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eHIP: Health Information Platform
The Project
Dr. Dirk Colaert
Clinical Applications Research Manager
Agfa HealthCare
Caring through Sharing
2
The eHIP Project
eHealth Concepts
The XDS platform
The Project
3
The goal of eHealth
Provide ubiquitous access to life-long clinical care record of a patient by all relevant stakeholders, including the patient, in a community, region or country - at anytime, anyplace, on any device
Guarantee the privacy of the patient
Integrate and enrich the clinical, medical and operational knowledge to support lifelong health guidance of citizens
Facilitate inter-professional collaboration
Integrate workflows into shared clinical and operational pathways to enable true disease management and optimally support the clinical process
4
The Clinical Process
collect, distribute,share
Information
collect, distribute,share
Information
think, decide
Reasoning
think, decide
Reasoning
plan, schedule,act, collaborate
Workflow
plan, schedule,act, collaborate
Workflow
ActivitiesActivitiesInformationInformationAssessmentAssessment
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The Clinical Process
collect, distribute,share
Information
collect, distribute,share
Information
think, decide
Reasoning
think, decide
Reasoning
plan, schedule,act, collaborate
Workflow
plan, schedule,act, collaborate
Workflow
Information
Workflow + collaboration
Rules and reasoning Clinical Workflow
Decision Support
Information
Workflow + collaboration
Rules and reasoning Clinical Workflow
Decision Support
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Continuum of Time
The Continuum of Care
Continuum
of Space
indi
vidu
al
popu
latio
n
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indi
vidu
al
popu
latio
n
Scaling out the Clinical Process into e-Health
Information
Workflow + collaboration
Rules and reasoning Clinical Workflow
Decision Support
e-HealthPhase 3Phase 2Phase 1
e-Prescribe, CPOE
Shared Pathways
Shared Information (EHR) + collaboration
Drug interactions, monitoring, compliance, alerts, …
Personal Health Record (PHR)
Population monitoring, epidemiology, Bio surveillance
Research from bench to bed, from bed to bench
Information
Workflow + collaboration
Rules and reasoning Clinical Workflow
Decision Support
e-Prescribe, Order Entry
Shared Information (EHR) + collaboration
Personal Health Record (PHR)
Research from bench to bed, from bed to bench
Drug interactions, monitoring, compliance, alerts, …
Population monitoring, epidemiology, Bio surveillance
Shared Pathways Disease Mgmt. Programs
Personal Health Plan
Electronic Health Record
Health Monitoring
Health Mgmt. Programs
Inter-professional collaboration
Translational Medicine
Sharing informationis the first phase
and already pays off !
8
What Community Healthcare is NOT
This is the classic e-Portal functionalitywhich provides a many-to-one connectionBetween many GP’s and one hospital,based on propriety solutions.
Disadvantages:-Still the hospitals are not interconnected-One GP needs multiple portals to accesshis patients data in different hospitals-Impossible to connect any one with any one
Hospital
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The e-Health Infrastructure
A central infrastructure enabling e-Health
This can but doesn’t need to imply that data is physically persisted in a central storage
The bottom line:a user should have a consolidated and complete
view on the clinical data of the patientresearch and care should be able to “connect”
eHealthinfrastructure
Patients
Pharmacy
Laboratory
PolyclinicHospital
Government
GP
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The eHIP Project
eHealth Concepts
The XDS platform
The Project
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XDS
Standard, introduced by IHE 2 years ago
Principles:
Document oriented, but independent from the document format (can be KMEHR)
Keep the data where they are originated
Maintain a central registry with references
Use a external Master Patient Index to consolidate patients
Use an external Security Server
Central repositories can be mixed with distributed, when needed (example: SUMEHR server)
Scalable architecture
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What is IHE ?
IHE = Integrating the Healthcare Enterprise
IHE = association of users, vendors and public healthcare authoritiesAll major healthcare imaging&IT companiesPresent in all regions
IHE provides pragmatic integration solutions Based on existing standardsUser drivenVendor supportedIncremental in scope and time
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IHE XDS
Regional Health Information Networks are pushed by healthcare authorities
HealthConnect in Australia
NHS EHR in UK
Nictiz in the Netherlands
Onchit in USA
Health Infoway in Canada
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IHE XDS in national & regional projects
Quebec, Toronto,Alberta, British Columbia
Canada Infoway
Denmark (Funen)Italy (Veneto)Spain (Aragon)
Austria
THINC- New YorkNCHICA – N. Carolina
Italy(Conto Corrente Salute)
Boston Medical Center - MA
FranceDMP
UK CfH(Radiology WF)
Philadelphia HIE
CHINA-MoHLab results sharing
CPHIC –Pennsylvania
CHINA-ShanghaiImaging Info Sharing
JAPAN-NagayaImaging Info Sharing
South Africa
VITL-Vermont
CareSpark – TN & VA
NetherlandAmsterdam
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XDS principles
XDS repository
XDS repository
XDSregistry
XDS repository
XDS repository
XDS repository
XDS repository
XDS repository
XDS repository
Meta data
Clinical data
Document producer
Document consumer
Newdoc
Newdoc
Meta data
Meta data
QueryQuery
PointerPointer
Newdoc
Newdoc
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XDS infrastructure: how it works
XDS Rep
Hospital
CIS/HIS
Data
Local Doc Store
XDS Rep
Hospital
CIS/HIS
Data
XDS Rep
Hospital
CIS/HIS
Data
Local Doc Store
XDS Reg
Home
Home device Sensor
Laptop
MPI
Security
GP
CIS
Data
Local Doc Store
Pharmacyst
DataLocal Doc
Store
Government
Insurance
Other care providers
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The eHIP Project
eHealth Concepts
The XDS platform
The Project
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IBBT Attributes
independent research institute founded by the Flemish government:stimulate ICT innovationmulti-disciplinary research (technical and non-technical)collaboration between industry, non-profit organizations, authorities
5 area’s: eHealth ( & Elderly Care)Mobility and logisticsNew Mediaenabling technologieseGovernment
demand-driven research projects (to be defined by the industry)
additional rulescomplementary companies and organizations in one projectIBBT finances up to 50% of all research costsownership of the research results is shared between all parties involved
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The eHIP Project in a nutshell
Partners153 person months from Industry: Agfa, Barco, Cronos, Medibridge202 person months from IBBT:
IBBT- KULeuven: DitriNet, COSIC, ICRI, UZ-KULeuvenIBBT- VUB: ETRO, AZ-Brussel
Duration: 2 years: 2006-2008Objectives
KnowledgeApplication requirementsLegal and privacy issuesArchitecture, security and performance
Prototype of the eHIP platformClinical Demonstrators
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The eHIP Project in a nutshell
ResultsKnowledge
Application requirementsUse cases for clinical applications
Legal and privacy issuesPrivacy Report
Architecture, security and performanceArchitectural and Technical ReportReport on Security components and Load Balancing and Availability
Prototype of the eHIP platformXDS prototype (registry and repository)Security Component
Clinical DemonstratorsPortal and demo applicationMovie