Telemed 2010, Berlin, 3. November 2010

Transkript

1 Telemed 2010, Berlin, 3. November 2010 Verbesserung der sektorübergreifenden Kommunikation für eine integrierte Versorgung Rolf Engelbrecht, ProRec Deutschland Hans Demski,, Claudia Hildebrand, HelmholtzZentrum München Siegfried Jedamzik,, GO IN Ingolstadt

2 Outline ByMedConnect Introduction of Standards o CCR (Continuity of Care Record) o ISO/CEN (EHR Communication) Actual Developments

3 ByMedConnect Kommunikation zwischen Sektoren im Gesundheitswesen zur Unterstützung tzung von Integrierter Versorgung in Bayern Ein Projekt im Helmholtz Zentrum München in Zusammenarbeit mit GO IN Ingolstadt, ProRec Deutschland, TMF Berlin, LMU München,, ID-Berlin und Ocean informatics Laufzeit Juli 2009 Juli 2012 Unterstützt tzt durch das Bayerische Ministerium für Gesundheit und Umwelt Ziele Kommunikation von relevanten Patientendaten und Wissen Verbesserung der Kontinuität der Versorgung über Einrichtungsgrenzen hinweg Weiterentwicklung und Anwendung von Standards der EHR-Kommunikation Kommunikation: Interoperabilität Einbindung von Routinesystemen

4 Communication in ByMedConnect

5 Kommunikation in ByMedConnect

6 ICT in German Health Care More than 200 different Physicians Office Management Systems Big number of Hospital Information Systems Heterogenous information systems Concurring solutions for online communication (e.g. D2D, efa,, vita-x) National Health Telematics Platform (egk( egk, ega) not yet available Status Quo: No common infrastructure for online exchange of health data

7 Region Ingolstadt GO IN Gesundheits-Organisation 520 Haus- und Fachärzte im GOIN Allgemeine Notfallambulanz Notfallambulanz für f r Kinder Krankenhaus

8 Praxis Verwaltungs Systeme im GO IN Netz

9 Elektronische Kommunikation: Zugang zum Internet 70% haben schnellen Netzzugang 85% schicken Arztbriefe als Papierdokumente

10 ICT in German Health Care Example GO IN Regional Network Ingolstadt Communication of Doctor's Letters 8 8 by paper by digitalised 46

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12 Wünsche an die elektronische Kommunikation

13 Wünsche nsche an die elektronische Kommunikation

14 State-of of-the Art Documentation and Communicaton Computer-based systems for accounting, letter writing and patient administration The only data electronically communicated is remuneration, laboratory and radiological images Doctor s s letters and reports from external are collected in a paper-based patient record The heterogeneous landscape of practice administration systems poses a challenge A safe network for electronic exchange of health data has to be set up as the German Health Telematics Platform is not yet available -> > The physicians welcome electronic communication

15 EHR-Standards im Konzept CCR (Continuity of Care Record) als Basis und Struktur. CCR wird auch in Google Health, Mocrosoft Health Vault und HL7-CCD benutzt EHRcom (ISO EN 13606) Archetypes für f Beschreibung der medizinischen Konzepte, Benutzung in HL7-CDA ist in Vorbereitung OpenEHR Templates zur Strukturierung Sicherheitsstandards aus Telematikarchitektur und BioHealth-Projekt

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17 Communication Scenario ByMedConnect (BMC) Data input Import BMC data POS HIS Data adoption Viewing/Editing BMC data Communication of BMC data Viewing/Controlling BMC data Data adoption BMC-com BMC-com

18 ByMedConnect Kommunikations - Konzept Sicheres Netz Übertragung standardisierter Datenpakete Kommunikationsmodul

19 Continuity of Care Record (CCR) Patient health summary standard ASTM Provides a lean and application-oriented oriented dataset Developed by US - physicians Well established and widely used by more than 100 system vendors for transferring patients health data in the US (Google( Health, Microsoft Health Vault, Keas)

20 Continuity of Care Record (CCR) CCR standard sections or data objects include Insurers/Payers; Providers; Problems; Medications; Alerts; Vital Signs; Immunizations; Results; Procedures; Encounters; Family History; Social History; Functional Status; Support; Advance Directives; Medical Equipment; Plan of Care; Comments Detailed information at: Used to define the medical content to be transferred in ByMedConnect Adaptation to the requirements of the GO IN health network physicians expected

21 ISO EN Electronic Health Record Communication The Europe based international standard specifies an information architecture to deal with the heterogeneous medical data world Reference model defines generic structures that form the building-blocks of a health record Archetype model is used for the design of information patterns (medical concepts) that add knowledge and thus enable semantic interoperability -> Dual-model approach allows to separate systems engineering and content definition More info at:

22 ISO EN 13606: LEGO Analogy Knowledge Data elements The LEGO Group

23 Benefits ISO EN Archetypes empower the medical professionals to define the semantics of their own information systems Archetypes are a formal model of real clinical concepts that are standarised and can be reused The definition of archetypes is an important step towards semantic interoperable EHRs that are portable (via institutional / regional ( boundaries precise (e.g. terminology ( binding accessible (individual queries + decision ( support durable (life-long long health record)

24 Status ByMedConnect EHRflex a generic archetype based medical record system o Import of archetypes o Data capturing and storage o Open source project at SourceForge Archetype Definition o Enabling the use of the CCR within ISO EN based systems o Usage of LinkEHR a tool developed by Institute IBMI at Universidad Politécnica de Valencia Survey on communication needs within the GO IN Health Network

25 EHRflex - View Patient Record

26 EHRflex Add New Entry

27 Next Steps Mapping of legacy data o Metadata of archetypes allow for a precise mapping that obeys the semantics of data o LinkEHR will be used Development of a transformation module o Import of legacy data o Conversion to standardised format Pilot implementation at GO IN Health Network in Ingolstadt

28 Contact