelona, 17 March 2010

Synergies (1)

Accreditation schemes for research units (e.g. by ECRIN) and

certification of EHR vendor software for the re-use of data in

research (e.g. by EuroRec) can go hand in hand.

Together they will accelerate the adoption of a more

harmonised approach throughout Europe and serve as a

powerful means for ensuring reliability and trustworthiness of

the research partners (e.g. data providers) of the

pharmaceutical industry.

Page 13: EHR Certification, Semantic Interoperability and the Link to Clinical Research

G. De Moor, MD, PhD, EuroRec, Belgium Barcelona, 17 March 2010

Synergies (2)

Accreditation and certification will also enable research and

trials to be delivered more cost effectively.

Vendors of certified products and data sources (e.g. hospitals)

that will be accredited, will get a competitive advantage.

New business models in research will also be beneficial for

“all” stakeholders and strengthen the collaboration amongst

the partners!

Page 14: EHR Certification, Semantic Interoperability and the Link to Clinical Research

G. De Moor, MD, PhD, EuroRec, Belgium Barcelona, 17 March 2010

Thanks for listening!

http://www.eurorec.org

[email protected]

Page 15: EHR Certification, Semantic Interoperability and the Link to Clinical Research

G. De Moor, MD, PhD, EuroRec, Belgium Barcelona, 17 March 2010

EHR-Certification, Semantic Interoperability and the

Link to Clinical Research

Georges De Moor, EuroRec, Belgium

The Role of Clinicians in Clinical Concept Modelling

Dipak Kalra, Univ. College London, U.K.

Different Interoperability Needs for Clinical Research

Mats Sundgren, Astra Zeneca, Sweden

Parallel Session 25