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.
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Points to be addressed
Lower Austria:Local EHR project Nömed WAN
Austria:National EHR program ELGA
InteroperabilityAdvantages of international Standards
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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.
2008-10-09Alexander SCHANNER Open Days Seite 5
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
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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
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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
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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.
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
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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
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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
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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
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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
HSP-SystemHSP-System
Consumer Source
Document-Repository
LocalPatientindex
HSP-SystemHSP-System
Consumer Source
ProviderProvider
Document-Repository
AuditSystem
Information
Authori-zationSystem
AuditSystem
AuditSystem
(Aggregation)
virtualRegistry
Document-Registry
Gateway
ELGA-Architecture
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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.
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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??”
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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
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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
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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)
Seite 192008-10-09Alexander SCHANNER Open Days
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.
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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
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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
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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
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