Program- and Project Management, architecture and standards

Transcription

1 The ELGA Program - a national EHR solution as driving force of health communication and health reform Program- and Project Management, architecture and standards 10 th European Health Forum Gastein 2007 Dipl.-Ing. Dr. Alexander Schanner Program-Manager A-1020 Vienna, Schiffamtsgasse 15 Agenda 1. Introduction 2. Architecture 3. Standards 4. Program- and Project-Management Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 2

2 Definition of ELGA ELGA contains relevant multimedia-based and health related data and information referring to a precisely identified person. Data und information originate from different health service providers and from the patient himself/herself and are stored in one or several different information systems (virtual health record). Data are available independently of place and time (costsaving) at the place of treatment for all authorized persons according to the tasks and needs of these persons and in compliance with data protection rules Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 3 Overview of Basic Components and Core Applications Preconditions for ELGA ELGA Basic Components ELGA Core Applications First Implementation Phase ELGA Basics Citizen / Patient Storage and Filing Legal Measures Data Protection Master Patient Index nationwide compatible with EU HSP Index roles Portal Health Information Current Topics Document Registry centralized e-medication (doctor, hospital, pharmacy) e-report (radiology) Consumers Acceptance Management Organisational Measures Authorization System Access Protocols Network Standards Portal HSP Information Health Promotion Portal Applications Document Repository decentralized e-report (laboratories) Discharge Summary Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 4

3 Agenda 1. Introduction 2. Architecture 3. Standards 4. Program- and Project-Management Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 5 Framework Architecture and Core Applications A hyper-index with sophisticated search functions Doctor HSP Index ELGA Portal Citizen Card with PIN Master Patient Index Authorization System Registry reading writing Data Sources Adaptor e-medication Adaptor e-report (radiology, laboratories) Adaptor Discharge Summary Adaptors: Interfaces which make existing applications compatible with ELGA Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 6

4 Hierarchical View on ELGA Authorization System HSP Index ELGA Visibility Master Patient Index Registry Central Storage of Data Signature, Entry in Registry HSP - Local Storage of Data Reports Laboratory X-ray Discharge Summaries Precise link to a document, URL Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 7 ELGA View on Data HSP HSP Index Patient Authorization System Master Patient Index Registry Central Storage of Data Radiology reports HSP - Local Storage of Data Laboratory reports Medication Discharge Summary Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 8

5 Federal Health Agency (BGK) decision (1/3) Architecture Basis Components - Master Patient Index - Health Service Provider Index - Document Registry - Authorization System - Portal Core applications - discharge Summary - e-report - radiology - e-report - laboratory - e-medication Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 9 Overview System Architecture ELGA Context Audit System External Registries (base identification number,...) Pat - Index Autohorization System Document Registry HSP - Index HSP System HSP System Portal Consumer Source Repository Consumer Source Consumer Source Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 10

6 Agenda 1. Introduction 2. Architecture 3. Standards 4. Program- and Project-Management Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 11 Interoperability Standards and Catalogs Technical (syntactical) interoperability Content wise (semantical) interoperability Requirement: Assortment of international standards 1. Standards rise quality and reduce costs! 2. Standards promote competition! Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 12

7 Federal Health Agency (BGK) decision (2/3) International standards for ELGA in Austria: 1. IHE Frame-Work with domain - IT Infrastructure - Patient Care Coordination - Laboratory - Radiology 2. HL7 CDA 2.0 as document standard 3. LOINC (area laboratory data) 4. DICOM 3.0 incl. WADO (area radiology) 5. HL7 (in Version 3 with RIM as prospective data model) Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 13 International standards Strategy: established, international used standards Hospital Information System (HIS) Providers have to comply with the international market, Austria s operating companies focus on internationally widespread HIS HL7 RIM (Health Level 7 Reference Information Model) and CDA (Clinical Document Architecture) are preferred candidates for data model and document configuration IHE XDS (Cross Enterprise Document Sharing) including PCC (Patient Care Coordination) for document exchange. Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 14

8 Technical framework: IHE Profil XDS MPI Master Patient Index Patient Identity Source SEARCH MAKE EPA-I Elektronischer Patienten Akte - Index Document Consumer Document Repository Document Registry 3 Query Document Consumer Document Source 2 Register VIEW 1 Provide 4 Retrieve Document Source Document Repository STORE Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 15 Information path in IHE XDS with Patient Care Coordination (PCC) Doctor Authorization System HSP Index Doctor Hospital Patient Index Hospital MAKE Dokumentenregister Registry lesend reading writing writing Data Source Data Source STORE After storage and registration specific information to another HSP with transmission of registry data (URL) reading VIEW SEARCH Storage Registry Log in Patients Identification Search for Documents, URL Access to Documents Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 16

9 Regional and national Projects Kassner, Berlin, 2007/04 Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 17 Project CDA documents Content wise interoperability via Clinical Document Architecture from HL7 Level 1 Level 2 Level 3 for 1. discharge Summary 2. e-report - radiology 3. e-report - laboratory 4. e-medication by Arge ELGA, members of standardization institute with different medical associations Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 18

10 Document struktur HL7 CDA 2.0 source: Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 19 International data exchange Request HSP authorization Request patient identifikation Request insurance status Request patient consent Search med. documents Access / download med. documents Public Insurance ELGA HSP Public LSP HSP Insurance Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 20

11 Agenda 1. Introduction 2. Architecture 3. Standards 4. Program- and Project-Management Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 21 Task Force Electronic Health Record - Arge ELGA - Arbeitsgemeinschaft Elektronische Gesundheitsakte 1. Decision of Federal Health Commission from July 2006 concerning establishment of Arge ELGA and financial remuneration 2. Working basis of Arge ELGA is an agreement between 1. Federal Government 2. Provinces and 3. Social Insurance Institutions 3. Since September 2006 ARGE ELGA is acting operationally Location: A-1020 Vienna, Schiffamtsgasse 15 Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 22

12 Object of Arge ELGA according to Agreement The objective of the ELGA Task Force is to drive the connection of existing and future electronic information and documentation systems in the Austrian health care system within the scope of a multi-project management. The main target is the establishment of the so called electronic health record (ELGA) in order to increase quality and efficiency of the health care system. Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 23 Tasks of Arge ELGA according to Agreement Among others: 1. Assistance to the Federal Health Agency concerning controlling and coordinating activities; 2. Definition of strategic priorities for the establishment of ELGA and of the roadmap for its implementation; 3. Planning of detailed concepts and implementation of projects to introduce ELGA as well as the development of financing proposals; 4. Demand of necessary legal amendments and the binding use of approved standards; 5. Crisis and escalation management 6. Evaluation of project results Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 24

13 Implemetation preliminary planning 2006: February to June 2006: Preparation of Arge ELGA (contract) 28. June 2006: Decision about contract Arge ELGA Summer/Autumn: Feasibility Study September 2006: Arge ELGA is operational 2007: January: Publication of Feasibility Study Dec 06 Feb 07: Architecture plan for the first implementation phase March / April: Consultation with Stakeholders BGK: Acceptance of architecture plan and commissioning of first implementation phase Masterplan Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 25 Federal Health Agency (BGK) decision (3/3) Detailed planning and first piloting (2007 / 2008) Concretion Basis Components and Master Plan (IBM-Follow-Up Mission) Mai to August 2007 Project 1 Master Patient Index Project 2 HSP Index Project 3 Document Registry Project 4 Authorization System Project 5 Portal Project 6 Main Application first phase of implementation Project 7 Acceptance Management Acceptance of each project after the presentation of an organizational and financial concept through BGK Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 26

14 ELGA Projects first phase of implementation Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 27 Program- and Project-Organization Program-Management Integration Project Functional Projects Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 28

15 Thank you for your Attention! Dipl.-Ing. Dr. Alexander Schanner EHR Program in Austria Page 29