Information event «ehealth Suisse» and IHE Suisse

Information event «ehealth Suisse» and IHE Suisse

Agenda 1. Benefit for the practitioner Franz Marty, Medizinisches Zentrum gleis d AG, Chur, Switzerland 2. Evolution and Functions Tony Schaller, medshare GmbH, Switzerland 3. Technical implementation Axel Helmer, University Clinic Heidelberg, Germany 4. Questions and Answers

About me Franz Marty General practitioner since 1994 1994-2003 General Practitioner, a single handed practice in a mountain valley 2003-2008 Research, Engagements in different GP-Projects, establishing a Medical Center in Chur run by doctors 2008 - General Practitioner Medical Center in Chur Education in General Practice Special Interest in smart doctor-software Member of the develompment-team Elexis, an OpenSource Patient Information System (PIS) and Electronic Patient Documentation (EPD)

Reason for commitment I The EPD - it can be a very useful tool for Documentation Information Communication But handling an EPD can be time consuming, attention absorbing and tedious Fits the software in the doctor workflow? Or has the doctor to fit in the software? There is a risk that the EPD establishes itself as the centre of the patient - doctor encounter

Reason for commitment II

Reason for commitment III Doctors have to tell about their workflows and processes to propose smart graphic user interfaces (GUI) Doctors have to play part in the development of Software

Benefit for the practitioner Data entry only once Let the machine do as much as possible Make complicated things simpler Keep simple things simple Straight user interface Operate in and through the software you are used to

Benefit - use case vaccination Vaccination means prevention of serious diseases and death Vaccination ist a important Issue of public health Vaccination status of persons is often not available (documents lost, ) In the Swiss ehealth strategy the electronic vaccination dossier is of high priority Funcionality: Documentation, upload and download of vaccination datas, Check for pending vaccinations Vaccination documentation in the EPD is often a too complicated process (GUI problem) Entry of past vaccinations ist a very time consuming process It s for the doctor not always easy to know the recommended vaccinations

Use case vaccination - recommended vaccination

Use case vaccination - data representation I

Use case vaccination - data representation II

User Issues - have to s As user you want good data representation (graphic user interface) and you will do the necessary work in the frame of this data-representation you know That means No barriers like web services with user/password entries and manual data filling No change to other applications or interfaces Send from and get the data in your preferred software As user you want to send Vaccination datas with one click to receive the datas with one click and to get a vaccination check with one click No good user Interface - no acceptance of the processes

User Issues - GUI Check S I

User Issues - the effect If you deliver such software - you ve won!

About me Tony Schaller Independent consultant for ICT in health care Member of HL7.ch (chief of its technical committees 2007-2012) Member of the ehealth Suisse team "Standards & Architecture" Technical project manager of IHE Suisse and IHE Connectathon monitor Major contributions to the specifications and templates around CDA in Switzerland IHE and HL7 training courses Projects and mandates in the national and international ehealth environment Lecturer at the Bern University of Applied Sciences

Observed market situation Usage of standards is widely welcome, accepted and also recommended by ehealth Suisse But Required know-how for software vendors is extremely high In-depth knowledge of known standards are often missing Thus, the entry barrier is too high right now Objective: An ehealth Connector should encapsulate as much functionality as possible

The project - spirit Free and Open Source Software (FOSS) Give and take Enable interoperability Reduce barriers

The project - yesterday 2012-08: HL7 CDA in Arztpraxissoftware - Konzept zur Integration 2013-11: Konzept zur Implementierung und API Spezifikation 2014-02: ehealth Connector - Proof of concept Many thanks to - Franz Marty Documents in German, only: http://medshare.net/publikationen ehc - Proof of Concept: http://sourceforge.net/p/ehealthconnector/wiki/r20140211/

The project - today ehealth Connector Release 1 is comming soon CDA-CH-VACD - evacdoc Many thanks to - Ärztekasse - IHE Suisse - Viavac ehc Open Source: http://sourceforge.net/p/ehealthconnector/code ehc Runtime Download: http://www.ihe-suisse.ch/mitgliederbereich/login.html (for IHE-Suisse members only)

The project - tomorrow Implementations Vendor products using the ehc will pass IHE Connectathon tests IHE Suisse members get support Vendors plan to use the ehc: HCI Solutions Triamed (http://mytriamed.ch) My Vaccines (http://myvaccines.ch) Open Source Elexis (http://elexis.ch) Viavac Clinical Decision Support System (http://www.viavac-cdss.ch) Evolution (upcoming releases) CDA-CH-EDES - Emergency Department Summary CDA-CH-SMTL Shared Medication Treatment List IHE XUA Integration Many thanks in advance to - Inselspital Bern University Hospital - HUG Geneva University Hospitals - Infomed Canton of Wallis

The project - incubator CDA-CH-LRTP (Laboratory Reports in the Transplantation Process) Bachelorproject Bern University of Applied Sciences, Medical Informatics Biel Loosli Helen, 2014, KIS-Integration mittels Open ehealth Connector, Informationsaustausch rund um die Allokation von Organen für die Transplantation Managed by: Dr. Stephan Nüssli, Checked in: June, 16 2014, Status: stand-by CDA-CH-VACD (evacdoc) Author: Gerhard Schmutz, viavac Checked in: November, 3 2014 Status: will be released, soon Please contribute populate our incubator http://sourceforge.net/projects/ehealthconnectorincubator/

Who is on stage? Head medshare Ltd, Thun, Switzerland Project Team - Tony Schaller, medshare (Project Manager) - Cornelia Schmid, medshare (Product Manager) - Franz Marty, Medizinisches Zentrum gleis d (Health Professional) - Axel Helmer, Open Connections, Oldenburg, Germany (Chief developer) - Michael Onken, Open Connections, Oldenburg, Germany (Head of Development) Promoter - IHE Suisse - «ehealth Suisse»

Understanding and using the project logos Main project logo: Iconized logo: Contributor indication: User indication: These Logos by medshare Ltd., Switzerland are licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

The project - architecture

The project - functions Upcoming release will contain: Serializing and Deserializing of CDA-CH-VACD documents (evacddoc) for immunizations

About me Axel Helmer Academic career Diploma University of Oldenburg Lectures & Graduation University of Oldenburg / OFFIS Postdoctoral fellow University Clinic Heidelberg National and international projects in the area of ehealth Electronic Health Records Interoperability IHE Connectathon Monitor Member of working groups in the VDE, GMDS, and DGBMT Independent consultant for ehealth Cooperation with OpenConnections

Clinical Document Architecture (CDA) Interoperability in medicine Computers are stupid you need to explain everything CDA is a complex standard Example : Pseudonym «Dr.-Ing. Axel Foo Helmer der Dritte.» Person Name (PN) In the CDA data model derived from the Entity Name Datatype (EN) EN is a collection of the Entity Name Parts datatype (ENXP) <prefix> - «Dr.-Ing» - Qualifier: Academic Title (Code: «AC») <suffix> - «der Dritte» <given> - «Axel Foo» <family> - «Helmer» <delimiter> - PN -> Name use: Artist/Stage Name (Code: «A») CDA R-MIM http://hl7cn.com/infrastructure/cda/graphics/lpocd_rm000040.gif

CDA Frameworks CDA Frameworks HL7 SDK, CDAR2.Net, RIMBAA,... Model Driven Health Tools (MDHT) Supported by Oracle, IBM, HL7, Eclipse,... Used by experts worldwide Open Source Technically mature MDHT approach Everything is a model HL7 datatypes IHE section templates CDA-CH Document Templates Software Toolkits for CDA Implmentation http://hl7book.net/index.php?title=cda http://motorcycleguy.blogspot.de/p/ask-me-question.html

Modeling CDA

Implementing a CDA Template with MDHT MDHT uses models to generate Application Programming Interface (API) Validators Documentation (Spec., Javadoc) Implementation Example: Available Methods for the PN Object Example: Available Javadoc for the Method PN.addDelimiter() Knowledge you should have RIM, CDA, HL7v3, Clinical Terminology, IHE, UML Modeling, Ecore Modeling, MDD, MDHT Not convenient but mighty

ehealth Connector Convenience API Convenience API Fast results API is very easy to use Recommendation what should be implemented Guidance for application developers Javadoc that explains what you need to know Javadoc in your language Demo application for every template As few expert knowledge as possible Hide the complexity of CDA and MDHT But you can access underlying MDHT Objects at any time Convenient and mighty

Summary & Future Work Summary Standards in medicine are complicated..so are the frameworks MDHT is a mighty tool, but time consuming to learn ehc uses the MDHT to provide a CDA API that is easy to understand Future Work Create a first release and two releases per year Let vendors use it and integrate their feedback Include support for more document templates Include support for communication functions

Thank you!