Transcript ICW Professional Suite (PXS) - ehealth

Integration of hospitals and other medical specialists
through international standards,
technologies and best practices
Christian Ohr
ICW Germany, Feb 13th 2008, Sofia
NATIONAL DISCUSSION FORUM „E-HEALTH”
REGIONAL HEALTH NETWORKS. PUBLIC ELECTRONIC
SERVICES. ELECTRONIC HEALTH RECORD
Under the aegis of Ministry of Health
Agenda
• Standards and Interoperability
– Examples
– Barriers to Adoption and Acceptance
• IHE Initiative
– Leverage instead of reinvent
– Profiles
– Showcases
• Strategies to introduce standard-compliance
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Standards and Interoperability
• Medical IT Standards
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HL7 v2
HL7 v3
CDA, CCOW, CCR
DICOM
ISO 11073, 13606, … , CEN …
• Medical IT Terminologies and Vocabularies
– SNOMED CT
– LOINC
– ICD
• Industry IT Standards
– XML, ebXML
– SOAP, WSDL, WS-*
– BPM, BPEL
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Standards – Barriers to Adoption and Acceptance
• … there are so many to choose from …
– Competing standards
– Complementing standards
• … each of them covers only part of the story …
– Real-world use cases and scenarios span over:
• Health domains
• Technical layers
• … they are too generic and add extra overhead …
– Even using a small part of it requires you to use the whole stack
• … they are interpretable …
– Using the standard and still don’t understand each other (“plug-andplay”)
– Constraining the standard by defining profiles
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Standards – Barriers to Adoption and Acceptance
• … none of them cover your special needs …
– Project-, region- or country-specific requirements
– Process to generalize these features and propose them for the official
standard is often troublesome and time-consuming
• … consciously ignored …
– “not invented here”-principle
– recognition, funding, significance
• … unconsciously ignored …
– Missing knowledge about existence
– Limited accessibility of standard documents
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IHE Initiative
• IHE
– Driven by users and industry
– Workflows in Frameworks
– Goal: “enable health information systems to share and exchange
medical data more easily”
– www.ihe.net
• Leverage standards instead of reinvent standards
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IHE Initiative
• Profiles
– define how a particular system can
exchange its information with
another, to meet specific (clinical)
needs
– Use-case driven
– Clear distinction between use-case and technical implementation
– Leverage existing standards for information exchange
(at times, the chosen ones seem arbitrary and heterogeneous)
– Detailed, also covers boundary conditions
– Dependencies between profiles
• Domains
– Groups of profiles
– cardiology, eye care, IT infrastructure, lab, pathology, patient care
coordination, patient care devices, quality, radiation oncology and
radiology
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IHE Connectathons
• Largest interoperability testing event in health care
– vendors refine and test their products for conformance with IHE
integration profiles and interoperability with corresponding healthcare
IT systems.
– Chicago, Jan/Feb 2008: 70 companies, ~ 400 participants
– Results are published
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Strategies how to introduce standard compliance
• Adding another interface to an existing product is a non-trivial task
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Doesn‘t match existing interfaces
Uses different technology
Bloats the core product with integration issues
…
• "Any [software] problem can be solved by adding another layer of
indirection.” (Steven M. Bellovin)
• Exceptions
– the problem of too much indirection (complexity)
– improve performance
– minimize usage of [computing] resources
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ICW - General portfolio
PATIENT / CITIZEN
HEALTH INSURANCE COMPANIES
Care
Management
Health conscious
Athletes
Chronically ill
patients
Young mothers
Elderly
- Patient Information
- HomeCare Integration
- Fitness and Prevention
- Rehabilitation
Patient
Information
Physician networks
Pharmacies
Radiology
Call Center
- DMP Management
- Card Management
- Kiosksystems
- Teleconsulting
- Telemonitoring
Patient
Integration
Physician‘s offices
Insurance
Companies
Telemonitoring
Electronic Medical
Record
- Teleconsultation
- Patient Integration
- eHealth Integration
- Networking of Physician‘s
Virtual Medical
Record
Case
Record
- Hospital Networking
- Referrer
- Patient Integration
- Telemedicine
PHYSICANS / -NETWORKS /
PHARMACIES
Hospitals
Hospital Associations
HOSPITALS / -ASSOCIATIONS
Healthcare Professionals
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Example: introduce messaging middleware
ICW Professional Suite (PXS)
Health care provider – primary systems, hospitals
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Example: introduce messaging middleware
ICW Professional Suite (PXS)
Messaging Middleware
Passed IHE PIX
profile tests
Health care provider – primary systems, hospitals
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Example: introduce messaging middleware
ICW Professional Suite (PXS)
Messaging Middleware
Integration Process Management
Passed IHE PIX
profile tests
Health care provider – primary systems
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ICW e-card Project – (ePrescription)
Health Professional
Card
Card
Terminal
ePrescription
Service
ICW Box
Connector
NHIF
Contract Data
Service
Patient Card
GP
Software
VPN
Tunnel
Pharmacist Card
Patient Card
Card
Terminal
ICW Box
Connector
Certificate
Authority
Pharmacy
Software
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ICW e-Card project – pharmacy processes
1. Successful authorization
Pharmacist
1. Patient authentication
2. Requests patient ePrescription
Patient Card
3./ 9. Transfers Request for
ePrescription/ dispensing
Primary System
8. Dispense ePrescription
6. Visualize ePrescription
4. Reads ePrescription
Info from card
7. Cross check print out
and deliver drugs
Connector
10. Delete ePrescription
Info on card
5. ePrescription is
transferred together with
ePrescription ID
X.509
ePrescription
Server
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ICW e-Card project – pharmacy processes
1. Successful authorization
Pharmacist
1. Patient authentication
2. Requests patient ePrescription
Patient Card
3./ 9. Transfers Request for
ePrescription/ dispensing
Primary System
8. Dispense ePrescription
6. Visualize ePrescription
4. Reads ePrescription
Info from card
7. Cross check print out
and deliver drugs
Connector
10. Delete ePrescription
Info on card.
5. ePrescription is
transferred together with
ePrescription ID
X.509
ePrescription
Server
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ICW project – Building of eHealth portal and Personal Health Record
Patient‘s
Home
Physician
Authorization
Primary System
Portal
ICW e-Government Health Record (MSAAR)
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Summary
•
Adoption of standards is often troublesome
– Choice, complexity, abstractness, applicability, support
•
IHE puts standards in context with
real-world health care integration scenarios
– Description of use cases, required standards and boundary conditions
– offers an exciting compliance test platform
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ICW actively supports standardization activities
– Member in many standardization boards (national + international)
– Coordination of standard activities by own department
– Standards compliance in core products
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ICW products and projects started in Bulgaria
– Relevant to the standards accepted by eHealth industry
– Relevant to European plans and initiatives
– Oriented to the integration of legacy (existing) systems and not to the rejection
of these systems.
•
The message of ICW is „Connect, don‘t reject!“
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Thank you
[email protected]
NATIONAL DISCUSSION FORUM „E-HEALTH”
REGIONAL HEALTH NETWORKS. PUBLIC
ELECTRONIC SERVICES. ELECTRONIC HEALTH
RECORD
Under the aegis of Ministry of Health