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Project ABRUMET Proposal for a Regional Medical Network Vrije Universiteit Brussel R. Van de Velde University Hospital Brussels AZ VUB 1 december 2005.

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Presentation on theme: "Project ABRUMET Proposal for a Regional Medical Network Vrije Universiteit Brussel R. Van de Velde University Hospital Brussels AZ VUB 1 december 2005."— Presentation transcript:

1 Project ABRUMET Proposal for a Regional Medical Network Vrije Universiteit Brussel R. Van de Velde University Hospital Brussels AZ VUB 1 december 2005

2 Vrije Universiteit Brussel R. Van de Velde 2 About Abrumet : Organisation for Telemedicine in Brussels Members GP FAMGB, BHAK Hospitals AZ-VUB, CHIREC, Clinique de lEurope, Erasme, C. de Paepe, Sanatia, Saint Jean, Saint Luc IRIS (hospitals – CTO) Objectives To foster availability, accessibility and portability of patient records by means of Health Information Networks (HIN) Collaboration: ability to share medical information between authorized HC workers To stimulate confidence of general Practitioners and increased investment in CPR Bilingual To encourage patients to take a more important role in managing their health records.

3 Vrije Universiteit Brussel R. Van de Velde 3 Why? What? How? When? Why?

4 Vrije Universiteit Brussel R. Van de Velde 4 What if a physician requests a patient record? H1H2H3 May I please have the Patient Record?

5 Vrije Universiteit Brussel R. Van de Velde 5 The Answer is Yes, but … Hospitals : H1H2H3 xx Do not share information Lock up data in proprietary formats Perceive competition Have distinct security approaches AZ-VUB AMIS UZL LISA...

6 Vrije Universiteit Brussel R. Van de Velde 6 The Answer is Yes, but … Even when information is electronically available in an electronic medical record in a pharmacy system in a digital radiology system …. The patient is generally given at personal inconvenience, a hard copy No export function available !

7 Vrije Universiteit Brussel R. Van de Velde 7 What if we gave GPs a tool to request their records electronically? H1H2H3 xx First Phase: Abrumet

8 Vrije Universiteit Brussel R. Van de Velde 8 Clinical Encounter Clinical IT System Records Sent Laboratory Results Specialist Record Hospital Record The challenge: Finding and accessing easily documents from other care providers in the community. Finding Records: Manual Approach

9 Vrije Universiteit Brussel R. Van de Velde 9 Clinical Encounter Clinical IT System Temporary Aggregate Patient History 3-Patient data presented to Physician 1-Patient Authorized Inquiry 3-Records Returned Laboratory Results Specialist Record Hospital Record 2-Reference to Records for Inquiry Finding Records: The Abrumet Way Index of patients records (Document-level)

10 Vrije Universiteit Brussel R. Van de Velde 10 What? Why? What? How? When? What?

11 Vrije Universiteit Brussel R. Van de Velde 11 Services Publication & Visualisation Documents Distributed Location – Written Consent Bi-directional Data Keepers Messaging (Push/Pull Model) Location messages : secured centrally Specific system (uniform access method) SMS : Event-driven For Critical Messages (Panic Lab Values, Emergency Adm,…)

12 Vrije Universiteit Brussel R. Van de Velde 12 General Practitioner Other Specialized Care Typically, a patient goes through a sequence of encounters in different Care Settings The Patient Longitudinal Record Clinical A Clinical B

13 Vrije Universiteit Brussel R. Van de Velde 13 Requirements (1/2) Foundation for a federated Health IT Infrastructure: Focussing on a shared Electronic Health Record, in a community, region Distributed: A federated system composed of distinct, distributed, disparate, decentralized systems defined as data keepers. Each Health Care organization publishes clinical information for authorized users. Information that remains in the original location of creation. Document Centric: Published clinical data is organized into clinical documents based on agreed standard document types Sharing of documents between General Practioners, clinics, pharmacists, … with different medical IT systems Consistent graphical user interface: Care providers are offered means to query and retrieve clinical documents of interest in the same consistent way independent of the source of information

14 Vrije Universiteit Brussel R. Van de Velde 14 Clinical B Clinical A Laboratory Abrumet Portal Master Patient Index Document Repository Submission of Patient & Doc References Retrieval of selected Documents The Master (Community) Patient Index L-716 M Patient Registry Document Registry

15 Vrije Universiteit Brussel R. Van de Velde 15 Requirements (2/2) Cross-Enterprise: A Master Patient (Community) Index provides an index for published information to authorized Healthcare Patient maintains control and can grant access to selected portions of his/her medical record (ACL) for authorized users specific to their role Physicians can be granted access to the record or portions of it to read or write. Should the patient choose they may be locked out at a future time. Collaboration is optimised Standardized Queries: Are based on Web Services and KMehr standard Easy access based on Single Sign On (SSON) without installation of specific software at the user site with the same tokens/cards Interconnectivity: The system enables links to other related networks such as CareNet, Be Health, Social Security, RIZIN-INAMI,...

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19 Vrije Universiteit Brussel R. Van de Velde 19 SUMEHR (Summarized Electronic Health Record) Patient Identification Id Patient Presentation Name Forenames Sex Birth date Usual language Contact person Author Health care practitioner Id GMD relationship Risks Allergies Adverse drug reactions Social factors Other factors Relevant personal antecedents [ICPC2, ICD10, Other Code, Begin date, End date, text, links] Actual problems list [ICPC2, ICD10, Other Code, Begin date, text, links] Actual medications [CNK or other Id, Various administration informations, Begin date, text, links] Vaccination status Administrated [CNK or other Id, Date] To be administrated [CNK or other Id, Date] Contextual comment

20 Vrije Universiteit Brussel R. Van de Velde 20 Future CPR Environment First Class Healthcare PATIENT Records Clinic & Hospital Records PERSONAL Records Consumer & e-health records PUBLIC HEALTH/ POPULATION Records Community Records Data Banks Repositories

21 Vrije Universiteit Brussel R. Van de Velde 21 How? Why? What? How? When? How?

22 Vrije Universiteit Brussel R. Van de Velde 22 The Architecture (1/3) S Med A Med S Med Pharmacy Data Keepers Abrumet Doctors Specialist Hospitals ST. PIERRE Universitair Ziekenhuis VUB A Med = Access Mediator S Med = Service Mediator S Med Nw Med S Med S Med Labo Sécurité Sociale Network

23 Vrije Universiteit Brussel R. Van de Velde 23 S Med S Med Hospitals St. Pierre Universitair Ziekenhuis VUB Abrumet Documents Sécurité Sociale Nw Med Link S Med Pharmacy Prescription Dr. X Dr. Y Dr. Z A Med Abrumet Clients/Users The Architecture (2/3)

24 Vrije Universiteit Brussel R. Van de Velde 24 The Architecture (3/3) tunnel VPN MPI t= 1 month Access Mediator Auth Journal Access Messages HTTPS Import Web Portal Visualisation Msg Service Mediators Journal Access ACL Auth. Network Sécurité Sociale

25 Vrije Universiteit Brussel R. Van de Velde 25 ACL (Access Control List) Scenario: ExampleLogic Do Not release the record of the dermatology specialist(SOAP) Do Not release 1 specific document Everything what is treated by the department of Psychiatry Do Not release 1 type of document Everything what is entered by a specific physician Do Not release all documents related to one physician Keep everything protected during a specific period Time constraints

26 Vrije Universiteit Brussel R. Van de Velde 26 When? Why? What? How? When?

27 Vrije Universiteit Brussel R. Van de Velde 27 Ongoing Work : Project Life Cycle Public Tender: Hardware-Level Servers, Location: to be determined Software-level tool, Mediators, Portal-site (consisting), Authorization Server, Web Services Health Information Network Telecom: Security & Access (Tokens) between points of care (with broadband connectivity) Member Fees- Quid? Helpdesk

28 Vrije Universiteit Brussel R. Van de Velde 28 When ? Study Group « Preparation Public Tender » Vendor Selection Public Tender « Publication » Public Tender « Closure » First « Prototype » Test Production

29 Vrije Universiteit Brussel R. Van de Velde 29 Thank You Questions


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