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Applying the XDS profile - Best Practice in Austria

Applying the XDS profile - Best Practice in Austria. World of Health IT 2007 IHE-Europe Session, Vienna Dipl.-Ing. Dr. Alexander Schanner Program-Manager 23.10.2007. Agenda. Introduction ELGA = Austrian’s EHR XDS in Lower Austria IHE Austria.

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Applying the XDS profile - Best Practice in Austria

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  1. Applying the XDS profile - Best Practice in Austria World of Health IT 2007 IHE-Europe Session, Vienna Dipl.-Ing. Dr. Alexander SchannerProgram-Manager 23.10.2007

  2. Agenda Introduction ELGA = Austrian’s EHR XDS in Lower Austria IHE Austria

  3. Task Force Electronic Health Record - Arge ELGA - Arbeitsgemeinschaft Elektronische Gesundheitsakte • Decision of Federal Health Commission (BGK) 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

  4. Object of Arge ELGA according to Agreement The objective of the ELGA Task Force is to drive the connectionof 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.

  5. 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(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

  6. Implemetation – preliminary planning 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 ELGA • 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 and Roadmap

  7. Federal Health Agency (BGK) – decision (1/3) ELGA Architecture consists of the following basic components • Master Patient Index • Health Service Provider (HSP) Index • Registry • Authorization System • Portal ELGA provides in the first phase of implementation the core applications • discharge Summary • e-Report - radiology • e-Report - laboratory • e-Medication

  8. Federal Health Agency (BGK) – decision (2/3) 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)

  9. Federal Health Agency (BGK) – decision (3/3) Detailed planning and first piloting (2007 / 2008) • Concretion Basic 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

  10. Agenda Introduction ELGA = Austrian’s EHR XDS in Lower Austria IHE Austria

  11. 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

  12. 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

  13. 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

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

  15. Why Standards ? Standard Non Standard HIS Patient Identify Source Patient Identify Source HIS Consumer Consumer Registry Registry Source Source Repository Repository IHE conform: easy to replace Vendors not IHE conform: no replacement of Vendors possible

  16. Technical framework for ELGA: IHE Profile XDS

  17. Agenda Introduction ELGA = Austrian’s EHR XDS in Lower Austria IHE Austria

  18. Project Patienten-Index NÖGUS (www.noegus.at) Lower Austrian health and welfare fund NÖ Landeskliniken-Holding (www.lknoe.at) going there ……

  19. Lower Austria • Federal stateofLower Austria • approx. 1.6 million inhabitants • 27 hospitals • approx. 8000 beds • approx. 3000 general practitioners Vienna

  20. Starting PointHospitals in Lower Austria Waidhofen an der Thaya Gmünd Allentsteig Horn Eggenburg Zwettl Hollabrunn Mistelbach Krems Stockerau Tulln Korneuburg Klosterneuburg St. Pölten Melk Gugging Hainburg Amstetten Mauer Mödling Lilienfeld Scheibbs Baden Waidhofen an der Ybbs Wiener Neustadt Neunkirchen Hochegg Situation 2004 • 27 Locations • 22 Organizational Units • 18 Different Owners • 270 IT Systems supplied by 70 Manufacturers

  21. Global Aims of NÖGUS • Creation of a central and integrative information and communication platform to meet the patient-related requirements of healthcare and welfare in Lower Austria. • 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. • Synergy and cost efficiency in the acquirement and operation of IT systems.

  22. Regional and national Projects Kassner, Berlin, 2007/04

  23. Patient Demographics embedded in HIS Find Patients in HIS plus Index Retrieve Query Result Admission in HIS HL7 Server IHE: Patient Cross Reference Manager IHE: Patient Demographics Supplier NÖMED Patient Index IHE: Patient Demographics Consumer KIS: Patientensuche Local Client Connector

  24. Document Consumer embedded in HIS

  25. Document ConsumerWeb Application

  26. IHE Profiles in Lower Austria Already used • PIX • PDQ • EUA • ATNA • PWP • XDS.a • XDS.b Planned for future • XDS-I • RFD • BPPC • XUA • XCA

  27. Agenda Introduction ELGA = Austrian’s EHR XDS in Lower Austria IHE Austria

  28. IHE Austria will cover some add-ons • Support development of requirements and specifications for ELGA and other health IT Projects • Coordinate with IHE international • Develop „national extensions“ • Contribute to international work on the profiles • Take care for „certification“ of software products • This is more than interoperability! • QA, security audits, load balancing, …, • Cooperate with IHE international, Eurorec, CCHIT, … • Make sure that vendors can use „ELGA certificates“ in international markets, too.

  29. Tasks of IHE Austria • Manage project groups • For use cases, specifications, international contacts • Provide „ELGA-thon“ • What exactly is this? Concept work • Build up infrastructure • Keep everybody informed • Website, communication platform, events, …

  30. Thank you for your Attention!

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