EuroRec Functional Statements Repository

1. EuroRec Functional Statements Repository EHR-QTN Workshop Vilnius, January 26, 2011 Dr. Jos Devlies, Belgium

2. Health IT has a great potential • To increase efficiency of care by • Reducing useless and duplicated tests and interventions; • Reducing cost of processing (paper) documents. • To increase quality of care by • Availability of shared interoperable patient data; • Monitoring and enabling evidence based disease management; • Integrating knowledge based clinical surveillance and decision support. EHR-QTN Workshop – Vilnius - Lithuania

3. But we have… EHR-QTN Workshop – Vilnius - Lithuania

4. a big quality issue… Quality of the products as such very disparate, sometimes incredibly poor, not always offering what they promise. Poor availability of “interoperable” content due to a lack of standards, due to insufficient use of existing standards. Poor “usability” of content due to insufficient structuring of that “content”: still too much free text in the absence of efficient tools to interpret that free text. Enormous issue of no usage, under-usage, wrong usage of even the best applications. EHR-QTN Workshop – Vilnius - Lithuania

5. Quality • Is never obvious. • It requires a commitment to quality requirements • It requires for applications to be • Reliable & Trustworthy • Functional & Comparable • Sufficient user friendly • Structured and as much as possible “interoperable” EHR-QTN Workshop – Vilnius - Lithuania

6. This means that authorities need to Define requirements for EHR systems => regulation Test or verify compliance of a system to these requirements Quality assess an e-Health application EHR-QTN Workshop – Vilnius - Lithuania

7. But we have a problem… To express what we expect an application has to do. To document in a reliable way the functions of an application in order to optimise procurement of applications. To translate political and social functional needs into product requirements. To verify that these requirements are met… To measure the appropriate use of the systems. EHR-QTN Workshop – Vilnius - Lithuania

8. We need… a “language” in a consistent way across domains and countries To describe functionality. To describe requirements. To translate those requirements in product specifications. To redact test criteria and procedures to validate applications against these specifications. EHR-QTN Workshop – Vilnius - Lithuania

9. EuroRec approach to quality assessment----------EuroRec Repository EHR-QTN Workshop – Vilnius - Lithuania

10. EuroRec created • A repository of functional “descriptive statements” • Over 1.700 statements • A subset translated in 19 languages • Generic statements as well as statements addressing “specialised” areas as e.g. “requirements for EHR systems as source for clinical trials data” • EuroRec does not define what’s required • Suggesting “professional profiles”. • Leaving it to the authorities to decide what’s important… slightly different in each country (healthcare still national competence). • Also “less than best” practice needs to be described. EHR-QTN Workshop – Vilnius - Lithuania

11. EuroRec created • Tools to use these statements • As test criteria for quality labelling • For Product procurement • For Product documentation • A set of services to assist interested parties • A validation service against “cross-border subsets” of quality requirements (EuroRec Seal) EHR-QTN Workshop – Vilnius - Lithuania

12. The EuroRec Repository EHR-QTN Workshop – Vilnius - Lithuania

13. Sources… http://www.eurorec.org Belgium (1999-2006-2010) CCHIT (USA) Alberta (Canada) Ireland (GP-IT) France (LAP) Denmark Meaningful use (USA) Clinicalresearch (eClinical Forum) Austria (Labfunctions) EHR-QTN Workshop – Vilnius - Lithuania

14. Medication related decision support… EHR-QTN Workshop – Vilnius - Lithuania

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16. Indexing and Search Interface EHR-QTN Workshop – Vilnius - Lithuania

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18. Overview translated statements EHR-QTN Workshop – Vilnius - Lithuania

19. A set of statements in Serbian EHR-QTN Workshop – Vilnius - Lithuania

20. A set of statements in Croatian EHR-QTN Workshop – Vilnius - Lithuania

21. A set of statements in Serbian EHR-QTN Workshop – Vilnius - Lithuania

22. A set of statements in Greek & English EHR-QTN Workshop – Vilnius - Lithuania

23. “National Variants” Statements are “generic” which means that some of them need to be specified. The intention is to be more specific on some issues in order to comply to e.g. national regulations. Can be defined in each of the local languages, but only after producing an English version of the National Variant. EHR-QTN Workshop – Vilnius - Lithuania

24. National variant interface Grey flag indicating: no national variant Coloured flag: existing national variant. Click on grey flag: interface for data entry English version of a national variant first. Click on coloured flag: specific national variant(s) will be displayed. EHR-QTN Workshop – Vilnius - Lithuania

25. National variant creation (English first) Only after adding the English statement, possibility to add national variants in national language(s). Possible to edit an existing national variant with version management. (see next slide) EHR-QTN Workshop – Vilnius - Lithuania

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27. List of (some/all) National Variants EHR-QTN Workshop – Vilnius - Lithuania

28. HL 7 criteria ? • Main difference: functionality and “regulation” in one statement • Problem: • -quite some criteria does (not/only) apply in a given environment / domain of application • regional / national differences depending on legal / cultural context or on local priorities • Nevertheless: addressing the same issues EHR-QTN Workshop – Vilnius - Lithuania

29. Conclusions As explained in other presentations: there is a big role for national health authorities in quality assurance of e-Health products used in the respective countries. There is also a need to cross-border recognition of quality labelling and certification. EuroRec developed tools to facilitate that quality labelling and certification USE THEM ! EHR-QTN Workshop – Vilnius - Lithuania

30. Thank You ! EHR-QTN Workshop – Vilnius - Lithuania