ehealth Infrastructure and Medical Data Exchange Agenda

Transcription

1 Medical Data Exchange Solution & ehealth Records ehealth Infrastructure and Medical Data Exchange for Health Professionals Luxembourg 14th 16th April, 2010 Joachim Goedecke CEO ehbs GmbH

2 ehealth Infrastructure and Medical Data Exchange Agenda ehbs The Problem with medical data exchange Why do we have a Problem? The Solution: MDES ehealth Platform What does MDES do? Patient centric view on all data IHE: International Standards for medical data exchange MDES Collaboration Micro and Macro View epsos South Africa MDES Screenshots Tiani EHR Viewer MDES ehealth Platform and medxchange - Electronic Patient Record ehbs - Services & Products Page 1

3 ehealth Business Services GmbH Elevator Pitch ehealth Business Services GmbH (ehbs) is a Swiss company from the Zurich area, founded in ehbs focusses on IT based Medical Communication Solutions for the Healthcare Industry (ehealth) ehbs' state-of-the-art software solutions support the exchange of health information across healthcare enterprises and communities. Products range from interoperable ehealth communication infrastruktur to epatient Records, medical boards and registers as well as telemedicine solutions (prevention, evidence based medicine)

4 Today s Problem Unsufficient Accessability of Patient Data 22% information about previous visits was available 14% of discharge summaries reach the primary care provider within a week of a hospital discharge 15% of Emergency Department visits had important information missing at the time of the encounter that was very likely to result in patient harm Today, caregivers are constrained by an episodic view of patient information Documents are often only available within single organisations - organisation centered view Individual medical records are spread over various locations and are not instantly available at the present point of care or when needed No sharing of critical healthcare information - Availability only on request No digital data multiple ways of data transfer (e.g. fax, paper) Often no/not sufficiently integrated systems (e.g. data silos) Not/not sufficiently structured (e.g. manual transfer of master data) Page 3

5 Why do we have a problem? Organisation Centered Healthcare System Complex information exchange in the process chain of medical treatment with multiple media (Mail, Fax, Post etc.) Exchanging medical images and clinical data for diagnosis and treatment is difficult and costly Duplicate of labs and diagnostic images increase costs Documents are only available within one organisation (silos) Individual medical records spread across various locations Reports and information only on request -> Standardised and uncomplicated exchange of essential medical information across internal and external system boarders.

6 The Solution: MDES ehealth Platform Tiani IHE-Platform Medical Data Exchance Solution MDES supplies 100% IHE compliant bus system for standardized communication Overall Master Patient Index (MPI) Interoperability of systems and medical devices: all information are permanently available Connection management and management of changes automated and standardized by the Tiani software and by IHE IHE compliant and standardized data storage Patient data from medical systems and devices in the clinical workprocess are highly available in and outside the medical institution

7 How does MDES work? Patient centric view on all data Middleware Documents from various source systems and data bases are consolidated to one individual virtual epatient Record Patient centerd view on clnical information for medical practitioners Medical History quick and simple acess and overview on patient data, that medical practitioners need along the patient s treament process MDES Integration Platform and epatienten Record Collaboration Same information level for all medical practitioners by sharing patient data from various organisations and source systems world wide All Document Formats (CDA-format, PDF, DICOM etc.) for all Documents, that are produced during the treatment process (e.g. Patient summary, laboratory report, images etc.) IHE 100% based on international standards for medical data exchange infrastructures

8 International Standards for medical Data Exchange IHE - Integrating the Healthcare Enterprise International Non-Profit Initiative of clinical users and 150 vendors Founded in USA 1998 by HIMSS (Healthcare Information and Management System Society) and RSNA (Radiology Society of North America) Non Standard Goal is to standardize and zu harmonize the Exchange of information between IT- Systems in healthcare HI S Patient Identify Source Registry Consum er Fokus is on medical processes and the creation of Interoperability between the supporting medical IT systems Source not IHE conform - no replacement possible KIS Repository Standard Patient Identify Source Use case-based development: Medical community of IHE defines requirements and use cases, IT Experts of the IHE Technical Commitees identify relevant existing Standards and they develop Integration Profiles (technical guidelines) for vendors to develop their products according to IHE interoperability standards On international "Connectathons" vendors can test their systems in technical cooperation with others to proof interoperability and function Registry Consumer IHE today: Worldwide Initiative, 12 European coutry organisations Source Repository IHE conform - easy to replace Page 7

9 IHE Integration Profiles Medical Domains Anatomopathology Cardiology Eye Care IT Infrastructure Laboratory Framework Patient Care Coordination Patient Care Devices Quality Assurance Radiation Oncology Radiology Pharmacy and Prescriptions Domain IT Infrastrucure PIX Patient Identifier Cross Referencing PDQ Patient Demographics Query CT Consistent Time ATNA Audit Trail and Node Authentication Patient Identifier Cross-Reference and Patient Demographics Query for HL7v3 (PIX/PDQ/v3) XDS.b Cross Enterprise Document Sharing XDS-I Cross Enterprise Image Sharing Stored Queries XCA Cross Communication Access XUA Cross User Assertion RFD Retrieve Form for Data Capture BPPC Basic Patient Privacy Consents PSA - Patient Synchronized Applications PWP - Personal White Pages Page 8

10 Tiani/ Cisco are Technology leader in IHE Infrastructure Connectathon Test Results Chicago/Wien 2009

11 Medical Data Exchange Solution What s new? Technology MDES Software deployed on AXP enabled Integrated Services Routers Turnkey, secure, IHE-based platform for medical data/image exchange Duplicate labs and diagnostic images increases costs and compromises patient safety MDES is the base technology for the medxchange Applications Installation and Use Simplified deployment and remote management Enhanced physical and system security, including built in VPN and Firewall capability Scalable, federated model for healthcare information exchange Dramatically reduces deployment time + cost + ongoing operation costs for information exchange Hardware incl. Network Technology, Security + Access Mgmt. Medical Data Exchange Solution MDES Software Integration Platform incl. IHE Middleware Tiani

12 A look inside the MDES Tiani Spirit - Electronic Health Record Software Patient ID/ Master Patient Index Patient Cross Reference Manager IHE Integration Profiles IHE Integration Profiles Patient Identity Cross Referencing PIX Patient Identity Cross Referencing PIX Patient Demographics Query PDQ Patient Demographics Query PDQ Cross Enterprise Document Sharing XDS Cross Enterprise Document Sharing XDS Document-Index Document Registry (-ies) 3. Query Create/delete Create/delete document document Store Store document document Document Repository (-ies) 2. Register Search Search document document Display Display document document Physician Physician Document Source(s) 1. Provide & Register 4. Retrieve Document Consumer(s) Page 11

13 MDES Tiani Spirit IHE Platform Document Consumer Imaging Document Source Document Repository Document Registry Patient Registry Provider Registry Audit Repository Web Based Viewer Image Cache Document Store Document Index Patient Demographics & Patient Identifier Cross Referencing Personnel White Pages Audit Trails / Log Routing Transformation Security Proxy, Broadcast, Orchestration Formats, Identifiers, Terminology Encryption, Patient Consent, Auditing

14 Collaboration - Macroview Cross-Organisational Document Exchange Medical Data Exchange Solution MDES is the base for medical communication appications (epatient Records, Boards, Registries) Collaboration across medical sectors Interoperability of systems and devices All medical information in one record Basis for telemedicinc and tele monitoring 100% IHE compliant Non proprietory MPI generating Local - national - international GP PAS Rehabilitation HIS Specialist PMS/Labor Adapter Hospital 1 HIS/PACS Adapter Hospital 2 HIS/Labor

15 IHE Global Architecture Patient Indexing and Cross Community Access (XCA) with MDES Medical data is not stored centrally, but locally where it is generated, directly in an MDES in the respective hospital, health center or physicians practice. ( Load Balancing ) Data from the local level (yellow) is stored redundantly in regional data centers (orange) for resilience reasons. On a national level MEDS is used to aggregate and administer regional knots of smaller units with less than 1 mio. users PIX Federation Matching Algorithm and Doublet Management International Level National Level Regional Level Data Centers Local Level Examples Hospitals and Clinics GP Network Onkology Board Laboratories Health Centers Page 14

16 EU ehealth Project European Patients Smart Open Services 12 EU member states: D, AT, CZ, S, DK, UK, NL, F, ES, IT, SK, GR (Ministeries of Health, Comptence Centers etc.) IHE Europe, 35 companies of healthcare sector Deployment of "Cross-Boarder Services in Europe, being provided across national or regional borders to guarantee a safe and efficient medical treatment, while travelling abroad on vacation or business trips Secure access to patient summary, particularly with respect to basic patient summaries and eprescriptions between different European healthcare systems Interoperability among systems and services must be achieved between the different national and/or regional systems Page 15

17 epsos Global Architecture - XCA Page 16

18 MDES Reference Project EHR Projects in Gauteng and State of South Africa Largest IHE implementation project for Electronic Health Record (EHR) Exchange of patient data and images based on Tiani- Spirit sehr Software Goal: AIDS treatment and prevention EHR for Province of Gauteng with 11 Mio. Inhabitants Cities of Johannesburg und Pretoria 29 large hospitals 348 medium and small clinics Roll-Out since Project duration : 3 years EHR for South Africa with 42 Mio. Inhabitants 270 large hospitals 700 medium clinics small clinics Roll-Out since Project duration : 5 years Page 17

19 Project Gauteng, South Africa Global Architecture with MDES 18

20 Document types e.g. Referals, Report Surgery, Laboratory, x-rays CDA document Structured data Pdf documents Un-structured data DICOM pictures Page 19

21 MDES - EHR Viewer of Tiani-Spirit Patient Search - Display Documents

22 MDES - EHR Viewer of Tiani-Spirit DICOM Images Discharge Summary 2006 Cisco Systems, Inc. All rights reserved.

23 MDES ehealth Platform and medxchange - Electronic Patient Record Electronic Patient Record Medical History Documents and medical informationof all completed treatments Allows physicians to access information about previous treatments Current Treatment Record - Record for current treatments and therapies/medication Allows one or more physicians to access and share information about a patient during current treatment process e.g. GP referring patient to a hospital, physician network ehealth Record Software Netzwerk Technologie Software Integration Platform including Middleware + Security + Access Mgmt. Tiani Page 22

24 medxchange Electronic Patient Record X-Rays EKGs - Endoskopies

25 What can ehbs offer you? ehealth Applications for Health Professionals Electronic Electronic Patient Patient Record Record Medical Medical Boards Boards (AIDS/Cancer) (AIDS/Cancer) Medical Registries Medical Registries Disease Disease Management Management Basic ehealth Infrastructure Medical Data Exchange Solution MDES Hospitals/ -networks, GPs/ -networks Medical Insurances Organisations Page 24

26 Contact For further information please consult Joachim Goedecke ehbs GmbH Menzingen - Switzerland Tel. mobile and Swiss Office +41- (0) Tel. German Office +49 (0) joachim.goedecke@ehbs.ch Page 25