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... Networked Healthcare ... Networked Healthcare Systems ...Systems ...

IT-Platforms help to IT-Platforms help to improve efficiency in improve efficiency in Healthcare Healthcare Sofia, June 27th, 2006

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eHealth: another Buzzword?

Internet/Extranet/Intranet

Bioinformatics system

Hospital Information System

Consumer Health Systems

eLearning Systems

Clinical Decision Support

Systems

Clinical Trial System

ADT System

Electronic Medical Records

Clinical Data Repositories

Data Integration Computer-Telephony

Integration

Electronic Commerce

Integrated Medical Devices

Workflow Technologies

Imaging

Telemedical Technologies

Workforce Enabling Technologies

Research Systems

Expert System

Communication Server

ePrescription Service

Networks/Connectivity

eProcurement

Laboratory Systems

eHealth

Clinical DWH

Departmental Systems

Practice Management SystemPharmacy SystemRadiology Information System

PACS

Card Management System

Patient RegistryHealth Provider Registry

Health Professional Registry

Patient CardHealth Professional Card

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Siemens coverage of all key-stakeholders in healthcare

Patient’shome

Patient

Physician

Private Healthcare

Teaching Hospital

Hospital

RehabCenter

Self-helpGroup

Pharmacy

Healthauthority

NursingHome

ambulance/transport service

Community Care

Healthcaresystem

HealthInsurance/payer

Insurancecardholders

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NÖMED WAN Patient- and Medical History Index:Overview Client

Lower Austrian Health and Welfare Fund Area of Health

Federal state of Lower Austria Lower Austria: Approx. 1.5 million inhabitants 22 hospitals, Approx. 8000 beds, 5 different HIS Approx. 3000 general practitioners, 40 different PMS Currently: own patient identifier each, medical record on their own

devices, exchange of information only on request, few reuse on clinical documentation …

Pilot Project Objective of step1 is to set up a Master Patient index and Medical History

Index and lookup services to identify on which place relevant medical information is stored. Document exchange via already existing secure eMail.

In Step2 we will provide direct access to clinical documents at the local document repositories by using standardized IHE XDS integration profiles.

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…

NÖMED WAN Patient- and Medical History Index:Overview – Data Management

…

PatientMaster (MID)

Copy of LocalPatient Record (LID)

Doc 1 Doc nHIS 1 HIS n

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NÖMED WAN Patient- and Medical History Index:Benefits Improved patient identification and patient

demographics data management by a central master patient index system more efficiency on patient admittance process

Patient centered storage of medical history access to all patient related data, improved quality of care

Access to medical history at any point of care, anytime improved quality of care

Access to already existing clinical documents reduces the need for repeated examinations less exposure on the patient, cost reduction

Basis for secondary useRetrospective studies on anonymized data evidence based

medicine, cost reductionsDisease Management prevention, cost reductions Epidemics / Outbreak management efficient healthcare

management

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Replacement of health insurance voucher (paper) with a smartcard solution

Assured high quality data for surrounding processes and further applications

Robust, secure, high-available scalable, and future proven infrastructure rolled out for 12.000 practitioners, 8.000.000 cards

Simple and fast checking of insurance claims to achieve appropriate user acceptance

eCard: Overview

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Central Services

Medical Practice/

Hospital

Medical PractitionerSoftware Solutionsof 3rd Party Vendors

Main Association of Social Security Agencies

CardSystem

Call Center andSocial SecurityAgencies

GINA

GIN

eCard: Solution Overview and Integration Landscape

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eCard: Benefits

Eligibility Check Service, process integration into PMS, no more paperwork (replacement of 42 Mio paper vouchers / year) process efficiency, lower administration costs

Smartcard based Patient identification managed by a central Patient Registry system more efficiency on patient admittance process

Drug approval Service process efficiency, no more fax and paperwork, faster service, lower administration costs

Infrastructure Rollout, Secure Connector, improved bandwidth on practice access future proof infrastructure also for direct image access, encapsulated security layer for simple PMS or HIS connectivity, performance

The Patient Card is also able to be used as a Signature Card for eGovernment

Basis for additional eHealth services like Electronic Prescription Electronic Health Record Electronic Exchange of Referrals, Clinical Documents & Images …

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National eHealth architecturesApplications and communication infrastructures

Secure Communication Network Common ApplicationServices

ApplicationServices

Public Registers(Providers, Professionals,

Citizens)

Trust Center

CommunicationServer

Medicationhistory,adv. Drug Reactions

Emergency Record

Patient Record

...

Reimbursement

Prescriptions & Referrals

Referral Letters

PrimaryInformation

Systems

Citizens/Patients

Providers

Pharmacies

Hospitals

Practices

Firewall/VPN/Connector

Smartcards

SmartcardTerminals

Payers

GovernmentInstitutions

BroadbandNetwork

ArchivingService

User Management

NetworkManagement ...

external public services

a clear architectural blueprint based on international standards is a prerequisite to build a national eHealth infrastructure

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Document Consumer

Document Repository Document

Consumer

IHE: Cross-Enterprise Clinical Documents Sharing (XDS)

Document Source

Document Registry

Patient Identity Source

MPIMPIMaster Patient Index

EPR-IEPR-IElectronic Patient Record - Index

Document Source

Document Repository

Document Repository

1 Provide & Register

2 Register

3 Query

4 Retrieve

STORE

VIEW

SEARCH

MAKE

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eHealth-applications: Main non functional requirements

Security Customizability / Extendibility / Localization Support of health-standards Scalability (regional - national) Interoperability (regional - national) Support of patient registers Support of health professional registers Single Sign On Smart Card Support 24x7 Operation, High Availability Performance Lifetime readable eHR data (140 years)

a reliable and proven IT-Framework is necessary to build eHealth applications …

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eHealth: Functionalities & Process Integration

ePrescription eMedication eHealthRecord eReferral eEmergencyData eLaboratory eEligibility eAppointment eOrdering eVaccination e…

besides applications, integration is a big issue experienced professional service staff for process integration and integration of IT-systems is important

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Secure E-Health Network and Integration Infrastructure

Primary Care Systems, Patient Registries, Health Care Professional Registries,

Provider Registries

eHealth Applications,eHealthRecord, ePrescription, …

Disease Management,Surveillance & Analysis

PatientSelf-Service

Portals

eHealth: Foundation

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... Networked Healthcare ... Networked Healthcare Systems ...Systems ...БЛАГОДАРЯ ВИ ЗА БЛАГОДАРЯ ВИ ЗА ВНИМАНИЕТО !ВНИМАНИЕТО !

Franz Krenn, SIEMENS AG Austria

Program and System Engineering

Gudrunstraße 11, A-1100 Vienna

franz.krenn@siemens.com

+43 676 5680040