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Convergence and the eHealth Interoperability Framework
Benoit AbeloosDG Communications Networks, Content and Technology
European Commission Unit, Health and Well-beingBrussels, 20 March, 2013
Interoperability in the EC policy agenda
• Large scale deployment of Digital Services• Part of the Multi Annual Financial Framework proposal• CEF Regulation in co-decision
Towards a single digital market in 2020
Source: Digital Agenda for Europe (http://ec.europa.eu/information_society/digital-agenda/ )
The need for an eHealth Interoperability Framework
CEF
Phase II of eHealth Interoperability Framework study
4
An assessment framework to assess profile development organisations and individual profilesAn assessment framework to assess profile development organisations and individual profiles
The vision on the eHealth European Interoperability Framework (EIF) (including the legal, semantic, organisational and technical levels)
The vision on the eHealth European Interoperability Framework (EIF) (including the legal, semantic, organisational and technical levels)
Jan June Dec 2013
eHealth EIF Phase IeHealth EIF Phase I
Workshop
eHealth EIF Phase IIeHealth EIF Phase II
July
Study report including the methodological approach Study report including the methodological approach 11
A first proposal for the population of the technical level of the eHealth EIFA first proposal for the population of the technical level of the eHealth EIF
22
33
44
Vision on eHealth EIF structure
Interoperability Levels High-Level Use Cases
Use case 1Use case 1
Use case 2Use case 2
......
Pri
ncip
les
Inte
rop
era
bilit
y
Ag
reem
en
ts
Governance
Legal Interoperability
Legal Interoperability
Organisational InteroperabilityOrganisational Interoperability
Semantic Interoperability
Semantic Interoperability
Technical Interoperability
Technical Interoperability
EU Cross-Border deployment under the CEF
Vision on technical interoperability
6
International base standards and profile development
Base Standard 1
Base Standard 1
Base Standard 2
Base Standard 2
Base Standard 3
Base Standard 3
Base Standard 4
Base Standard 4
Base Standard 5
Base Standard 5
Profile 1
Profile 1
Profile 2
Profile 2
Profile 4
Profile 4
Profile 3
Profile 3
eHealth European Interoperability FrameworkeHealth European Interoperability Framework
Use Case A
Use Case A
Use Case B
Use Case B
Profile 1
Profile 1
Profile 2
Profile 2
Profile 4
Profile 4
Profile 1
Profile 1
Profile 3
Profile 3
Profile 4
Profile 4
Profile 1
Profile 1
Profile 2
Profile 2
Profile 4
Profile 4
Use Case A1
Use Case A1
Specific
Profile
Specific
Profile
(Extensions)(Extensions)
National/Regional eHealth Interoperability Project
Profile 1
Profile 1
Profile 2
Profile 2
Profile 4
Profile 4
Use Case A2
Use Case A2
Specific
Profile
Specific
Profile
(Extensions)(Extensions)
Local (e.g. Hospital) eHealth Interoperability Project
Profile 1
Profile 1
Profile 2
Profile 2
Profile 4
Profile 4
Use Case B1
Use Case B1
Specific
Profile
Specific
Profile
(Extensions)(Extensions)
The PDOs in scope for this study were IHE and Continua
7
• IHE has developed a use case based methodology which is being endorsed by the ISO: ISO TR28380 IHE Global Standards Adoption Process.
• IHE and Continua are international organizations developing and testing (technical) interoperability specifications in eHealth.
• They represent organizations which have a good market penetration.
• History: M403 was already going to work on epSOS, hospital and telehealth use cases.
IHE and ContinuaIHE and
Continua
• A profile combines and refines the use of a set of base standards to address a specific technical use case
• A technical use case is a description of sequences of technical events that, taken together, lead to a system doing something useful
NoteNote
• IHE and Continua profiles used in some national frameworks
Note: PDO = Profile Development Organisation
The selected list of ten use cases covers a relevant excerpt of medical care provision
Citizens at home & on the move
- PC-based Care Mgt.
- Mobile-basedCare Mgt.
- Sensor-based Care Mgt.
UC 8
UC 9
UC 10
- Hospital IIIa
- Hospital IIIb
RIS LIS
RIS LIS
(2 hospital locationsaffiliated to same
hospital mgt. organization)
UC 6 UC 7
UC 3 + UC 4
National / Regional Level
Cross-border Level
- Primary care physician
- Hospital I
Medical care provision
- Pharmacy
- Medical Specialist
- Rehabilitation
UC 2a/ 2b
Inpatient medical care provision
- Hospital II
- Medical Specialist
- Rehabilitation
UC 1Medical care provision
- Pharmacy
UC 5b
UC 5a- Primary care physician
The assessment framework is based on Annex II of the Regulation on European Standardisation
9
Organisational criteria Technical Specification criteria
Annex II of Regulation of European StandardisationAnnex II of Regulation of
European Standardisation
Category ‘Market
Acceptance’
Category ‘Coherence ’
Category ‘Availability’
Category ‘Relevance and Effectiveness’
Category ‘Neutrality and
Stability’
Category ‘Quality’
Category ‘Type of
organisation’
Category ‘Openness’
Category ‘Consensus’
Category ‘Transparency’
Category ‘Maintenance’
Category ‘Intellectual
property rights ’
Conclusions of the study
• IHE • No major non compliance• Rooms for improvements
• Continua:• Original non compliances on transparency,
openness and consensus• Continua Board approved changes in their process
in Dec 2012• This will affect future specifications only
Governance of eHealth EIF
CEF Governance (MS, EC, industry)CEF Governance
(MS, EC, industry)
From 2014, permanent From 2014, permanent
eHealth Governance Initiative
eHealth Governance Initiative
Until 2014, project basedUntil 2014, project based
eHealth Network (MS, EC)
eHealth Network (MS, EC)
From 2012, permanent From 2012, permanent
ICT standards multi-stakeholders platform
(MS, EC, others)
ICT standards multi-stakeholders platform
(MS, EC, others)
From 2013, permanent From 2013, permanent
eHealth standardseHealth standards
eGov standardseGov standards
Internet standardsInternet standards
Other ICT standardsOther ICT standards
eHealth EIF project
eHealth EIF project 11
eHealth Stakeholders
Group
eHealth Stakeholders
Group
7 IHE profiles were submitted to the ICT MSP in Feb 20137 IHE profiles were submitted to the ICT MSP in Feb 2013
The eHealth EIF study is only the start of a process to populate the eHealth EIF
12
Review by Commission,
MS and stakeholders
Identification of specs by
ICT MSP
New insights
Receiving feedback
Update of eHealth
EIF
EHR reference models
Clinical document registries
EHR information modelsConcept representation
Hierarchical terminology
systems
Post-coordinated
terms
OntologyDefined
subsets of terms
Clinical models
Archetypes Templates
Datasets Data dictionaries
Use Case Driven
The next step is to populate the semantic level
Convergence between EU initiatives is needed…
BACKUP SLIDES
Nr Level Use case
1 Cross-border epSOS project : e-Prescription and e-Dispensation for cross-border information sharing for citizens travelling in Europe
2a Cross-border epSOS project : patient summaries for cross-border information sharing for citizens travelling in Europe
2b Cross-border epSOS project - patient having access to his or her patient summary.
3 National/Regional Request and results (imaging results, diagnostic examinations) sharing workflow for radiology in inter-hospital setting on national/regional scale
4 National/Regional Request and results (laboratory reports, test results) sharing workflow for laboratory in inter-hospital setting on national/regional scale
5a National/Regional Cross-Enterprise Sharing of Medical Summaries IHE Integration Profile: Ambulatory Specialist Referral
5b National/Regional Cross-Enterprise Sharing of Medical Summaries IHE Integration Profile: Acute Care Discharge to Ambulatory Care Environment
6 Intra-Hospital Request and results (imaging diagnostics tests) distribution workflow for radiology in intra-hospital setting
7 Intra-Hospital Request and results (clinical laboratory tests) sharing workflow for laboratory in intra-hospital setting
8 Citizens at home and on the move.
Involvement of patient in documentation of his/her specific chronic disease and making it available via PC or web based applications to healthcare provider (e.g., diabetes, CVD, COPD, hypertension)
9 Citizens at home and on the move.
Involvement of patient in documentation of his/her specific chronic disease and making it available via mobile monitoring devices and mobile phones to healthcare provider (e.g., diabetes, CVD, COPD,…)
10 Citizens at home and on the move.
For ever-present care outside conventional care facilities, involving the interoperability necessary from sensor devices to monitor activity, e.g. of elderly people
Use cases list
