Www.arge-elga.at+43 1 212 70 50 1020 Wien, Schiffamtsgasse 15 eHealth: from promise to...

www.arge-elga.at +43 1 212 70 50 1020 Wien, Schiffamtsgasse 15

eHealth: from promise to sustainability eHealth – sharing of experiences and lessons learned

EHR in Austria – regional and nationwide

Dipl.-Ing. Dr. Alexander SCHANNER

Program-Manager

2008-10-09Alexander SCHANNER Open Days Seite 2

Agenda

Overview: points to be addressed;

Introduction: personal and organisational information;

Background: region, programme or project to be presented;

Major issues: lessons learned, requirements and future

outlook;

Conclusions: final remarks.


Points to be addressed

Lower Austria:Local EHR project Nömed WAN

Austria:National EHR program ELGA

InteroperabilityAdvantages of international Standards


Agenda





outlook;



NÖGUS (www.noegus.at)

Lower Austrian health and welfare fund

Project-ManagerNÖ Landeskliniken-Holding (www.lknoe.at) 2003-2006

Personal and organisational information

Arbeitsgemeinschaft Elektronische Gesundheitsakte

(www.arge-elga.at) Program-ManagerSince 2006

Dr. Alexander SCHANNER


Task Force Electronic Health Record

Decision of Federal Health Commission (BGK) from July 2006 concerning establishment of Arge ELGA and financial remuneration

Working basis of Arge ELGA is an agreement between Federal Government Federal states / Provinces and Social Insurance Institutions

Since September 2006 ARGE ELGA is acting operationally

ArgeELGA=Arbeitsgemeinschaft Elektronische Gesundheitsakte

Arge ELGA•Steering Committee•Program-Management

BGK


Federal Health Commission(BGK –Bundesgesundheitskommission)

Consists of 27 members7 Federal Government,

9 for provinces (1 for each federal state),

6 Main Association of Austrian Social Security Institutions,

1 representing cities and

1 representing communities,

1 bishops’ conference together with the Protestant’s,

1 patients’ ombud,

1 General Medical Council of Austria Chair: Minister of Health, Family and Youth


Agenda





outlook;


Seite 92008-10-09Alexander SCHANNER Open Days

Regional EHR-Solutionin Lower Austria

Started 2004, in operation since 2006

approx. 1.6 million inhabitants

27 hospitals approx. 8000 beds

approx. 3000 general practitioners

270 IT Systems supplied by 70 Manufacturers

Project:

Patienten-Index

Project:

Patienten-IndexMistelbach

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

MauerMödling

Baden

Hochegg

Wiener Neustadt

Neunkirchen

Klosterneuburg


ELGA the EHR-Solution in Austria

~ 8.3 million inhabitants

~270 hospitals ~700 institutes ~ 1200 Pharmacies ~ 15000 general

practitioners & specialists

Core applications discharge Summary e-Report – radiology e-Report – laboratory e-Medication


Definition of ELGA

ELGA contains relevant multimedia-based and health related data and information referring to a precisely identified person.

Data und information originate from different health service providers (HSP) and from the patient himself/herself

and are stored in one or several different information systems (virtual health record).

Data are available independently of place and time (cost-saving) at the place of treatment for all authorized persons according to the tasks and needs of these persons and in compliance with data protection rules.

ELGA (Elektronische Gesundheitsakte) = Austrian EHR


ELGA Steps of progress

ELGA Feasibility Study 2006

Architectureplan, 1th Phase of Implementation

Masterplan

BGK Decision 04 05 2007 Architecture Standards Detailed planning projects

2008 Cost-Benefit Study

Requirements document

BGK Decision Autumn 2008


ELGA basic supply domainELGA domain 1..NELGA domain 1..N

CentralPatientindex

+ RLS

HSPIndex

Role based Access Service

Portal

LocalPatientenindex

Document-Registry

Authori-zationSystem

Consumer Source

HSP-SystemHSP-System

Consumer Source

Gateway


Consumer Source

Document-Repository

LocalPatientindex


Consumer Source

ProviderProvider

Document-Repository

AuditSystem

Information

Authori-zationSystem

AuditSystem

AuditSystem

(Aggregation)

virtualRegistry

Document-Registry

Gateway

ELGA-Architecture


Agenda





outlook;



Requirements

Technical (syntactical) interoperability Content wise (semantical) interoperability

Requirement:

Assortment of international standards

Standards raise quality and reduce costs!

Standards promote competition!

“Legal interoperability??” “Financial interoperability??”


Why Standards ?

HIS PatientIdentifySource

Registry Consumer

Repository

Source

IHE conform:

easy to replace Vendors

not IHE conform:

no replacement of Vendors possible

HIS Patient Identify Source

Registry

Consumer

Repository

Source

StandardStandard Non StandardNon Standard


Example for International data exchange

Request HSP authorization

Request patient identifikation

Request insurance status

Request patient consent

Search med. documents

Access / download med. documents

Public

HSP

ELGA

Insurance Public

HSP

LSP

InsuranceSWG eHealth


Austria & epSOS

European Patients Smart Open Services – Open eHealth Initiative for a European Large Scale Pilot of Patient Summary and Electronic Prescription

Arge ELGA is Austrian‘s national Competence Center,

Austria is the leader in the Working Package 3.6 Identity Management

ELGA Connex e-Prescription (ELGA-eMedication) Patient Summary (~ELGA-Discharge summary)


Agenda





outlook;



Key success factors

Patients are in the Center

Involvement of all Health Service Providers and Stakeholders in planning and implementation phase

Considerations concerning the federated healthcare structures in Austria


Recommendations

Identify balance between centralized and decentralized solutions

Recommend a step by step migration from existing, proprietary local systems to a compatible distributed and shared eHealth infrastructure

Require the separation between IT-Infrastructure Applications Data


Recommendations

Don‘t think about „point to point communication“n*(n-1)/2

27 EU-Members 351 Interfaces

Don‘t reinvent the wheel

Look for best practices

Think big and global, act small and local


Thank you for your Attention!

[email protected]

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