The EuroRec Institute: Its Structure, Activities and New Services

1. The EuroRec Institute:Its Structure, Activitiesand New Services François MENNERAT, MD PhD EuroRec ProRec-France

2. Introduction to EuroRec www.eurorec.org

3. The EuroRec Institute • European Institute for Health Records • Non-profit organisation • founded in December 2002 as their Federation by the four ProRec centres that were established at that time (Belgium, Spain, France, and Bulgaria) • registered on 12 May 2003 • according to the French law • Active at the European level with respect to the "subsidiarity principle" • Bound to become self-sustainable EuroRec 2006, Genève

4. A succession of EU projects • MEDIREC - Medical Record • (EC, FP3, A-2103, 1994-1995) • PROREC - Promotion Strategy for the European HC Record • (EC, FP4, HC-1110, 1996-1998) • WIDENET - Offering World-Wide Services through an International Network of Health Record centres • (EC, FP5, IST-14203, 2000-2003) • Q-REC - Quality Labelling and Certification of Electronic Health Record systems in Europe • (EC, FP6, IST-27360, 2005-2008) EuroRec 2006, Genève

5. A succession of EU projects • MEDIREC • The Lisbon Declaration • PROREC • First ProRec centres established and co-operation between all stakeholders • WIDENET • Extension of the PROREC network (additional ProRec centres created) • Establishment of EuroRec (June 14, 2003) • Q-REC • Harmonisation of EHRS Certification • Delivery of new Services EuroRec 2006, Genève

6. EuroRec's overall objectives • Foster Quality of EHR Systems (EHRS) • To the benefit of patients • Support Interoperability of EHRS in Europe • To the benefit of citizens • Facilitate the emergence and consolidation of a European market of medical software EuroRec 2006, Genève

7. EuroRec's goals • Support ProRec centres • Inform users of current trends in EHRs and express their needs • Helppublic authoritiesto define and implement strategies • Support the EHRsindustry (ROI) • Promoteresearch, educationand development in EHRs • Fosterinternational co-operation • with US, Canada, Japan, Australia… EuroRec 2006, Genève

8. Members: Belgium Bulgaria Denmark France Germany Italy Ireland Romania Slovenia Spain Applicants: Norway Greece Hungary Portugal Poland Sweden The Netherlands Slovakia United Kingdom? The Network of ProRec centres “ Differences in legal and organisational framework, languages, etc. EuroRec 2006, Genève

9. EuroRec (Economy of scale / Synergy) (Complementarity / National pecularities / Law / Languages) … ProRec Centres… … Users (Clinicians, Citizens) Healthcare Authorities Purchasers, Payers EHRS Vendors EuroRec: Organisation

10. EuroRec: Organisation The current Board: • President Georges DE MOOR (BE) • Vice President (1) Kieran HICKEY (IE) • Vice President (2) Rolf ENGELBRECHT (DE) • Treasurer Louis SCHILDERS (BE) • Deputy Treasurer Knut BERNSTEIN (DK) • Secretary General François MENNERAT (FR) EuroRec 2006, Genève

11. EuroRec: Funding • Membership fees • Annual conferences • Services (cf. newBusiness Plan) • E.C. funded projects : CERTFE, QREC, RIDE... EuroRec 2006, Genève

12. 1997, Paris 1998, Rotterdam 1999, Sevilla 2001, Aix-en-Provence 2002, Berlin 2003, Dublin 2004, Bruxelles/Brussel 2006, Genève PROREC WIDENET Q-REC European Conferences on Electronic Health Records(EUROREC conferences) EuroRec 2006, Genève

13. EHRs and EHRsFrom data storageto data interchangeand to data processingFrom communication to interoperability

14. Electronic Health Record EHR - Basic generic form • repository of information regarding the health of a subject of care, in computer processable form ISO TR 20514:2005 "Definition, Scope and Context of Electronic Health Records" EuroRec 2006, Genève

15. Electronic Health Record System (EHRS) • system for recording, retrieving and manipulating information in electronic health records • CEN prEN 13606-1 "Electronic Health Record Communication - Part 1: Reference Architecture" • set of components that form the mechanism by which electronic health records are created, used, stored, and retrieved • It includes people, data, rules and procedures, processing and storage devices, and communication and support facilities • ISO TR 20514:2005 "Definition, Scope and Context of Electronic Health Records" EuroRec 2006, Genève

16. Clinical process • relies on data and information management (and processing): • acquisition • reception/sending out (emission) • storage • classification • interpretation/confrontation against knowledge • building up and validating hypotheses, making decisions • production of new data and information EuroRec 2006, Genève

17. Flows and stocks of health data • do reflect this activity • EHR systems are (should be) at the core of any health information systems • The idea of a single centralised health record is nothing but a pipe dream • Even if repositories of sharable data are increasingly needed • several health records held by different parties will inevitably always exist • between which messages will convey data • Some of them will contain sharable data • Interoperability between these records is an unavoidable requirement EuroRec 2006, Genève

18. Definition of Interoperability CEN / TC251 • a state which exists between two application entities when, • with regard to a specific task, • one application entity can accept data from the other and perform that task • in an appropriate and satisfactory manner • without the needfor extra operator intervention EuroRec 2006, Genève

19. Key role of interoperability • Single most importantcharacteristic of EHRs= ability toshare EHR information between different authorised users • In technical terms requires: • interoperability of information in the EHR • interoperability of EHR systems which exchange and share this information ISO TR 20514:2005 "EHR Definition, Scope, & Context" EuroRec 2006, Genève

20. Administrative Records Medical Records Nursing Records Patient Personal Health Records Trends in EHR Systems • EHR Systems become • transmural / virtual • multidisciplinary and interactive • intelligent Integration with other health care software applications into bigger systems... EuroRec 2006, Genève

21. Trends in EHR Systems • Medical and Bio-Medical data • “The PHENOMES will meet the GENOMES in the EHRs of the Future” • Security: Privacy Enhancing Techniques • Semantic Interoperability: Ontology based approaches • Added value of EHRs: eg.Decision Support Systems • Grid Technology: HealthGrid EuroRec 2006, Genève

22. Current and future activities:The Q-REC project European Quality Labelling and Certification of Electronic Health Records (EHR) Systems IST – 27370 - SSA

23. Objectives of the project • Design an effective, credible and sustainable mechanism for the Quality Labelling / certification of EHR Systems in Europe • Define a model for Quality Labelling / Certification including • Good Practices and Guidelines • Harmonised procedures EuroRec 2006, Genève

24. The scope of Q-REC • does not include • either national projects • or general issues regarding interoperability • is restricted to interoperability between EHR Systems • With an emphasis on conformity testing and certification EuroRec 2006, Genève

25. Operationally • State of the art and existing procedures for the Quality Labelling / Certification of EHR Systems • Terminology regarding Quality Labelling/ Certification • Functionalprofiles for the classification of EHR Systems to certified • Good practices and models of certification procedures • including a list of quality criteria • Manual of benchmarking processes by formal testing for the quality labelling / certification of EHR Systems • Business Model for Certification / Quality Labelling EuroRec 2006, Genève

26. Resources to support interoperability of EHR Systems Permanent publicly accessible Registers of • Quality conformance criteria • EHR Archetypes • Coding Systems used in Health Care • Relevant standards for EHR Systems • Available XML schemas and Open-Source components for EHR Systems EuroRec 2006, Genève

27. Partners in the consortium EuroRec 2006, Genève

28. Other projects • EuroRec is part of the RIDE project • "A Roadmap for Interoperability of eHealth Systems in Support of COM 356 with Special Emphasis on Semantic Interoperability" • EuroRec is part of the EHR-Implement project • Meant to examine political, social and organisational factors influencing large scale EHR implementations, and to identify best practices EuroRec 2006, Genève

29. Conclusion • EuroRec is playing its part in the development of eHealth in Europe, as anticipated by the European Commission • By facilitating and supporting the extensive development, implementation and use of interoperable high quality EHR systems throughout Europe • By providing an increasing number of effective services to suppliers, users, and public authorities EuroRec 2006, Genève

30. as well as for your questions ! Thank you for your attention… www.eurorec.org EuroRec 2006, Genève