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Gitter Lower Austria EHealth Integrator
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Lower Austria regionaleHealth Integrator
Thomas Gitter, MDProduct Manger Int. CC Health ServicesRennweg 97-991030 Vienna, [email protected]
Project OverviewHIMSS06
San DiegoFeb., 14th
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“Lower Austria”….
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PrerequisitesSituation of healthcare in Austria
Hospital and Primary Care landscape in Austria Primary Care doctors are independent, most of them having
conctracts with one or more insurances Hospitals are owned mostly by regional authorities or clerical;
few private High frequency out-patient clinics in most of the hospitals
Insurance and healthcare – finanzing „Dual“ financing: Different payors for in/out – patients Patient is at risk to get „ping-pong“ subject eCard: Recently rolled out for prove of eligibility
Patient identification No unique Identification of patients (nor inhabitants) Insurance – number good for search and matching
not necessarily unique not from birth.
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Addressed point-to-point delivery of discharge letters and reports Using kind of mail-box-systems Recipient known at time of delivery
Portals for admission Still only few, individual
Teleradiology Gains ground Point-to-point Images less problematic compared to reports.
eHealthExisting regional examples
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eHealth IntegratorFeatures
Functional scope Patient Index Medical History Index (Admissions, visits, document registry) Integration interfaces for connecting participants Implemented business processes Web Application
Future Extensions Clinical Repository Increased collaborative processes between healthcare
facilities
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Healthcare RecordApproach: Product and Solution
Base technology • Database• Application Server
eHealth Integrator• Patient Index• Medical History Index
Middleware: Health Transaction Base (HTB®)• Health Data Repository• Integration Platform <
Base technology• Integration:
SeeBeyond eGate®
Solution specifics• NÖMED WAN
Customer specific solution
Product baseOracle HTB®
Coordination by T-Systemsint. CC health Vienna
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Network across all Healthcare Service providers Hospitals General Practitioners Specialists Nursing Services Emergency Units Pharmacies etc.
Availability of all kind of data with medical relevance Anywhere At any time For everybody authorized At required Scope
EU – Target !
eHealth and telematicsGeneral Goals
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Lower AustriaWhat we face
Mistelbach
Hainburg
Hollabrunn
St. Pölten
Lilienfeld
Amstetten
Waidhofen an der Thaya
Gmünd
Krems
Tulln Korneuburg
Stockerau
Melk
ScheibbsWaidhofen an der Ybbs
Zwettl
Horn
Eggenburg
Allentsteig
Gugging
Mauer Mödling
Baden
Hochegg
Wiener Neustadt
Neunkirchen
Klosterneuburg
Landscape 2003
•27 sites•22 organizational entities•18 owners
270 IT Systemsby
70 providers
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Duties: (some) Steering of healthcare providing Investments Structural improvements Defining of guidelines for economical behavior of hospitals Ongoing improvement of service-oriented finanzing Setting up appropriate acute-care capacities Extension of alternative care-institutions Coordination and planning of structures of care Balancing of service offerings between hospitals
The Customer:NÖGUS (transltd) Lower Austrian Health and Welfare Fundhttp://www.noegus.at/
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= Platformfor Healthcare
Additional to eCard=
Patientindex
Additional for local HIS
Additional for Primary Care and family doctor´s Information Systems
=
=
Patient IndexCore Component
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Clear/Unique Identity of the PatientMaster Patient Index (MPI)
Medical History IndexElectronic Patient Record - Index
(EPR-I)MPI
• Establishment of a unique identity and linking it to already existing local (Lower Austrian) records (based on master records) yielding at international applicability
• Linking-up with index systems of other regions /countries …..
• Linking up with e*governmentEPR-I
• Historical record of all interactions in conjunction with healthecareAdmissions Outpatient treatments Visits with
physicians• With the vision of being a key to the relevant documents
Medical summary Medical reports X-Ray images Drug applications
Master Patient Index
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Avoiding redundancies of examinations Awareness of and utilization of already existing, recent
findings e.g. from medical laboratory or preceding examinations
Data should accompany the patient; e.g.:
Electronic referral by the local practitioner
Automatic reception of data at the hospital and forwarding to the relevant ward (outpatients)
Results and findings always reach the practitioner or the ward ahead of the patient – they are already waiting for him/her
Master Patient IndexReasons
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Lower Austria eHealth Integrator Phase 1… …is a solution tailored to customer-specific needs …has been developed in parallelism to developmet of PIX
and PDQ and follows these IHE profiles to a high degree …eHI has as product “as it is” not been Connectathon-
proven jet
T-Systems and Partner PIX and XDS (XDS-I, XDS-MS) - Implementations passed Connectathon in Chicago recently.
XDS Document registry - according to customer – strictly follows
the IHE profiles, applicable; (Phase 2 of project, this year)
Customer specificity will still remain (additional objects to cover)
Master Patient IndexIHE and Product Perspectives
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A distributed lifetime electronic medical history
requires a strict Separation of:
• MAKE = Creation of Documents
• STORE = Archiving of Documents
• SEARCH = Looking for Documents resp.dedicated content
• VIEW = Presentation of documents
Medical Documentation
This VISION has been empowered by the DICOM Standards in the area of radiology and today is reality-proven there
and has become REALITY by the IHE model for the entire healthcare segment.
Editor
User
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Document Consumer
Document Repository Document
Consumer
Cross-Enterprise Clinical Documents Sharing (XDS)
Document Source
Document Registry
Patient Identity SourceMPIMPI
Master Patient Index
EPR-IEPR-IElektronic Patient Record - Index
Document Source
Document Repository
Document Repository
1 Provide & Register
2 Register
3 Query
4 Retrieve
STORE
VIEW
SEARCH
MAKE
IHE profile describes the “how-to”
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Patient and Medical History Index.Overview – Data Management.
……Doc 1 Doc n
HIS 1 HIS n
Patient Master ID
Copy of local data
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NÖMED WAN. Patient and Medical History Index.Process Example: Index Query, Patient Data Transfer.
Pat. & FindingsIndex
KIS-Dialog
Web Server
Abfrage Index
MsgServer
Local Client
Connector
HIS: Patient Search
Quer
y ResultHIS Extension
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NÖMED WAN Patient and Medical History IndexProcess Example: Medical History Query.
Pat. & FindingsIndex
HIS
Web Server
Link
MH Query
Medical History, Browser
Msg Server
Projekt NÖMED WANTimeline
Step 1 – Patient Index Index went live January 2006 Initial Load of patient data (demography) from pilot -
hospitals Integration with SAP Patient Management/ i.s.h.med at ZK
St.Pölten
Step 2 – Patient History Enrichment of Index by: Admissions, Document-MetaData:
June 06 Initial Load from pilot hospitals Integration with SAP Patient Management/ i.s.h.med at ZK
St.Pölten
Future Scope Connection with decentralizd Document repositories Direct Document retrival from respective archive.
Projekt NÖMED WANTechnical Architecture
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T-Systems Austria
Thank You for Your attention!
Dr.Thomas GitterProduct Management Int.cc Health Services [email protected]
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Backup….
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NÖMED WAN the Healthcare-Network
NÖMED WANNÖMED WAN = Family of projects to establish a state-widenetwork across all Healthcare providersin Lower Austria
General Conditions: Countrywide Applicability (Austria) Conformity with International Standards Consideration of National Healthcare reform-programs
• Healthcare Agency / Platform• Regional Concepts• Electronic Healthcare Record (ELGA)
Consideration of the e-Health Europe action plan(EU-Target)
Consideration of chip-card for Healthcare Services (e-card)
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Global Aims
Global aims
Creation of a central and integrative information and communication platform to meet the patient-related requirements of healthcare and welfare in Lower Austria.
To make all relevant medical data of a patient available at any location and at any time for authorized persons or organizations to the extent required, thus providing quicker and more efficient medical assistance.
Synergy and cost efficiency in the acquirement and operation of IT systems.