1 / 34

Healthcare Transformation an the role of EHR: Views from government

Healthcare Transformation an the role of EHR: Views from government. Dipl.-Ing. Dr. Alexander Schanner Program-Manager 22.10.2007. Agenda. Introduction ELGA Architecture ELGA Standards ELGA Projects. Initial Situation. Political target:

kioko
Download Presentation

Healthcare Transformation an the role of EHR: Views from government

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Healthcare Transformation an the role of EHR: Views from government Dipl.-Ing. Dr. Alexander SchannerProgram-Manager 22.10.2007

  2. Agenda Introduction ELGA Architecture ELGA Standards ELGA Projects

  3. Initial Situation Alexander Schanner EHR in Austria • Political target: Using IT for the establishment of integrated medical care • Legal assignment: Agreement according to article 15a federal constitutional law • Legal framework: • data protection act • health telematics act • E-Government act • Laws on hospitals • … • Technical requirements: • e-card • Present HIS-systems • present intramural and extramural networking

  4. Government Program 2007Chapter 7 – Health 2 Agreement according to article 15a federal constitutional law article 7, paragraph 3 „In diesem Zusammenhang bekennen sich die Vertragsparteien prioritär zur Konzeption und Einführung der elektronischen Gesundheitsakte (ELGA) sowie der elektronischen Arzneimittelverschreibung und -verrechnung (eRezept). Der Bund verpflichtet sich, zur Planung und Akkordierung der Einführung der elektronischen Gesundheitsakte eine österreichweite Steuerungsgruppe unter umfassender Einbindung aller Betroffenen einzurichten. Die Länder verpflichten sich, an dieser Steuerungsgruppe teilzunehmen.“ Alexander Schanner EHR in Austria “… Unterstützung integrierter Versorgungsformen durch ausgeweitete Anwendungen der e-card und der ‚Elektronischen Gesundheitsakte‘ unter Wahrung der PatientInnen-rechte und des Datenschutzes. Die Finanzierung der ELGA ist sicherzustellen. …“

  5. Agreement according to article 15a federal constitutional law (version 2008-2013) article 7 • (1) Main targets: • 1. Qualitative Verbesserung der Versorgung, • 2. Nutzung der ökonomischen Potenziale von Informations- und Kommunikationstechnologien, • 3. Harmonisierung der nationalen Vorgangsweise mit Programmen und Aktivitäten auf europäischer Ebene und • Sicherstellung des Rechtes der Patientinnen und Patienten auf Zugang zu persönlichen und allgemeinen Gesundheitsdaten. • (2) ICT is a tool for modernizing health care • (3) Continuation of ELGA planning- and implementation tasks Alexander Schanner EHR in Austria

  6. ELGA (Elektronische Gesundheitsakte) = Austrian’s EHR Definition of ELGA • ELGA contains relevant multimedia-based and health related data and information referring to a precisely identified person. • Data und information originate from • different health service providers and • from the patient himself/herself and are stored in one or several different information systems(virtual health record). • Data are available independently of place and time(cost-saving) 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 Alexander Schanner EHR in Austria Page 6

  7. Primary goals Alexander Schanner EHR in Austria Page 7 Medical care Patients‘ management Organisation of treatment processes Information for patients

  8. Secondary goals Alexander Schanner EHR in Austria Page 8 Quality management Self-contained health related activities of the patient Financial and administrative processes Monitoring of healthcare system Science and research Target: avoid parallel structures!

  9. Federal Health Commission – BGK -Bundesgesundheitskommission Alexander Schanner EHR in Austria • Organ of the Federal Health Agency • Consists of 27 members 7 Federal Government, 1 for each province, 6 Main Association of Austrian Social Security Institutions, 1 representing cities and 1 representing communities, 1 bishops’ conference together with the Protestant’s, 1 patients’ ombud, 1 General Medical Council of Austria • Commercial operated by Ministry of Health, Family and Youth

  10. Task Force Electronic Health Record - Arge ELGA - Arbeitsgemeinschaft Elektronische Gesundheitsakte • Decision of Federal Health Commission from July 2006 concerning establishment of Arge ELGA and financial remuneration • Working basis of Arge ELGA is an agreement between • Federal Government • Provinces and • Social Insurance Institutions • Since September 2006 ARGE ELGA is acting operationallyLocation: A-1020 Vienna, Schiffamtsgasse 15 Page 10

  11. Object of Arge ELGA according to Agreement The objective of the ELGA Task Force is to drive the connection of existing and future electronic information and documentation systems in the Austrian health care system within the scope of a multi-project management. The main target is the establishment of the so called „electronic health record” (ELGA) in order to increase quality and efficiencyof the health care system. Page 11

  12. Tasks of Arge ELGA according to Agreement Among others: • Assistance to the Federal Health Agency concerning controlling and coordinating activities; • Definition of strategic priorities for the establishment of ELGA and of the roadmap for its implementation; • Planning of detailed concepts and implementation of projects to introduce ELGA as well as the development of financing proposals; • Demand of necessary legal amendments and the binding use of approved standards; • Crisis and escalation management • Evaluation of project results Page 12

  13. Implementation – preliminary planning Alexander Schanner EHR in Austria Page 13 2006: • February to June 2006: Preparation of Arge ELGA (contract) • 28. June 2006: Decision about contract Arge ELGA • Summer/Autumn: Feasibility Study • September 2006: Arge ELGA is operational 2007: • January: Publication of Feasibility Study • Dec 06 – Feb 07: Architecture plan for the first implementation phase • March / April: Consultation with Stakeholders • 4.5.2007 – BGK: Acceptance of architecture plan, standards and commissioning of first implementation phase • Masterplan

  14. Federal Health Commission (BGK) – decision (1/4) Alexander Schanner EHR in Austria Page 14 Overview about decisions • Architecture of Basic Components and Core Applications • Standards • Projects for planning and implementation

  15. Agenda Introduction ELGA Architecture ELGA Standards ELGA Projects

  16. Federal Health Commission (BGK) – decision (2/4) Alexander Schanner EHR in Austria Page 16 Architecture Basis Components • Master Patient Index • Health Service Provider (HSP) Index • Registry • Authorization System • Portal Core applications • discharge Summary • e-Report - radiology • e-Report - laboratory • e-Medication

  17. Overview of Basic Components and Core Applications ELGA Basic Components ELGA Core Applications First Implementation Phase Preconditions for ELGA ELGA Basics Citizen / Patient Storage and Filing Master Patient Index nationwide compatible with EU Portal Health Information Current Topics HSP Information Health Promotion Portal Applications Document Registry centralized Legal Measures Data Protection Discharge Summary e-Report (radiology) HSP Index roles Consumers’ Acceptance Management Authorization System Access Protocols e-Report (laboratories) e-Medication (doctor, hospital, pharmacy) Document Repository decentralized Network Organisational Measures Standards Portal Alexander Schanner EHR in Austria Page 17

  18. Framework Architecture and Main Applications „A hyper-index with sophisticated search functions“ ELGA Doctor Portal HSP Index Citizen Card with PIN Authorization System Registry Master Patient Index reading writing Adaptor Adaptor Adaptor e-Report (radiology, laboratories) Discharge Summary … e-Medication Data Sources Adaptors: Interfaces which make existing applications compatible with ELGA

  19. Hierarchical View on ELGA Authorization System HSP Index Master Patient Index Central Storage of Data ELGA Visibility Registry Signature, Entry in Registry HSP - Local Storage of Data Reports Laboratory Discharge Summaries X-ray Precise link to a document, URL Alexander Schanner EHR in Austria Page 19

  20. ELGA View on Data HSP HSP Index Patient Central Storage of Data Master Patient Index Registry Authorization System HSP - Local Storage of Data Radiology reports Laboratory reports Medication Discharged Summary Alexander Schanner EHR in Austria Page 20

  21. ELGA Context Audit System External Registries (base identifi- cation number, ...) Autohorization System Document Registry Pat - Index HSP - Index HSP System HSP System Portal Repository Consumer Source Consumer Source Consumer Source Overview System Architecture Alexander Schanner EHR in Austria

  22. Agenda Introduction ELGA Architecture ELGA Standards ELGA Projects Alexander Schanner EHR in Austria

  23. Federal Health Commission (BGK) – decision (3/4) Alexander Schanner EHR in Austria Page 23 International standards for ELGA in Austria: • IHE Frame-Work with domain • IT Infrastructure • Patient Care Coordination • Laboratory • Radiology • HL7 CDA 2.0 as document standard • LOINC (area Laboratory data) • DICOM 3.0 incl. WADO (area radiology) • HL7 (in Version 3 with RIM as prospective data model)

  24. Interoperability – Standards and Catalogs Alexander Schanner EHR in Austria • Technical (syntactical) interoperability • Content wise (semantical) interoperability Requirement: Assortment of international standards • Standards rise quality and reduce costs! • Standards promote competition!

  25. International standards • Strategy: • established, international used standards • Hospital Information System (HIS) Providers have to comply with the international market, Austria‘s operating companies focus on internationally widespread HIS • HL7 RIM (Health Level 7 Reference Information Model) and CDA (Clinical Document Architecture) are preferred candidates for data model and document configuration • IHE XDS (Cross Enterprise Document Sharing) including PCC (Patient Care Coordination) for document exchange. Alexander Schanner EHR in Austria Page 25

  26. Technical framework: IHE Profil XDS Alexander Schanner EHR in Austria Page 26

  27. Project CDA documents Alexander Schanner EHR in Austria Content wise interoperability via „Clinical Document Architecture“ from HL7 • Level 1 • Level 2 • Level 3 for • discharge Summary • e-Report - radiology • e-Report - laboratory • e-Medication by Arge ELGA, members of standardization institute with different medical associations

  28. Document structure HL7 CDA 2.0 source: www.ihe.net Alexander Schanner EHR in Austria

  29. International data exchange Public Public Insurance Insurance ELGA LSP HSP HSP Alexander Schanner EHR in Austria Request HSP authorization Request patient identifikation Request insurance status Request patient consent Search med. documents Access / download med. documents

  30. Agenda Introduction ELGA Architecture ELGA Standards ELGA Projects Alexander Schanner EHR in Austria

  31. Federal Health Commission (BGK) – decision (4/4) Alexander Schanner EHR in Austria Page 31 Detailed planning and first piloting (2007 / 2008) • Concretion Basis Components and Master Plan (IBM-Follow-Up Mission) Mai to August 2007 • Project 1 – Master Patient Index • Project 2 – HSP Index • Project 3 – Document Registry • Project 4 – Authorization System • Project 5 – Portal • Project 6 – Main Application first phase of implementation • Project 7 – Acceptance Management Acceptance of each project after the presentation of an organizational and financial concept through BGK

  32. Facts for Planning and Implementation Alexander Schanner EHR in Austria Page 32 • Preliminary Planning • Architecture Plan • Standards • Data Protection • Detailed Planning and Piloting • Implementation / Rollout

  33. ELGA Projects first phase of implementation Alexander Schanner EHR in Austria

  34. Thank you for your Attention! Alexander Schanner EHR in Austria Page 34

More Related