AORTA

National IT-infra for healthcare applications

Karel de SmetIT architect NICTIZ

Noordwijkerhout, The Netherlands2005 May 5th

Agenda

• Current IT in health care

• NICTIZ purpose

• National IT infrastructure– HC information broker– National citizen register– National HC provider register– HC provider directory

HC Chain Management

Patient

GP Specialist Pharmacist Other HC provider

Current IT-facilities

Patient

GP Specialist Pharmacist Other HC provider

GPIS HIS PhIS xIS

Problems due to shortcoming IT

• Wrong medication prescriptions• Redundant examinations• Double registrations• Insurance fraud • Administrative burden • etc.

Current IT developments

GP Specialist Pharmacist Other HC provider

GPIS HIS AIS xISAIS

AISPhIS

RIS

LIS

Regional networkSMTP/POP3

VPN

HL7MLPTCP/IP

OZIS:EdifactSMTPxDSL

HC Insurer

IS

Insurance infra: Edifact/XMLWeb

GPpostIS

ASP

NICTIZ purpose

Patient

GP Specialist Pharmacist Other HC provider

NationalHealth Care Record

Where to store HC data?

• Chipcard with patient– however law says: HC provider responsible

• National database– however privacy law does not allow

• With HC providers– possibly regional/categoric central database

HC Information Broker

GP Specialist Pharmacist Othet HC provider

GPIS HIS PhIS xIS

HCInformation

Broker

-> pull HC data (query)-> push HC data (orders, notifications)

Pull: whom to send a query?

GP Specialist Pharmacist Other HC provider

GPIS HIS PhIS xIS

HcIBRI Reference index

Citizenregister

National citizen number

Query

Citizen register

• National citizen number• Given name• Birth surname• Birth date• Birth place• Sex• Address

Pull: how to protect HC data?

GP Specialist Pharmacist Other HC provider

GPIS HIS PhIS xIS

HcIBRI

Citizen register

LOG Access log

Providerregister

National HC provider number

APTAuthorisation protocol

APFAuthorisation profile

HC provider register

• National HC provider number• Name• Profession• Specialism, if any • HC organisation• PKI certificates

Push: where to send an order?

GP Specialist Pharmacist Other HC provider

GPIS HIS PhIS xIS

HcIB

Citizen register

Providerdirectory

HC provider Contact data

ACT Application Conformance Table

Providerregister

Order

HC provider directory

• National HC provider number• Name, Profession, Specialism, …• Availability of services • Contact data:

– Visiting address, mail address– Telephone numbers– E-mail adress– URL organisation– HL7 application ID

National IT infrastructure

GP Specialist Pharmacist Other HC provider

GPIS HIS PhIS xIS

HcIBRI

LOG

APT

APF

interoperability:• HL7v3• SOAP• HTTP

security:• PKI• SSL

scalability management by SSC

response times up to date

Citizen register

Providerdirectory

Providerregister

Well Managed HC system

GP Specialist Pharmacist Other HC provider

GPIS HIS PhIS xIS

HcIBRI

LOG

APT

APF

availabilityup-to-datesecurityinteroperability

Citizen register

Providerdirectory

Providerregister

The End