international hl7 interoperability conference - ihic 2010
TRANSCRIPT
International HL7 Interoperability Conference - IHIC 2010
National eHealth Initiatives: Global Health Information Technology Standards Serving Local Needs
“Building Interoperability…across many localities”
Don Newsham – May 14, 2010
Three “localities”
Canadian Standards Direction
Global Standards Direction
Low Income / Low Resource Country Standards Direction
Connecting Standardsin Canada
Health Informatics standards community in Canada has completed a major governance transformation
Now a single cohesive, coordinated collaborative
With integrated organizations, process and services across numerous standards SDOs and domains
• resulting in a 50% reduction in committees
Providing a single point of contact for coordination of Pan-Canadian standards throughout the standards life cycle.
Infoway CIHISCC
Standards CollaborativeStrategic Committee
Standards CollaborativeCoordinating Committee
CSA
Technical Sub-Committee Clinical Sub-Committee
SCWG #1 -
Population Health
(Delivery of Care)
SCWG #2 -
Individual Care
(Delivery of Care)
SCWG #3 -
Managing the Health
System
pCSGSCWG #4 -
Medication
Management
SCWG # - Labs &
Diagnostics
SCWG #6 -
Infostructure &
Architecture
SCWG #7 - Non-
Clinical Registries
SCWG #8 - IT
Privacy & Security
Services
SCWG #9 -
Terminology
Representation &
Services
pCSG
Standards Collaborative Governance Model
Options Research
and Analysis
StandardsDevelopment
NeedsIdentification
&Business Definition
Maintenance
TrainingEducation
Conformance
ImplementationSupport
Test Pilot
Pan-Canadian Standards
Options Research
and Analysis
StandardsDevelopment
NeedsIdentification
&Business Definition
Maintenance
TrainingEducation
Conformance
ImplementationSupport
Test Pilot
Pan-Canadian Standards
Evaluation
AdoptionStrategies
Tools andTemplates
StandardsKnowledge
Management
Liaison
Promotion & Communication
Licenses
Change Management
Infoway Investment on Standards to date
Total Infoway investments in standards including source of other funds
$33 Million Investments in the development of standards through Infoway Programs
$30.0 Million Actual and planned investments in the deployment and maintenance of standards through the Standards Collaborative FY 06-10.
Standards to support the Infoway EHR mandate
SNOMED CT
National e-Claims Standards
Client Registry Standards
Provider Registry Standards
Diagnostic Imaging Standards
Drug Standards
Laboratory Messaging and Nomenclature Standards
Public Health Surveillance Standards
iEHR Clinical Messaging Standards
Physician Office Systems Requirements
iEHR Technical Standards
Security and Consent Standards
Patient Access to Quality Care Standards
JURISDICTIONAL INFOSTRUCTURE
POINT OF SERVICE
TerminologyRepository
Ancillary Data& Services
Registries Data& Services
EHR Data& Services
DataWarehouse
ImmunizationManagement
PHSReporting
SharedHealth Record
DrugInformation
DiagnosticImaging
Laboratory HealthInformation
Hospital, LTC,CCC, EPR
PhysicianOffice EMR
EHRViewer
Physician/Provider
BusinessRules
EHRIndex
MessageStructures
NormalizationRules
Security MgmtData
Privacy Data Configuration
Physician/Provider
Physician/Provider
Lab System(LIS)
Lab Clinician
RadiologyCenter
PACS/RIS
Radiologist
PharmacySystem
Pharmacist
Public HealthServices
Public Health Provider
Longitudinal Record Services
HIALCommunication Bus
Common Services
ClientRegistry
ProviderRegistry
LocationRegistry
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Standards Used in the EHRS
Standards Legend ���� Client Registry ���� Provider Registry ���� Location Registry ���� CeRx/Drugs
���� SNOMED / Clinical Terminology ���� Laboratory LOINC, PCLOD ���� iEHR Clinical Messaging ���� Public Health Surveillance ����National e-Claims
���� Diagnostic Imaging
Global HI Standards Direction
Underway for 10+ years
Launched under different “authorities”, with different or overlapping “mandates”
Global, European, US, WHO, Individual Country
Targeting segments of the interoperability problemImaging, Messaging, Laboratory Results, Terminologies, MedicinalProducts, EHR, Technical Transport, Devices, Research
Through multiple SDO’s Often volunteer based, varying infrastructure / proposal / development / balloting / publication processes
All with best intentions, all contributing to duplicate, overlapping, differing approaches to interoperability
With no coordinated answer to:1. What is the one standard (or package of standards) to solve my
health business problem, with 100’s of standards to choose?
2. What can be done to support local needs, to support countries atvarying stages of HIS development?
Joint Initiative
Joint Initiative on SDO Global Health Informatics Standardization
�CEN, HL7, ISO Initial Charter Signatories
� CDISC, IHTSDO and GS1 also now signatories
International Health Terminology
Joint Initiative Work Program
Work Program includes:Biomedical Research Information Domain Group (Bridg) Model
Data Types (in final FDIS ballot)
Pharmacovigilance / Identification of Medicinal Products (ICSR and IDMP)
Clinical Trial Registration and Results
SKMT (GLOSSARY and DOCUMENT Registry)
EHR Functional Model (R2)
Patient Identifiers for automatic identification data capture
Preliminary / PotentialQuality requirements and methodology for detailed clinical models
Generic Model for Dose Syntax
Tracking Medical Device Software regulation and Privacy standards across SDO’s
Collaborating with countries at varying stages
Developed countries using national mandates / national funded initiatives
Low Income / Low Resource countries
Becoming very active
Finding ways to address health information technology needs
Are challenged to access standards and engage with the standards community
Some Emerging Country Directions
Local needs in many countries
Need to support country wide Health Information Systems (HIS)
At population and public health levels
Nationally and for communities (of diseases and of people)
Moving also to EHR’s
A surge of interest in ehealth infostructures
Starting often with architectures
Local needs in many countries
Support for standards based ehealth architecture decisions that are
non-proprietary
robust and future proof
locally-driven and open
reference implemented based
And that use commonly shared standards to carry out monitoring and evaluation
• For govt bodies, international organizations, donors and others
Local (HI standards) needs supported by Global Action
Players
Countries at early stages of health information systems
Global players (being there, doing that)
• WHO / Health Metrics Network
• Standards Development Organizations
• Donors (Rockefeller, Gates, IDRC, ….)
• Country governments / associations / experts
• Technology associations (mhealth, …)
Local (HI standards) needs supported by Global Action
Actions
Collaborative, capacity building, design & standards development workshops
• Increasing scope and momentum
– Geneva, Kigali, Bangkok, Bellagio, Vancouver
WHO / HMN global coordination / strength
• Expertise, focal point, leadership
Donors engaged and also leading
• Targeting initiatives with momentum and broad participation, real impact on health,
• Targeting / leading collaborative initiatives
Local (HI standards) needs supported by Global Action
Actions
Country Governments
• Assigning government / academic leaders to develop their own ehealth plans, strategies & architectures
• Signing bi or multi-lateral mutual development agreements or assigning expert support
• Often starting with telehealth or public health
Technology companies / associations
• Increasing awareness of market potential
• Still find balance between providing their solution versus supporting local needs
Local (HI standards) needs supported by Global Action
Actions
SDO’s
• Bellagio workshop on ISO / ehealth architecture standard for low income / low resource countries & “declaration” for standards access and participation
• Joint Initiative
– Task group underway to determine joint actions needed for standards access and participation for low income / low resource countries
• HMN leading Framework For National Health Information Systems standard in ISO/TC215
• Developing list of standards now available
• …
Getting Started for Local NeedsGet involved and engaged with standards of priority to you / your country / your context
Participate in standards meetings, standards discussions where ever such take place
Connect your experts / academics to other nearby countries to address ehealth, architecture and standards issues
Track Joint Initiative actions
Build local capacity and awareness through education, workshops, support from SDO leaders for in-country conferences / meetings, donor engagement
Promote use of standards that are important to your local initiatives
International HL7 Interoperability Conference - IHIC 2010
“Building Interoperability…across many localities”
THANK YOU
Don Newsham