Enterprise Wide Meta Data Archive

Transcription

1 Enterprise Wide Meta Data Archive A individual Story how to handle Big Data Klinikum Wels-Grieskirchen / Austria Healthcare World Oslo E. Flamme Strategic CIO E. Flamme

2 Where ist Wels located? Center of Austria Wels Linz Population County Districts Wels / Grieskirchen = Population Upper Austria Federal State = Population Austria = E. Flamme Seite 2

3 Facts about Klinikum Fraternity Kreuzschwestern and Klinikum Wels Grieskirchen E. Flamme Seite 3

4 Fraternity Kreuzschwestern / Partner Enterprises Healthcare Public and Private Healthcare Education / Prevention Nursing Homes / Kindergarten Technical Hospital Services E. Flamme Seite 4

5 Facts about Klinikum Wels Grieskirchen A Cooperation of Fraternities Kreuzschwestern / Franziskanerinnen Private Clinic PKA Location Wels Psychiatric Clinic Location Wels Main Clinic Wels-Grieskirchen Location Wels Hospital Main Clinic Grieskirchen Location Wels-Grieskirchen Grieskirchen Location Grieskirchen Since January 2008: One hospital on four sites 1000 bed Hospital in Wels merged with 260 bed Hospital in Grieskirchen and 60 bed Psychiatric Hospital in Wels beds with over inpatients per year 37 departments, 26 different specialities 37 outpatient departments with approx outpatient visits /yr operations and births per year Number of staff is (including 500 doctors and 1200 nurses) Budget: approx. 288 million Euro The largest Convent Hospital in Austria 5th largest Hospital in Austria E. Flamme Seite 5

6 Klinikum Wels Grieskirchen / XT Partnership Sucsess in Healthcare IT Since 2003 Developing Partnership with Siemens SOARIAN Clinical Beta Side SOARIAN Physician Letter / Emergency Department Moduls Evaluating, Improving and Developing Healthcare Solutions together with X-tention and other Partners (HDS, CISCO) emedic (Medication Documentation and Reconciliation Tool) MDES (CISCO Tiani IHE compatible ehealth Solution emind Healthcare Meta Data Archive as HCR with HDS Pilot Site for Public Healthcare Solutions emedication Austria / epsos Integration in the Upper Austrian ehealth Infrastructure (Pre National Pilot) E. Flamme Seite 6 Seite 6

7 Klinikum Wels Grieskirchen Infrastructure Three data centers One high availability data center (200qm) / Second with 180qm) 80qm separated and dedicated for X-tention and X-tention customers. Backup Location (inside) and 60 miles away Clients >100 Mobile Devices (ipad on to clinical Tablets) > 500 servers (60% virtualized) VMWare Products (Vsphere, LabManager,.) Network Environment CISCO SAN / LAN / WLAN HDS Enterprise Storage Environment Hitachi Enterprise Solutions (Storage and Solutions) NEXSAN S-ATA / SAS Beast (Dual Vendor Strategy Low Cost) Falconstore VTL / Deduplication E. Flamme Seite 7 Seite 7

8 Challenges for Healthcare IT E. Flamme Seite 8

9 Healthcare Challenges for the next decades Maintenance of good Healthiness Information about health related quality of life Additional Information Personal Training Life Science Wellness Healing Detailed (Genetic) and Epidemical and Forensically correlations Data out of Modalities and other Healthcareprovider Treatment Data out of Admin or HIS Systems E. Flamme Seite 9

10 Challenges for Healthcare IT in Austria in the next years Government's Expectations: Cutting Costs Centralization of IT Services and Providers Collaboration between the different Health Care Providers User / Clinician / Healthcare Professionals Expectations: Data Exchange and Collaboration Support for Clinical Integration of new User Interfaces and new Devices including new integrations Strategies (BYOD / CLOUD ) ) Integration of new Software Platforms / User Interfaces similar to Apps / similar to Social Networks Decision Support and integrated Knowledge Management Medical Platforms similar to social Networks as (personal) PHR assentivs or part of a CRM Strategy E. Flamme Seite 10

11 The World of Heathcare Data is growing up from birth to death Seite 11

12 Our Challenge: Presenting Information From a large Number of Data only a few documents are important in a specific Situation Seite 12

13 Essential: Data Suppliers meets Content Consumers Main Data Suppliers in Healthcare are GP, Hospitals, Nursing Homes and HomeCare Main Consumers of Healthcare Information's are Healthcare Providers, Insurances, Science and Research Every Healthcare Employees and every Healthcare Consumer needs Application and Devices which offers him information: At the right time At the right place In the right context At the right role An NEW: The Patient himself will be OWNER and CONSUMER of relevant Healthcare Data (PHR) E. Flamme Seite 13

14 Starting thinking about a (clinical) Meta Data Repository E. Flamme Seite 14

15 Looking for Solutions Status Quo: Starting with PACS and a non DICOM Archive we needed additional archive solutions for SAP Digital Receipt Management, ehealth Repository, , Share Portal Server.. CEO Order: Look for a vendor who supports most of the our requirements! Considerations: Which vendor delivers most of our requirements and can help migrate from our previous archives? We decided not to do so! What happens in five years? Will we do this again, again and again?

16 1. Challenge: Avoiding Data Overload Accessing and Presenting data in different context cases for patient treatment, science and education Considering Commercial interests (prevention rather than cure / medical trial evaluations / managerial decisions) Prepared to Support decision support systems with data Meta Data Repository - A base for semantic networks solutions offering information for all Users in the right time, the right place and in the right context (Clinical / Administration / Business) Elmar Flamme Slide 16

17 2. Challenge: Stop Data Grave Yard Consolidation of the different archives, archive technologies, archiv vendors Content archiving in one plattform for common access Avoiding permanent Data Migration producing or losing Data and Information An Archive or Repository should not become a graveyard for data, information and knowledge Elmar Flamme Slide 17

18 3. Challenge: Delivering Data Compliance with meetings legal retention periods for data IHE compliance for health portals and health data exchange Data Independence avoid migrations, yet easy to access Readiness for a digital memory of a hospital and a regional healthcare record From unstructered Data to structured Information Elmar Flamme Slide 18

19 From Vision to Reality E. Flamme Seite 19

20 Our Vision Displaying Information / Content in new Context Adm. / ERP System (HR, FI, CO, DW, MM) Laboratory PACS Clinicals / Scheduling Clinical Information Systems EHR / CPOE / PoC / ED 3rd Party Departmental / Subsystems Selfdevelopment products Medication Coding GP Port al ehealth Home Care Portal Upper Austria n ehealt h Conne ct Seite 20

21 What we understand under Content Services? The knowledge to convert information into Standards and structured Information (like CDA). The knowledge to extract (Custom) Meta Data from structured Information. The knowledge to offer Custom Meta Data to Applications like Snomed or.dr. Watson to display information in individualized views based on roles, events and different point of care. The knowledge to offer Patient Safety Systems like Medication reconciliation Applications additional information. The possibilities to combine every object information under a knew Question. If you are Master of the Data (like a regional IHE repositories) you have under restriction of law and data privacy a lot of possibilities to develop Services around Content Elmar Flamme Slide 21

22 A clinical meta data repository needs high-availablity, flexible storage and content-based Platforms that are.. Open for Standards HL7 CDA DICOM PDF (PDF-A) HTML XML XLS Open for Access Enterprise Search Engine API-free Ingest from Multiple Sources Open for Data Object Oriented System Meta Data Custom Meta Data Seite 22

23 Our Concept Source systems or Semantic Network Applications Source systems exports data via standard interfaces Target system inbound Meta Data Robot analyzes and prepares data Automatic extraction and adding meta data information Storing as Object (HL7 message / PDF-A, DICOM, CDA) API delivers result back to the Apps. Using API for Query Hitachi Content Platform Seite 23

24 Preparing Meta Data Meta Data Structure Classification Defining document categories Defining rules and regulations Choosing standards for automatic classification of documents types and automatic content filtering Applications Chose application which provides extracting Meta Data otherwhile use the HCP Standard Features Analyzing all enterprise document types (clinical/ office documents) Analyzing the content of all documents Analyzing the possible different levels for information (equal content / different content) Consider your enterprise Architecture

25 How we did it E. Flamme Seite 25

26 Example: Defining CDA Level 2 Document Custom Meta Daten: Department / Speciality Information Custom Meta Data Sections Custom Meta Daten: Diagnosis / Coding Seite 26

27 Example: RIS / PACS DICOM / DICOM Header Custom Meta Daten: DICOM Header + RIS Result Text Seite 27

28 Access and Display via HIS System / Special Viewer Software Clinical User Clinicals / Scheduling Clinical Information Systems EHR / CPOE / PoC / ED Other Source Systems Output Input Seite 28

29 One Repository for All (Meta) Data emind KIS ISH PACS-Application IHE- Application Ward Application PACS IHE AIM Whatever Standard Connectors Specialised Connectors Documents Kernel IHE-Metadata DICOM-Header-Data Documents emind-metadata Master Index HCP HDDS Lucene PACS-MD IHE-Registry AIM Metadata Specialised Indices Whatever Elmar Flamme Slide 29

30 User View HIS EHR Portal Syndedra View Microbiology Radiology Pathology.. Seite 30

31 One Archiv, One Viewer for diff. Sources, diff. Appl. Seite 31

32 Different Applications Common View One Archive GP Portal View IHE Application Search result via Meta Data on CDA Level 2 Dokument/Ersteller Elmar Flamme: Slide 32

33 Example for emind Example: Phrase Search: Duodenalschleimhautbiopsien Expected Result: Pathology Results / Documents Search Documents with this Phrase CDA Level 2 Pathology Document Seite 33

34 emind / HCR Document / Project Status 15 diff. Source Systems 500 diff. Documenttypes 1.2 Mill Documents / Objects expected End of 2012.Physician Letter, LIS, Assesments, ECG. Seite 34

35 Summary Content Search / Forensic Search - Search over all (Custom) Meta Data (not on Object / Document) - Search for Phrases / Expressions - Including Objects (Pictures) which includes Expression and Phrases as Custom Meta Data Clinical Search - Real Time Search (depends from Transfer Time) - Search over PID (all Documents) - Including Merges - Custom Meta Data Changes - (including SAP Patient Reciepts PID) Administrative Search - SAP ERP / HR Documents - (later: ) - (later: SharePoint) - (later: FileServer) Seite 35

36 Summary Storing - Every (TextBased) Information is stored as CDA Level 2 Document - Every Information is stored as Orignal Information (HL7, TXT,..) - Every (TextBased Information is stored as PDF-A - Meta Data can be changed / updated (without impact to orginal object) Display - Every Stored Information can be displayed by - XML Viewer (CDA-L2) - DICOM / NonDICOM Picture Viewer - PDF Viewer Restoring - Every Information which is needed for Restoring is saved inside the Custom Meta Data - No DataBase is needed Only XML Tools for Reading Custom Meta Data (TXT) Seite 36

37 Long Term Project ( years) Building an enterprise-wide meta data repository needs a lot of preparation inside the enterprise organizations (Document Management, Standardization). Consider short-term requirements: A meta data repository can not substitute archive application solutions and most of the existing clinical and administration software is simply not ready for meta data yet. IHE is a key feature for improving patient treatment with the standardization based on IHE Profiles, CDA clinical document architecture etc. With standardization you can extract META DATA Information. Greater flexibility and cost effectiveness: Having stored data in a generic way you are independent from migration timelines and costs. Change applications as and when needed for user acceptance and improving your processes. Implementing a Qualitiy Process for Data (similar to Data Analyst ) Elmar Flamme Slide 37 Seite 37

38 Contact Strategic CIO E. Flamme Klinikum Wels Grieskirchen A-4600 Wels, Grieskirchner Straße 42 Tel: + 43 / (0) 7242 / , Fax: DW 3774 / Mobil: + 43 / (0) 699 / elmar.flamme@klinikum-wegr.at Homepage: