The international experience in interoperability of Health Information Systems

George Kakoulidis CEO, Apollo SA

8th WORLD HELLENIC BIOMEDICAL CONGRESS

in this Presentation HL7 Hellas

Interoperability definitions

HL7 Standards

Interpretability Tools

The Future

Health Care Industry

Health Care is an industry where a diverse set of players must collaborate to provide a wide array of

services

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Primary Hospital

Doctor’s OfficePharmacy

Employee Employer

Chem Lab

Secondary HospitalNursing Home CareHome Health Care

Insurance

PATIENT DATA

HealthCare Enterprise

involve complex processes involve clinical and administrative

tasks large volumes of data large numbers of patients and

personnel performed either by humans or by

automated systems

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Definition

What is computer interoperability?

"The ability of two or more systems or components to exchange information and to use the information that has been exchanged.“

[Institute of Electrical and Electronics Engineers IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries, IEEE, 1990]

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Definition

What is application integration?

"The way to create interoperability solutions in HealthCare Information Systems "

" The successful integration of disparate systems, applications, data, vendors, functions"

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Historical need for Integration

Main

frames

No need

Min

i - Lan

Som

e Interfaces

LAN

/ WA

NA

lot WA

N

EA

I

1960 1980 1990 2000

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Problems in HealthCare IT

Hospitals never had a lot of money Lots of Departments with unique IT solution Multiple proprietary systems, varying

platforms, different languages Local data /Lack of Standards Structured and Unstructured data (free text) All systems Must work together

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What need integration ?

Hospital service-related functions, as ADT, Order Entry, Result Reporting, Materials Management, Patient Accounting, Medical Chart

Departmental systems, as Clinical Laboratory, Pharmacy, Radiology, Pathology

Resource management, scheduling, physician billing

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Interoperability

“Interoperability” can only be achieved through the use of data standards and clinical terminologies.

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Standards

Why Standards ?

HealthCare information is increasingly transmitted electronically

In order to exchange information using common data format cost effective

Examples (Mobile –GSM, ATMs,)

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What standards are needed?

Communication standards Data interchange standards Information model standards Vocabulary standards Security standards

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Standards – HL7

HL7 provides a set of communication standards as a cost-effective approach for connecting disparate information systems in health.

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HL7

Health Level Seven is an ANSI Standards Developing Organization

Mission :"To provide a comprehensive framework and related standards

for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services. Specifically, to create flexible, cost effective standards, guidelines, and methodologies to enable healthcare information system interoperability and sharing of electronic health records.“

(Source: HL7 Mission statement, revised 2001)

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HL7 History

1987 : Start work as a standard

1990 : First standard (v2.1)

1993/94: First International Affiliates join.

1994: HL7 becomes ANSI-accredited.

August 2001: 1st V3 Draft is released.

June 2003: HL7 V2.5 released.

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HL7 Organization

ANSI-approved Standards Developing Organisation (SDO).

Not-for-profit.

>2200 members.

>500 corporate members.

Local organisations in more than 27 countries.

www.HL7.org

www.hl7hellas.org

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Why HL7 ?

International Standard since 1991 International Standard since 1991

Used Worldwide (27 HL7 Affiliates) Used in EU (Germany, Holland, Finland, Italy

etc) HL7 HL7-TC251 Task Force ANSI Standard ANSI Standard Used in Real-life for more than 10 years Open Standard continuously updated Latest Version 2.5 (Conformance Statements)

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HL7 Facts

HL7 is not a software application The HL7 standard is a ‘book of rules’ prime objective of HL7 is to simplify the

implementation of interfaces between healthcare software applications

HL7 has grownup and become the de facto model for the entire healthcare industry’s data exchange challenges.

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Interoperability & HL7 Considerations

HL7 is not a plug and play

Not all the Health Information Systems have HL7 interface

Complex data exchanges needs special software applications like “Interface Engines”

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Interface Engines

Mission Critical Component

Formatting Messages and Routing them

Complex data exchanges needs special software applications like “Interface Engines” or “Integration Engines”

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Interface Engines

Hospital’s Clinical Data “Telephone Exchange”

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Interface Engines

Past complicated issue required extensive programming expertise from IT stuff hard to deal with different HL7 versions and formats different communication points complicated administrative tasks maintenance and support was very complex

Today Graphical UI Easy of use Ready Protocol Libraries (HL7 Versions) Different ways to Communicate

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Large Scale Implementation HL7 Hellas

Health Regional SystemHealth Regional SystemCDR

ERP

Scheduling

Integration Engine

Hospital 1Hospital 1

HIS

LAB

IE

Hospital 10Hospital 10

HIS - ERP

LAB

IE

……

PortalPortal

Scheduling

Reg.CentersReg.Centers

ERP - MR

Sub-SystemsSub-Systems

MIS

PACS

ADT

Integration strategy

Integration Engine on its own is not enough!

Need Master Patient Index for validation

Need highly skilled IT resources

Need money to invest in integration (not a given today)

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HealthCare Interoperability the FutureWhat we expect ?

HL7 v3.0 Promise of plug and play interoperability Robust approach to development Widespread support

Open Systems Integration of Services and Technologies Use of new Technologies in Software

Integrations Web Services Service Oriented Architecture

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8th WORLD HELLENIC BIOMEDICAL CONGRESS

HL7 Hellas, Apollo SA