www.arge-elga.at+43 1 212 70 50 a-1020 vienna, schiffamtsgasse 15 applying the xds profile - best...

www.arge-elga.at +43 1 212 70 50 A-1020 Vienna, Schiffamtsgasse 15

Applying the XDS profile - Best Practice in Austria

Presented at World of Health IT 2007IHE-Europe Session, Vienna

23.10.2007Dipl.-Ing. Dr. Alexander Schanner XDS and other related profiles in Austria

Agenda

1. Introduction

2. ELGA = Austrian’s EHR

3. XDS in Lower Austria

4. IHE Austria


Task Force Electronic Health Record - Arge ELGA - Arbeitsgemeinschaft Elektronische Gesundheitsakte

1. Decision of Federal Health Commission (BGK) from July 2006 concerning establishment of Arge ELGA and financial remuneration

2. Working basis of Arge ELGA is an agreement between 1. Federal Government2. Provinces and3. Social Insurance Institutions

3. Since September 2006 ARGE ELGA is acting operationallyLocation: A-1020 Vienna, Schiffamtsgasse 15


Definition of ELGA

1. ELGA contains relevant multimedia-based and health related data and information referring to a precisely identified person.

2. Data und information originate from

1. different health service providers and

2. from the patient himself/herself

and are stored in one or several different information systems (virtual health record).

1. Data are available independently of place and time (7x24) at the place of treatment for all authorized persons according to the tasks and needs of these persons and in compliance with data protection rules


Federal Health Agency (BGK) – decision (1/3)

ELGA Architecture consists of the following basic components 1. Master Patient Index 2. Health Service Provider (HSP) Index

(global directory of healthcare providers)

3. Registry4. Authorization System5. Portal

ELGA provides in the first phase of implementation the core applications1. discharge Summary2. e-Report - radiology3. e-Report - laboratory4. e-Medication


International standards for ELGA in Austria:

1. IHE Frame-Work with domain1. IT Infrastructure2. Patient Care Coordination3. Laboratory4. Radiology

2. HL7 CDA 2.0 as document standard3. LOINC (area Laboratory data)4. DICOM 3.0 incl. WADO (area radiology)5. HL7 (in Version 3 with RIM as prospective data model)



Detailed planning and first piloting (2007 / 2008)

1. Concretion Basic Components and Master Plan2. Project 1 – Master Patient Index 3. Project 2 – HSP Index4. Project 3 – Document Registry5. Project 4 – Authorization System 6. Project 5 – Portal 7. Project 6 – Main Application first phase of implementation8. Project 7 – Acceptance Management

Acceptance of each project after the presentation of an organizational and financial concept through BGK



Agenda

1. Introduction



4. IHE Austria


Overview System Architecture

PortalHSP System HSP System

Consumer

Consumer Consumer SourceSource

Source

Pat - Index

Repository

HSP - Index

AutohorizationSystem

Document Registry

Audit System

External Registries

(base identifi-cation number,

...)

ELGA Context


Interoperability – Standards and Catalogs

1. Technical (syntactical) interoperability

2. Content wise (semantical) interoperability

Requirement:

Assortment of international standards

1. Standards rise quality and reduce costs!

2. Standards promote competition!


HIS PatientIdentifySource

Registry Consumer

Repository

Source

IHE conform:

easy to replace Vendors

not IHE conform:

no replacement of Vendors possible

HIS Patient Identify Source

Registry

Consumer

Repository

Source

StandardStandard Non StandardNon Standard

Why Standards ?


Technical framework for ELGA: IHE Profile XDS

Document Consumer

Document Repository

Document ConsumerDocument Registry

Patient IdentitySource

MPIMPIMaster Patient Index

EPAEPA--IIElektronischer Patienten Akte - Index

2 Register

3 Query

4 Retrieve

VIEW

SEARCH

Document Source

Document Source

Document Repository

1 Provide

STORE

MAKEDocument Consumer

Document Repository

Document ConsumerDocument Registry




2 Register

3 Query

4 Retrieve

VIEW

SEARCH

Document Source

Document Source

Document Repository

1 Provide

STORE

MAKEDocument ConsumerDocument Consumer

Document RepositoryDocument Repository

Document ConsumerDocument ConsumerDocument RegistryDocument Registry





2 Register

3 Query

4 Retrieve

VIEW

SEARCH

Document Source

Document Source

Document Repository

1 Provide

STORE

MAKE

Document SourceDocument Source

Document SourceDocument Source

Document RepositoryDocument Repository

1 Provide

STORE

MAKE


Agenda

1. Introduction



4. IHE Austria


NÖGUS (www.noegus.at)

Lower Austrian health and welfare fund

NÖ Landeskliniken-Holding (www.lknoe.at)

going there ……

Project

Patienten-Index

Project

Patienten-Index


Lower Austria

Federal stateFederal stateofofLower AustriaLower Austria

approx. 1.6 million inhabitants

27 hospitals approx. 8000 beds

approx. 3000 general practitioners

Vienna


Starting PointHospitals in Lower Austria

Situation ituation 20041. 27 Locations

2. 22 Organizational Units

3. 18 Different Owners

4. 270 IT Systemssupplied by

70 Manufacturers

Mistelbach

Hainburg

Hollabrunn

St. Pölten

Lilienfeld

Amstetten

Waidhofen an der Thaya

Gmünd

Krems

Tulln Korneuburg

Stockerau

Melk

ScheibbsWaidhofen an der Ybbs

Zwettl

Horn

Eggenburg

Allentsteig

Gugging

MauerMödling

Baden

Hochegg

Wiener Neustadt

Neunkirchen

Klosterneuburg


Global Aims of NÖGUS

1. Creation of a central and integrative information and communication platform to meet the patient-related requirements of healthcare and welfare in Lower Austria.

2. To make all relevant medical data of a patient available at any location and at any time for authorized persons or organizations to the extent required, thus providing quicker and more efficient medical assistance.

3. Synergy and cost efficiency in the acquirement and operation of IT systems.


Patient Demographics embedded in HIS

IHE: Patient Demographics Consumer

Local ClientConnector

HL7 Server

NÖMEDPatient Index

IHE: Patient Cross Reference ManagerIHE: Patient Demographics Supplier

Query

KIS: PatientensucheResult

Retrie

ve

Find Patients in HIS plus Index

Admission in HIS


Document Consumer embedded in HIS


Document ConsumerWeb Application


Already used

• PIX• PDQ• EUA• ATNA• PWP• XDS.a• XDS.b

IHE Profiles in Lower Austria

• XDS-I• RFD• BPPC• XUA• XCA

Planned for future


Agenda

1. Introduction



4. IHE Austria


IHE Austria will cover some add-ons

1. Support development of requirements and specifications for ELGA and other health IT Projects

2. Coordinate with IHE international

1. Develop „national extensions“

2. Contribute to international work on the profiles

3. Take care for „certification“ of software products

1. This is more than interoperability!

2. QA, security audits, load balancing, …,

3. Cooperate with IHE international, Eurorec, CCHIT, …

4. Make sure that vendors can use „ELGA certificates“ in international markets, too.


Tasks of IHE Austria

1. Manage project groups

1. For use cases, specifications, international contacts

2. Provide „ELGA-thon“

1. What exactly is this? Concept work

2. Build up infrastructure

3. Keep everybody informed

1. Website, communication platform, events, …


Thank you for your Attention!

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