National Kanta Services. Kela, Kanta Services Unit, Marina Lindgren & Marko Jalonen
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1 National Kanta Services Kela, Kanta Services Unit, Marina Lindgren & Marko Jalonen
2 Content National ehealth Services => National Archive of Health Information = Kanta eprescription & Pharmaceutical Database Patient Data Repository (earchive) My Kanta Pages (My Health Information) Kanta Architecture and Standards The Timeline of Interoperability In Finland Kansallinen Terveysarkisto 2
3 Background of the Kanta Services The applications built over the past several decades has been fragmented and often lack interoperability -> Act on Electronic Prescriptions (Act 61/2007) Act on the Electronic Processing of Client Data of Social and Healthcare Services (Act 159/2007) The goal is to integrate the information systems of public and private healthcare providers into a national system that allows real-time access to patient records and prescription information Kansallinen Terveysarkisto 3
4 Background of the Kanta Services A partnership between the Ministry of Social Affairs and Health and four public organizations Kela: responsible for building, operating and maintaining the national Kanta information systems THL (National Institute for Health and Welfare): national coordination and national code server (content) VRK (Population Register Centre): operation of authentication services (PKI infrastructure provider / Certificate Authority) Valvira (National Supervisory Authority for Welfare and Health): licensing of healthcare professionals & Thousands of Health Care Providers in public and private sector Kansallinen Terveysarkisto 4
5 New eprocesses with the Patient in the centre: eprescription Kansallinen Terveysarkisto 5
6 Public healthcare providers Hospital districts (20) Primary care org. (192) Private healthcare providers (4000) Pharmacies (~800) Citizens (> ) Health care professionals Swedish epsos NCP Other NCPs not yet connected IHE XDS IHE XDS-I Aged 18 and older epsos NCP Kanta services My Kanta pages Web services for HCPs Pharmaceutical database Kanta messaging layer eprescription service Renewals Patient data repository Health records, legacy (CDA R2 L1) Patient summary management Diagnoses Procedures Risks Consent and will management Organ donation wills Prescriptions Radiology DICOM studies Patient data management service Vaccinations Lab Health and care plan Living wills Logs Dispensations Metadata Logs Health records, structured (CDA R2 L3) Radiology Physical findings Medication Opt-ins and opt-outs Main standards HL7 V3: CDA R2 Level 3 and Medical Records IHE IT-I Profiles W3C XML DSig WS Addressing, WS-I TLS, X.509 Other national services National code server Code lists and terminologies Form and document structures Certification services Healthcare and social care organizations register Pharmacies register Health care professionals register
7 Electronic Prescription and Pharmaceutical Database designed for healthcare services and pharmacies Prescription Centre, into which all electronic prescriptions and their dispensing information are entered Pharmaceutical Database contains all essential drug information required for prescribing and dispensing Kansallinen Terveysarkisto 7
8 Patient Data Repository (earchive) centralised database into which patient records are entered nationwide designed for Healthcare services Kansallinen Terveysarkisto 8
9 My Kanta Pages Online service designed for adult citizens, through which they can view their own prescription information and medical records, e.g. Diagnosis, Patients Summary, Patient Risks as well as related log records in the Kanta Information A log record contains how and when the data system was used, who used it and information on various fault situations etc. Introduced simultaneously with eprescription Patient Data Repository Kansallinen Terveysarkisto 9
10 Statistics 2013 The Public Health Care Sector and Pharmacies are using the Prescription Centre, also the Private Health Care providers are on their way 15,5 milj. eprescriptions 22,1 milj. consents in pharmacies unique users on My Kanta Pages Patient Data Repository in use in Northern Carelia and Savonlinna District. The whole Public Health care is preparing implementations Kansallinen Terveysarkisto 10
11 eprescription: Monthly Prescriptions and Dispensations touko kesä heinä elo syys loka marras joulu tammi helmi maalis huhti touko kesä heinä elo syys loka marras joulu tammi helmi maalis huhti touko kesä heinä elo syys loka marras joulu tammi Kirjoitetut eprescriptions reseptit in healthcare terveydenhuollossa Lääketoimitukset edispensations in pharmacies apteekeista
12 Production Service Requests eprescription currently generates 15 million service requests monthly with average response time of less than a second at Kanta service Patient Data Repository currently generates 2 million service requests monthly with average response time of ~0,5 seconds at Kanta service Kansallinen Terveysarkisto 12
13 HL7 Finland founded Timeline of Finnish Healthcare ICT Standardization for Interoperability Experimental legislation on seamless service chains National health project starts Regional hospital information systems starting National core datasets defined Legislation about the national Kanta system and supporting services Kela appointed as a national actor in national healthcare ICT services eprescription service production phase incl. My Kanta pages service for citizens -> Finnish IHE SIG founded epsos work started in FIN Revised legislation on consent management and patient summary service Patient Data Repository production phase -> All public healthcare uses the Patient Data Repository, phase I content IHE FI founded Phase II content in the Patient Data Repository ICD-10 adopted in Finland First national HL7 v2 profiles PikaXML definition for electronic referral process Finnish profile for CDA R1 National code server founded Finnish basic profile for CDA R2 CDA R2 becomes ANSI standard Ministry decision on CDA R2 for national standard for structured dataset National Kanta architecture defined National pharmaceutical database founded KVARKKI national imaging architecture defined HL7 Medical records specifications for Finnish profile eprescription and for HL7 V3 Patient Data Repository messaging Oral and dental healthcare structured documentation specifications epsos national contact point in production
14 Thank you for your attention! Kansallinen Terveysarkisto 14
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