Transcript Document

EuroRec: current standing on EHR certification in Europe
EuroRec
(http://www.eurorec.org )
• The « European Institute for Health Records »
• A not-for-profit organisation, established April 16, 2003
• Mission: the promotion of high quality Electronic Health
Record systems (EHRs) in Europe
• Federation of national ProRec centres in Europe
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
ProRec Centers
Centres
Belgium
Bulgaria
Denmark
France
Italy
Germany
Ireland
Romania
Slovenia
Spain
Slovakia
Applicants
United Kingdom
Serbia
The Netherlands
Poland
Norway
Greece
Hungary
Portugal
Sweden
“ Differences in languages, cultures and HC-delivery/funding systems ”
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
EHRs: TRENDS
EHRs start to become:
• transmural, virtual
• multidisciplinary and interactive
• longitudinal and intelligent
Administrative
Records
Medical
Records
Nursing
Records
Personal Patient
Records
! Integration with other eHealth applications ...!
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
Q-REC
European Quality Labelling and Certification of Electronic Health Record
systems (EHRs)
Duration: 2006 - 2008
Contract No: IST-27370-SSA
Coordinator: Prof. Georges De Moor
http://www.eurorec.org/
EHR-Implement
National policies for EHR implementation in the European area:
social and organisational issues
Duration: 2007 - 2010
Contract No: IST-27370-SSA
Coordinator: Dr. Laurence Esterle
http://www.ehr-implement.eu/
RIDE
A Roadmap for Interoperability of eHealth Systems in Support of COM 356
with Special Emphasis on Semantic Interoperability
Duration: 2006 - 2007
Contract No: IST-027065
Coordinator: Prof. Asuman Dogac
Georges De Moor, MD, PhD – President EuroRec
http://www.srdc.metu.edu.tr/
22/10/2007
EuroRec: current standing on EHR certification in Europe
QREC’s Objective
To develop formal methods and to create a mechanism
for the quality labelling and certification of EHR systems
in Europe, in primary- and in acute hospital-care settings
EuroRec Institute is coordinating partner
QREC has 12 partners and 2 subcontractors
Project duration is 30 months (1/1/2006-30/6/2008)
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
QREC: ORIGIN
Several EU-member states (Belgium, Denmark, UK, Ireland, …)
have already proceeded since years with (EHRs-) quality labelling
and/or certification (more often in primary care) but these differ in
scope, in legal framework under which they operate, in policies and
organisation, and perhaps most importantly in the quality and
conformance criteria used for benchmarking …
These differences represent a richness but also a risk: harmonisation
efforts should help to avoid further market fragmentation in Europe
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
Central Repository
EuroRec will install a central repository of validated quality criteria and
other relevant materials that can be used to harmonise European
testing, quality labelling and procurement specification of EHR
systems.
It will not impose particular certification models or specific criteria on
any member country but will foster, via ProRec centres and other
channels, the progressive adoption of consistent and comparable
approaches to EHR system quality labelling.
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
Q-REC Rationale –Certification is Essential
To assure the quality of EHR systems, e.g., patient safety may be at risk due to:
• system design, specification and functional inadequacies,
• poor or confusing presentation of clinical relevant information.
Sharing of information requires a quality assessment of EHR products with a view
to ensuring interoperability with other systems because:
• healthcare information, in particular clinical information, is often scattered
over a number of informatics systems
• the structures of these EHRs may significantly differ from one system to
the other, depending on the creator and the purpose.
• more and more incentives are being given to share patients’ medical data
to support high quality care and “continuity of care” in a seamless way.
Certification of EHRs is essential for purchasers and suppliers
• to ensure that EHR systems are robust enough to deliver the anticipated
benefits as EHR systems and related product quality (data portability and
interoperability are difficult to judge).
• To reduce the risk for purchasers and therefore accelerate the adoption of
high quality and more interoperable EHRs.
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
The EuroRec Repository: Introduction
• The Q-Rec repository will comprise several kinds of artefacts
relating to the quality labelling and benchmarking of EHR
systems:
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EHR system requirements
The year 1 priority
EHR system conformance criteria
EHR system test plan items
An inventory of quality labelled (certified) EHR systems
An inventory of EHR related standards
An inventory of terminology and coding schemes
A directory of certified EHR archetype repositories
A directory of reviewed open source specifications and
components
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
EHRs Criteria: Business Cases
• A purchaser wishing to procure an EHR system module
• An e-Health programme wishing to ensure consistent EHR system
functionality nationally
• A vendor wishing to (re-)develop an EHR system module
• Developers wishing to interface to a given EHR system module
across multi-vendor systems
• All may be:
– seeking design guidance
– wishing to obtain quality labelling certification
– searching for trustworthy products
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
EuroRec Repository
Repository Workflow
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
Typology of EHR System Statements
• Source Statements
– faithfully extracted from original EHR system specifications
and test plans
– translated if necessary
• Fine Grained Statements (FGS)
– usually derived from source statements
– made more generic, decomposed, reworded, corrected
• Good Practice Requirements (GPR)
– recomposed from FGS into the more common useful building
blocks
– may enhance or extend the scope of FGS: “push the boat out
a bit”
• Generic Test Criteria
– derived from FGS and/or GPR
– formally worded as testable functions
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
EuroRec Repository
Repository Workflow
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
Indexing the statements (1)
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Multiple indexing of each statement
– to maximise the likelihood of finding all relevant statements
when searching via the indices
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Business Function (50 in 8 subcategories)
Care Setting (18 in 3 subcategories)
Component Type (18 in 4 subcategories)
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
Business Function (1)
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A0 EHR data (record) management
A00 EHR data entry
A01 EHR data analysis
A02 EHR data content
A03 EHR data structure
A04 EHR data display
A05 EHR data export/import
A09 EHR generic data attributes
A1 Clinical functions
A10 Clinical: medication management
A11 Clinical: long-term illness
management
A12 Clinical: health needs assessment
A13 Clinical: care planning and care
pathways
A14 shared care
A15 Clinical: alerts, reminders and
decision support
A16 Clinical: workflow and task
management
A17 Clinical: patient screening and
preventive care services
Georges De Moor, MD, PhD – President EuroRec
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A2 Administrative services
A20 Appointments and scheduling
A21 Patient consents, authorisations,
directives
A22 Patient demographic services
A23 Certificates and related reporting
services
A24 Patient financial and insurance
services
A3 Care Supportive services
A30 Supportive care service requests
(orders)
A31 Supportive care service reporting
(results)
A32 Laboratory services
A33 Imaging services
A34 Diagnostic and therapeutic
services (other): ECG/EEG etc.
A35 Pharmacy services
A4 Analysis and reporting
A40 Screening and preventive health
A41 Care setting reports
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Business Function (2)
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A5 Population health
A50 Screening and preventive health
A51 Disease registries
A52 Public health
A53 Epidemiology
A6 Health system services
A60 Healthcare organisation
management
A61 System maintenance and
technical support
A62 Education, training, support
A63 System configuration of the
application
A64 Individual configuration of the
application
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Georges De Moor, MD, PhD – President EuroRec
A7 Security: privacy and accountability
A70 Security: authentication
A71 Security: authorisation
A72 Security: access control
A73 Security: confidentiality and
consents
A74 Security: version management
A75 Security: de-identification
services and processes
A8 Security: technical
A80 Security: backup and integrity
validation
A81 Security: data retention,
availability and destruction
A82 Security: audit and override
monitoring
A83 Security: attestation and nonrepudiation
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Care Setting
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B0 Generic or ubiquitous
B01 Regional healthcare network
(specific distribution)
B02 Virtual or telehealth
B03 Personal health
B04 Community and home care
B05 Health, wellness and prevention
B06 Occupational health
B07 Public health
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Georges De Moor, MD, PhD – President EuroRec
B1 Health care enterprises
B10 Long-term care (institution)
B11 General practice
B12 Secondary care (hospital)
B13 Tertiary care centre (specialist
hospital)
B14 Domain specific
B15 Profession specific
B2 Secondary uses
B20 Research and knowledge
discovery
B21 Education
B22 Health service and planning
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EuroRec: current standing on EHR certification in Europe
Component Type
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C0 EHRS functional component
C1 EHRS infrastructure component
C10 EHRS Interoperability component
C11 Security management component
C2 Knowledge resources
C20 Knowledge: terminology
C21 Knowledge: ontology
C22 Knowledge: archetype
C23 Knowledge: template
C24 Knowledge: data set
C25 Knowledge: guideline
C26 Knowledge: algorithm
Georges De Moor, MD, PhD – President EuroRec
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C3 Directory services
C30 Directory: patients
C31 Directory: personnel
C32 Directory: equipment
C33 Directory: health service
directories
C34 Directory: service resources
C35 Third parties
C4 Profiling or authoring tool
C5 Documentation, support etc.
C6 EHR system functional component
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EuroRec: current standing on EHR certification in Europe
Some statistics
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
EuroRec Repository Maintenance Tools
• Creation of Fine Grained Statements
• Creation of Good Practice Requirements
• Indexing statements
• Linking statements
• Maintenance and update of Fine Grained Statements
• Maintenance and update of Good Practice Requirements
• Translation functions
• Access management
• Versioning and audit functions
• Overviews and statistics
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
1. From Reference Statements to Fine Grained Statements: selecting the Reference Statement
Reference statements frequently include multiple functions. Extract of the Irish 2007 criteria for General Practitioners
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
2. From Reference Statements to Fine Grained Statements: editor and linkage and indexing FGS
Editor
Linking an
existing FGS
Indexing
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
4. Fine Grained Statement: maintenance interface
Linked to 4 reference
statements
Included in 1 Good Practice Requirement
Version and translation management
Editing area
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
5. Fine Grained Statement: similar view of attributes of a FGS
Linked to 4 reference
statements
Included in 1 Good Practice Requirement
Applicable indexes
Area with comments from
outside, if any
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
6. Fine Grained Statement
View of a Fine Grained Statement with link to the Source Statements and the
Good Practice Requirements.
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
12. Overview of Good Practice Requirements
List of Good Practice Requirements, with
• number of Fine Grained Statements included
• number of EuroRec Baskets with this GPR selected
• view icon on indexes
• display icon of links and indexes
• icon enabling the user to give comments
• view icon on the translations
• maintenance icon
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
13. Good Practice Requirement View
The statement
Five Fine Grained
Statements included
The indexes for that Good
Practice Requirement
Area with comments from
outside, if any
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
16. Multilingual Good Practice Requirement
Example of Good Practice Requirement in
English, Bulgarian, German, Danish, French, Dutch, Romanian and Slovenian
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
EuroRec Languages
(non-exhaustive list)
• English (default language)
• Bulgarian
• Danish
• Dutch
• French
• German
• Romanian
• Slovenian
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
EuroRec Use Tools
The EuroRec Composer ™
To compose user defined, re-usable and exchangeable baskets of Fine
Grained Statements.
The EuroRec Certifier ™
To format a EuroRec Basket content to obtain the basic layer for the
certification of EHR systems. This is done by adding structure and
attributes to the selected Fine Grained Statements.
The EuroRec Documentor ™
To document EHR systems and their functions, enhancing their
understanding and comparability by using the EuroRec statements.
The EuroRec Procuror ™
To list and describe, for purchase purposes, required functionalities and
product characteristics using EuroRec statements.
The EuroRec Scriptor ™
To produce and link Test Scenarios to EuroRec Baskets for Certification,
Documentation and/or Procurement purposes.
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
EuroRec
Baskets
Certification
Documentation
Procurement
Test Criteria
Sets
Test
Scenarios
Georges De Moor, MD, PhD – President EuroRec
Test
Procedures
22/10/2007
EuroRec: current standing on EHR certification in Europe
EuroRec Services
1. An Inventory of Certification Criteria for EHR systems
2. An Inventory of Standards relevant for EHR systems
3. EHR Archetypes
4. Open Source Components and XML Schemas
5. EHR Tutorials
6. Register of Health Coding Systems in use in Europe
7. Events
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
Events at WHIT 2007
Tuesday, 23 October
13:30–14:30 Location: room 1
TL7 - Thought Leader Session
EHRs Certification: Global Issues
Wednesday, 24 October
11:30–12:30 Location: room 3
ES34 – Integrating IT Leadership to Improve Healthcare Delivery and Performance
Certification of EHRs: Criteria, Procedures and Tools
EuroRec will present an update on the development of its certification criteria repository, as well as on
its recommended procedures, including the use of its EHR profiling tool.
17:15–18:00 Location: product tutorial theatre - booth 1021
Demo of the EuroRec Tools
EuroRec EHR certification and documentation
New era in certification - Real time demo
Thursday, 25 October
09:00–10:00 Location: room 2
ES44 – Integrating IT Leadership to Improve Healthcare Delivery and Performance
EHR in Europe: A new paradigm. Archetypes: a Revolution
Three new CEN European standards constitute a new paradigm. The Archetype paradigm enables 'plug-andplay' semantic interoperability between EHR systems. Via the process of 'creative destruction' new ICT
vendors will enter the market using this new exciting paradigm. These European standards help fulfill the
ambitious 2010 goals, as accepted by the European Commission.
Georges De Moor, MD, PhD – President EuroRec
22/10/2007
EuroRec: current standing on EHR certification in Europe
Thank you for your
attention!
www.eurorec.org
[email protected]
Georges De Moor, MD, PhD – President EuroRec
22/10/2007