EHR Systems Use and Quality in Austria

FH-Prof. DI Dr. Stefan Sauermann UAS Technikum Wien Program Director, Biomedical Engineering Sciences ProRec Austria

EHR Systems Quality Labelling and Certification

21 - 22 November 2011, Belgrade

Myself:

     Communications engineer, ◦ 15 years MedUni Vienna, BME Head of national CEN ISO mirror „Medical Informatics“ Founding member of IHE Austria Consulting ELGA ◦ CDA harmonisation of the Lab Report Research project in personal healthcare ◦ www.healthy-interoperability.at

EHR Systems Quality Labelling and Certification

21 - 22 November 2011, Belgrade

Health Care in Austria

    Insurance based system ◦ ~25 public insurances 15000 GPs ◦ many with social security contracts Hospitals: mostly provincial holdings ◦ Additional private hospital groups Many legacy IT systems ◦ Big and small

EHR Systems Quality Labelling and Certification

21 - 22 November 2011, Belgrade

EHR systems: market (estimates)

    Software use ◦ ◦ 80-90% of GPs use software Nearly all hospitals use EHRs Number of products ◦ ◦ Many GP systems! (> 100 vendors) >10 hospital products (>10 vendors) Market shares ◦ 4 GP software vendors cover 60% of market ◦ 4 Hospital products cover 75% of market market stable over last five years

EHR Systems Quality Labelling and Certification

21 - 22 November 2011, Belgrade

Existing law: enables treatment

 Laws for the medical professions  eGovernment law  Data protection law  Enables point-to-point data exchange  Not suited for single access all data for one patient

EHR Systems Quality Labelling and Certification

21 - 22 November 2011, Belgrade

National EHR law : expected within months

 Enables sharing of patient related data  Data protection is primary concern ◦ Access only in context of treatment ◦ Patients have control on who may access what  Storage ◦ What, how long  ...

EHR Systems Quality Labelling and Certification

21 - 22 November 2011, Belgrade

EHR systems: quality assessment

 Existing GP software certification (in discussion) ◦ Approval of reimbursement for treatment (eCard) ◦ Reimbursement (Social insurance) ◦ Standardised data export (Chamber of doctors)  No incentive for using quality assessed / certified EHR systems

EHR Systems Quality Labelling and Certification

21 - 22 November 2011, Belgrade

National EHR ELGA: growing!

Central components (Built by ELGA) „Affinity domain“ (Build by HCP or vendor) Master Patient Index Local Document Registries with Repositories Healthcare Provider Index Domain … Domain B CIS GP SW CIS CIS CIS  Follows IHE IT Infrastructure (XDS, ATNA, BPC, ... )

EHR Systems Quality Labelling and Certification

21 - 22 November 2011, Belgrade

ELGA Timeline (roughly)

 Master patient, HCP index available  Harmonised CDA available  eMedication in pilot   Security system in procurement Conformant affinity domains existing ◦ Reference domain in procurement   Reference domain go live expected 2012/13 All hospitals integrated 2014  GPs integration in full swing 2015

EHR Systems Quality Labelling and Certification

21 - 22 November 2011, Belgrade

Highlight: Clinical Documents (Real beauties!!)

   http://www.elga.gv.at/index.php?id=28 Discharge information Radiology and Lab reports ◦ HL7 CDA  Content harmonized ◦ >120 medical experts ◦ Implementations already available  Usability guided design

EHR Systems Quality Labelling and Certification

21 - 22 November 2011, Belgrade

Possible steps to certification

„Affinity domain“ (Build by HCP or vendor) Local Document Registries with Repositories Central components (Built by ELGA) Master Patient Index Healthcare Provider Index Domain B Domain … CIS GP SW CIS CIS CIS  Security first? Then affinity domain connection? Then GP/CIS connection?

EHR Systems Quality Labelling and Certification

21 - 22 November 2011, Belgrade

Certification priorities

 Without access rights /security there is no data exchange  This is a task in Europe  May this be a first „eHealth Certificate“ on European level?

EHR Systems Quality Labelling and Certification

21 - 22 November 2011, Belgrade

Looking forward to hear from you!

 Stefan Sauermann ◦ University of Applied Sciences Technikum Wien ◦ [email protected]

 The Austrian national EHR: ◦ www.elga.gv.at

EHR Systems Quality Labelling and Certification

21 - 22 November 2011, Belgrade