INTEGRATING THE ESANTÉ DSP INTO GECAMED

Transcription

1 INTEGRATING THE ESANTÉ DSP INTO GECAMED A smooth integration of the Luxemburgish «dossier de soins partagé» (DSP) in the open source medical record system, GECAMed 1

2 THE GECAMED - ESANTÉ PROJECT Since 2007: GECAMed is developed by CRP Henri Tudor (now LIST) as open source alternative for a Lux. electronic health record (EHR) system GECAMed is used by aproximitely 110 generalists and specialists as their practice management system 2012: foundation of the esanté Agency 2013: RFP for an esanté Platform, comprising an EHR that has an integrated access to the platform s DSP Summer 2013: consortium «esanté» is formed, composed of Ido-In, ebrc, Accenture, CRP Tudor, Regify February 2014: esanté platform built and GECAMed fully integrated to the DSP 2

3 PRINCIPLE OF IHE INTEROPERABILITY Purpose: facilitate interoperability between systems from different vendors Means: a) Selection among existing standards (HL7, DICOM, WSDL, SAML, MIME, MTOM,..) b) Severe Restriction of implementation options Method: Integration Profiles (ATNA, XDS.b,...) Result: IHE Integration Statement through participation in a «Connectathon» 3

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5 INTEGRATIONPROFILE ATNA Audit Trail and Node Authentication Secure access control X.509 cryptography with Luxtrust PKI, for user authentication Audit trail logging Syslog protocol and messaging Network communication security HTTPS transport encryption over TLS (=SSL), for secure access over the Internet Basic Profile that any IHE Actor is required to implement 5

6 INTEGRATION PROFILE CT Consistent Time Synchronization of system clocks and time stamps across computer networks (accuracy: < 1sec) Needed to to synchronize logs, authenticate users, digitally sign documents, Basic Profile that any IHE Actor is required to implement 6

7 INTEGRATION PROFILE PDQ Patient Demographics Query Query patient identities from a central registry using patient demographics data 7

8 INTEGRATION PROFILE XDS Cross-Enterprise Document Sharing Discovering and sharing electronic documents between systems Document repository stores documents Document registry functioning as an index Document source provides dcuments Document consumer retrieves documents Patient identity source links every document to a patient identity 8

9 FROM THEORY TO PRACTICE How does it look like in GECAMed? ATNA Profile Login with Luxtrust SmartCard Presence password to obtain consultation mandate 9

10 PATIENT DEMOGRAPHICS QUERRY PDQ Select local patient Use local patient demographics data to perform PDQ Compare local with DSP patient data and confirm link 10

11 VIEW ON DSP DOCUMENTS XDS 11

12 DOWNLOADING & VIEWING CDA DOCUMENTS XDS 12

13 ADDING CDA DOCUMENTS TO LOCAL HISTORY DSP View Local GECAMed History View Copy from the DSP into GECAMed 13

14 UPLOADING DOCUMENTS XDS mydsp indicator for uploaded documents 14

15 GECAMED PATIENT HISTORY WITH UP- AND DOWNLOADED DOCUMENTS Downloaded CDA documents from the patient s DSP «normal» GECAMed clinical history entries Documents from the local history that have been uploaded into the DSP 15

16 PROJECT EXECUTION esanté platform «Connection Kit» by esanté Agency Test & integration environment (different from production) GECAMed was integrated in parallel with the build-up of the platform «moving target» Extremely tight schedule (6 months) with penalties! Regular follow-up meetings (every week) with customers (Ido-In and esanté) Formal acceptance test done in February 2015 Official project reception in March 2014 (both esanté platform & GECAMed) 16

17 GENERAL PROJECT DATA Subcontract with platform provider Ido-In Budget: ~200K Effort: 12 man months Duration 6 months Type: fixed price, with penalties Project was tightly managed within the esanté Consortium 17

18 KNOWLEDGE TRANSFER GECAMed is the first Lux. EHR system for doctors with esanté / IHE interoperability GECAMed = Open Source Market share of GECAMed: ~5% Ideal for knowledge transfer to other EHR developing companies in Luxemburg 18

19 SW EDITOR WORKSHOP FOR ESANTÉ INTEROPERABILITY Attended by 8 local SW editors for EHR systems Objectives: see what esanté integration means and how it can look like better understand the basic concepts behind esanté integration apprehend the technical protocols that are necessary to communicate with the platform learn which technical challenges will be faced and how they could be met 19

20 FUTURE DEVELOPMENTS Handling new structured document formats CDA level 2, 3 - structured XML instead of PDF Obtain esanté integration certification level 3 (highest) Participate in the 2015 Connectathon to obtain an official IHE integration statement for ATNA, CT & XDS profiles Integrate future esanté services for the doctors, such as eprescription, ebilling, etc. Stay on the technological foreferont for EHR interoperability in Luxemburg 20

21 ANY QUESTIONS?