1. Christopher Reed InterSystems Corporation
Swedish NPÖ National Patient Overview A Case Study for InterSystems HealthShare, Ensemble and Caché
Christopher Reed
InterSystems Corporation

2. The NPÖ in Sweden The NPÖ Project – Background & Introduction
The NPÖ Health Information Exchange – Objectives
Key Business & Societal Considerations
Key Architectural & Technical Considerations
Examples of NPÖ HealthShare Screens

3. Swedish National Patient Summary (NPÖ – Nationell Patientöversikt)
Population 9 million
21 healthcare regions
National EHR
InterSystems in partnership with Tieto.

4. Swedish National Patient Summary (NPÖ – Nationell Patientöversikt)
Tieto – Prime Contractor
InterSystems HealthShare™ – Health Information Exchange Platform
Health information exchange platform
National Patient Viewer Service
21 Swedish healthcare regions

5. NPÖ Timeline
Planning by Municipalities, Regions and 21 County Councils
2005: Four-County Trial/Proof-of-Concept
3/2008: Contract for NPÖ awarded to Tieto & InterSystems
5/2009-8/2009: Live Pilot in Örebro Municipality
9/2009: Full Production, Örebro Municipality
11/2009: Full Production, Östergötland County
: Remaining 19 Counties in Production

6. The NPÖ in Sweden The NPÖ Project – Background & Introduction
The NPÖ Health Information Exchange – Objectives
Key Business & Societal Considerations
Key Architectural & Technical Considerations
Examples of NPÖ HealthShare Screens

7. What does the NPÖ provide?
National Patient Viewer Service:
Access to patient data
Historical and current
Wherever sourced in Sweden
For authorized healthcare and welfare professionals
From anywhere
With appropriate computer configuration
(Identity card (“SITHS”) reader and software)

8. Objectives of the NPÖ The Primary Objective of the NPÖ is to
Improve the Quality & Consistency of Patient Care
Doctors are working from information that is:
More Complete
Trusted
Expected Benefits Include
Reduction in Preventable Medical Errors
Reduction in Adverse Drug Events
Improved Outcomes
Cost Reductions
Improved Security and Logging

9. The NPÖ Provides 16 Information Types
Patient Demographics
Encounter
Allergies and Alerts
Care Plan
(Primary, Secondary)
Community Healthcare Service
Activities of Daily Life
Disability
Diagnoses
Clinical Document
Prescribed Medication
Dispensed Medication
(Pharmacy)
Clinical Chemistry
Microbiology
ECG
Medical Imaging
Other Examination

10. The NPÖ in Sweden The NPÖ Project – Background & Introduction
The NPÖ Health Information Exchange – Objectives
Key Business & Societal Considerations
Key Architectural & Technical Considerations
Examples of NPÖ HealthShare Screens

11. Key Business & Societal Considerations
Participation
Governance
SKL/SALAR
SVR
Data Sharing - Patient Data Act
Access Authentication and Authorization
Content Authorization
Information Presentation

12. Data Ownership Considerations
Healthcare Data is Owned by the Counties
Individuals have rights to see their information
Primary Version of Data is Held at Source
Some Data is also Held Centrally
Patient Information is Assembled at Run-Time
Possible Future Enhancements:
Public Health
Patient Access
More Information Types

13. The NPÖ in Sweden The NPÖ Project – Background & Introduction
The NPÖ Health Information Exchange – Objectives
Key Business & Societal Considerations
Key Architectural & Technical Considerations
Examples of NPÖ HealthShare Screens

14. Key technological considerations
Architecture
Governance
Past work with integration
Communication and interoperability
EN 13606
Source data retrieval and handling
Response times
Possibilities for viewing data
Design of user interface
Standardized process for connecting

15. Security and Privacy Technologies
National platform
Sjunet (Seven net) – VLAN
SITHS – Secure IT in Health Services
HSA catalogue – Health Services Address Registry
HealthShare Security Services (HSS)
Authentication
Authorization
Consent management
Encryption
Logging
BIF – National security services

16. Conceptual view Application Integration A B A B Connection Care system
Patient summary service – NPO
Base service
Application
Integration
InterSystems
HealthShare A B
Deployment service
Responsibility of supplier
Responsibility of care provider
Connection service
(optional) A B
InterSystems
Ensemble
Connection
Care system
Care system
Care system

17. ... ... Viewer HealthShare Access Gateway Hub Edge Gateway 1 EdgeSI
(A)
Access Gateway
Hub
Integration
services
...
Edge
Gateway 1
Edge
Gateway n
Service interface (B)
SI = Service
interface
Connection
Connection
Connection
...
Care provider 1
Care provider 2
Care provider 3
Care provider n

18. The NPÖ in Sweden The NPÖ Project – Background & Introduction
The NPÖ Health Information Exchange – Objectives
Key Business & Societal Considerations
Key Architectural & Technical Considerations
Examples of NPÖ HealthShare Screens

19. Summary Screen Example

20. Level 2 Screen Example

21. Level 3 Screen Example

22. The NPÖ in Sweden
Questions and Discussion Please

23. Christopher Reed Director, Strategic Healthcare Projects
Enquiries please call InterSystems at Tel: