IHE in Veneto Region Elena Vio ArsenàIT Veneto's Research Centre for ehealth Innovation Arsenàl.IT Tutti i diritti riservati 1

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1 IHE in Veneto Region Elena Vio ArsenàIT Veneto's Research Centre for ehealth Innovation 1

2 Agenda Could it be strategic decision the use of IHE approach for deploying ehealth regional projects (e.g. RHIOs, HIE, EHR)?

3 Veneto Region & Arsenàl.IT 4,9 M inhabitants (2013 data) km 2 of land surface 21 Local Health Authorities Healthcare assistance (Hospitals) Territorial assistance and social issues (GPs, outpatients clinics, elderly care, in-home assistance, mental health, disability, drug addiction, ecc ) Prevention department 2 Hospital Trusts University education and research High-specialty services 3

4 The Consortium Arsenàl.IT: Veneto s Research Center for ehealth Innovation Founded in 2005 as Telemedicine Consortium, currently groups all the 23 Local Health Authorities afferent to the Veneto Region. Has succeeded in highlighting the critical issues of interoperability, standardization and organizational impact as key factors for driving Telemedicine applications to the mainstream of the care delivery process.

5 HIMSS HIMSS - Healthcare Information Management and Systems Society is a global, cause-based, not-forprofit organization focused on better health through information technology (IT). HIMSS leads efforts to optimize health engagements and care outcomes using information technology. HIMSS mission : Globally, lead endeavors optimizing health engagements and care outcomes through information technology

6 HIMSS assessment The EMRAM (Electronic Medical Record Adoption Model) is an eight-step process that allows you to analyze your organization s level of EMR adoption, chart your accomplishments, and track your progress against other healthcare organizations across the country. View and compare your scores in the HIMSS Analytics Database.

7 EMRAM

8 Veneto Region Hospital EMRAM Eu Hospitals Italy Hospitals Veneto Hospitals

9 BIG projects or SMALL projects? (profiles) HEALTH OPTIMUM European Project European Telemedicine Project aimed to diffuse and pilot-test some telemedicine services ( ) VENETO ESCAPE - giving to patient and to healthcare professional the possibility to obtain digitally signed electronic medical reports ( ) Doge: the GPs Network - Regional project aimed to set up a network of services for information and document exchange between GPs, Hospitals and LHAs ( ) RENEWING HEALTH - validation in real life settings and with a common assessment methodology of the use of Personal Health Systems for innovative Telemedicine services ( ) 9

10 HEALTH OPTIMUM: HEALTHcare Delivery OPTIMisation through telemedicine: European telemedicine Project aimed to support different specialties thanks to the application of Telemedicine. Phase 1: Market Validation Phase ( ) 11 healthcare Providers in Veneto Region 3 European Member States: Italy, Spain, Denmark Phase 2: Initial Deployment Phase ( ) Purpose: deploy organizational models based on telemedicine all the 23 healthcare Authorities of Veneto Region 5 European States: Italy, Spain, Denmark, Sweden, Romania Services: Telecounselling service for neurosurgery, Telelaboratory, Ischemic Stroke management, Oral Anticoagulation Therapy (OAT) management 1

11 The federative approach XDS Registry Provincial area of Vicenza Provincial area of Belluno XDS Repository Provincial area of Padova Provincial area of Treviso Provincial area of Venezia Provincial area of Verona Provincial area of Rovigo 1 1

12 Project results: telecounselling service for neurosurgery Project Results Quantitative indicators results Target EU % of success Consultations performed ,9 % Avoided transfers ,13 % 60 % 133,6 % TAC/RX connected ,8 % Requesting units ,2 % Number of operators involved ,0 % Volumes Avoided patient transfers Patient transfers after tele-consultation Source: HO Project Coordination Group, 2009 Period: June 2007 August 2009 Data for the period June 2009 August 2010 are being collected

13 IHE Profiles in Veneto Profile XDS XDS-I Use Sharing teleconselling docs Sharing CT Images

14 Veneto ESCAPE Project services ESCAPE: Electronic Signature in Care Activities for Paper Elimination Local Health Authority Certification Authority Citizens Home PC Diagnostic Services producing Clinical Reports Digital Signature Extraction Archiviation Mail Service GPs Hospital wards & Internal Services Distribution Territorial Service Providers 1 4

15 IHE Profiles in Veneto Profile XDS XDS-I XD-LAB Use Sharing teleconselling docs, lab reports Sharing CT Images Lab report structure

16 Project s goal: develop a network of services for the exchange of clinical data and documents between the different actors of the care process (LHAs, GPs, Paediatricians, etc ) Actors involved Regional Health Information System LHAs Health Information Systems Primary Care actors Citizens Project Services Patient demographic services Clinical Documents eprescription Privacy & patient informed consent LHAs Health Information Systems Veneto Region Primary care e actors Citizens

17 IHE Profiles in Veneto Profile XDS XDS-I XD-LAB EUA/XUA ATNA XDW XBeR-WD Use Sharing teleconselling docs, lab reports, eprescription, ereferral Sharing CT Images Lab report structure User security Connection security, audit Workflow management ereferral workflow

18 RENEWING HEALTH in a nutshell A Large Scale Pilot project co-funded by EU (CIP ICT-PSP) and 9 european regions with 3 European NGOs Project start date: 1st of February 2010 Project duration: 32 months Total budget: Euros EU contribution: Euros 26 pilot sites, grouped in 9 clusters and distributed over 9 EU regions

19 Objectives Clinical objectives improving the quality of life of chronic patients suffering from diabete, COPD and CVD and who account for well over 15% of the EU adult population by removing anxiety about health conditions reducing the need for the patient to use emergency services and/or hospital stays avoiding and/or slowing down the worsening of their disease and the insurgence of complications providing clinical evidence that a telemedicine-based delivery network can supply healthcare services with an appropriate level in clinical quality and reliability

20 From Telecare to Telemedicine Hospital or Local Health District Patient s home Telemonitorin g devices Gateway Regional ehealth Centre General Practitioner Patient Alarm device Regional Centre s Operator Social worker Family Data transmission Data access through Home Care portal Alarm management Contact with the patient

21 IHE Profiles in Veneto Profile XDS XDS-I XD-LAB EUA/XUA ATNA XDW XBeR-WD XTHM-WD Use Sharing teleconselling docs, lab reports, eprescription, ereferral, telehomemonitoring summaries Sharing CT Images Lab report structure User security Connection security, audit Workflow management ereferral workflow Telehomemonitoring workflow

22 Veneto Region RHIO (FSE R ) REgioNs of Europe WorkINg together for HEALTH 2012 Arsenàl.IT Tutti i diritti riservati

23 The DOGE Project ( ) General Practitioner Network Regional project to create a communication network and connect GP and Primary Care sites to the hospital and Local Health Authority. ACTORS: Regional information system Information System of Local Health Authorities GP Personal EHR HIS Hospital Information System VENETO REGION GP and PRIMARY CARE CITIZEN EHR

24 Pitfalls and results Arsenal s role was only to write specs Specs too technical not Use Case oriented No relation management between different vendors during implementation Result: ONE framework with SIX dialects

25 New National eprescription Project Very short time to deploying the entire project National specs NOT standard oriented Need to have ONE implementation oriented to Regional EHR

26 Legacy eprescribing Project National Healthcare System 40 M prescriptions by year XDS + XUA + ATNA + Legacy XDS + XUA +ATNA+ Legacy Veneto HIE/EHR GP (4000) Pharmacy (1500)

27 Project roadmap Technical specs & Test plan (Dec May 2013) Setup gazelle platform (July 2013) Pre-Labeling test (August October 2013) Labeling session (November 2013) Pre-production test (February 2014 March 2014) Deploying phase (April 2014 May 2014)

28 Labeling results

29 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% State of the art % of GPs that e-prescribe in each LHA LHA 1 LHA 2 LHA 3 LHA 4 LHA 5 LHA 6 LHA 7 LHA 8 LHA 9 LHA 10 LHA 12 LHA 13 LHA 14 LHA 15 LHA 16 LHA 17 LHA 18 LHA 19 LHA 20 LHA 21 LHA 22 LHA= Local Health Authority.

30 For the times they are a-changin * but core business will be always the same Thank you for your attention! an * By Robert 2012 Allen Arsenàl.IT Zimmerman Tutti i diritti riservati

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