Telemedicine Care Concept Using EHR Data

Size: px

Start display at page:

Download "Telemedicine Care Concept Using EHR Data"

Paul Johns
8 years ago
Views:

1 Telemedicine Care Concept Using EHR Data Alexander Kollmann Austrian Research Centers GmbH ARC ehealth systems Graz - Hall in Tirol Wien Head of Dept.: DI Dr. Günter Schreier, MSc ehealth Conference 2007, Berlin This Project is supported by the Styrian government

2 Outline Introduction Typical architecture of an EHR Telemedicine framework for collaborative pacemaker follow-up Interfacing the EHR Current state of developments Conclusion & Outlook 2

3 Introduction Electronic Health Record (EHR) - Tool for patient management and documentation - Identification management (e.g. ID-Card) - Document repository containing validated data Telemedicine - Separates the patient and his/her data and provides an additional link between the patient and his/her caregiver (e.g. Home Monitoring) - Provides communication between caregivers (e.g. Second Opinion, collaborative therapy management ) - Includes the patient itself in his/her therapy management - Heterogeneous data sources 3

4 Typical architecture of an EHR Biomedical Engineering / ehealth systems Patient identification Master Patient Index Patient ID Examination, Treatment Case ID EHR Reports, Documents Data review, validation Source data Adapter Source data storage Data pre-processing Workflow management Interface Document ID Telemedicine sub-system Telemedicine devices 4

Reports, Documents Data review, validation Source data Adapter Source data storage Data

5 Pacemaker therapy Characteristics - Many institutions involved (surgery, cardiologist, general practitioner) - Many pacemaker manufacturers, a lot of different models - Follow-up only in specialized clinics (up to 4 times a year), special programming devices needed Current status - Lack of integrated therapy management and collaboration (quality assurance loop not closed) - Inconsistent documentation (paper based / electronic) - Burden for elderly patients (transportation and waiting times) Goals - Cumulative record from the implantation to the explantation of the pacemaker (-> Pacemaker Patient EHR) - Collaborative therapy management between the specialist at the hospital and the caregiver at patient s side (-> Telemedicine) 5

closed) - Inconsistent documentation (paper based / electronic) - Burden for elderly patients (transportation and waiting times) Goals - Cumulative record from the implantation to the

6 Biomedical Engineering / ehealth systems Telemedicine framework for collaborative pacemaker follow-up Caregiver Hospital (ECG recording, examination) (Diagnostic findings) Drawbacks Lack of integration into the clinical workflow Missing cumulative data pool from the implantation to the explantation of the pacemaker Report Telemedicine Service Centre Review / Report No link to patient data in the EHR 6

into the clinical workflow Missing cumulative data pool from the implantation to the explantation of

7 Integration into the clinical workflow Biomedical Engineering / ehealth systems Implantation, Registration - Patient data and the unique PatID is fetched from the EHR and stored into the telemedicine sub-system (HL7 - Interface) - Pacemaker data (model information, settings,..) are added to the record Follow-ups - Extended, clinical follow-ups Data entry via Web-Portal (standardised input templates) PDF - Report generation - Screening, telemedical follow-us Mobile data acquisition and transmission (ECG, examination data) Data review via Web-Portal PDF - Report generation Explantation - Documentation via Web-Portal (quality assurance) 7

.) are added to the record Follow-ups - Extended, clinical follow-ups Data entry via Web-Portal (standardised input templates) PDF - Report generation -

8 Registration / Clinical follow-up Biomedical Engineering / ehealth systems Master Patient Index Patient ID Case ID EHR FTP HL7 File transfer - Query HL7 - Answer Adapter Web-Portal Interface Document ID Telemedicine sub-system 8

ID EHR FTP HL7 File transfer - Query HL7 - Answer

9 Telemedical follow-up Master Patient Index Patient ID Case ID EHR FTP File transfer Adapter Web-Portal Interface Document ID Telemedicine sub-system XML-RPC 9

10 Current state of developments Clinical evaluation (multi-centre, randomised, controlled) of 414 patients registered Web-Portal - Patient registration - Electronic data capture - Workflow management Interfaces - Patient data exchange (HL7) - Report exchange (FTP) - Data upload Telemedical Care - Mobile pacemaker follow-up unit - ECG signal processing - Data review, Validation Biomedical Engineering / ehealth systems 10

Interfaces - Patient data exchange (HL7) - Report exchange (FTP) - Data upload Telemedical Care - Mobile

11 Summary & Conclusion A telemedicine framework for remote pacemaker follow-up has been presented as an example of a telemedicine service supporting data exchange with an EHR. To use telemedical concepts in routine care they will have to be fully integrated into existing IT infrastructure to ensure data consistency and integration with existing workflows and processes. In accordance with the Austrian ehealth strategy we propose the development of telemedicine sub-systems which are connected to the EHR using an adapter layer. Telemedicine sub-systems will provide storage of source data, data processing, and workflow support. 11

To use telemedical concepts in routine care they will have to be fully integrated into existing IT infrastructure to ensure data consistency and integration

12 Telemedicine Care Concept Using EHR Data Project homepage: Alexander Kollmann Austrian Research Centers GmbH ARC ehealth systems Graz - Hall in Tirol Wien Head of Dept.: DI Dr. Günter Schreier, MSc ehealth Conference 2007, Berlin This Project is supported by the Styrian government

Graz - Hall in Tirol Wien Head of Dept.: DI Dr.

A telemedical therapy-management-system with rule-based active patient-feedback

A telemedical therapy-management-system with rule-based active patient-feedback Austrian Research Centers GmbH ARC ehealth systems Graz - Hall in Tirol - Vienna Matthias Pinsker, Peter Kastner, Günter