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Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) e-Health: Huidige Status en Toekomstperspectieven.

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Presentation on theme: "Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) e-Health: Huidige Status en Toekomstperspectieven."— Presentation transcript:

1 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) e-Health: Huidige Status en Toekomstperspectieven Prof Dr Georges De Moor Universiteit Gent

2 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Health & eHealth: Main Objectives –Quality –Efficiency –Security –Safety –Equity of the Health(care) Services cf. the Vision and Strategy in “Building Bridges” (1999)

3 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Historical Background –Commissie Telematica-Standaarden (3 Mei 1999) (15 December 2005) –BeHealth project en platform (23 Dec 2004) –‘FOD Volksgezondheid’- projecten “ …a step by step approach…” Future? –Wetsontwerp Verwerking Gezondheidsgegevens –Sectoraal Comité Gezondheidszorg van de CBPL (!)

4 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Projects / Activities –RIM2, ELODIS, CODENTAL, KINELECTRICS, HEPI-GO, FLOW (Alfa, Beta, Gamma), BePrescript, KMEHR Love, KMEHR Live, BeHEALTH, THESAURUS, KMEHR Lab, HEPI-Gone, HISABEL, KMEHR+, REGISTERS Working Groups –DATA, SECURITY, MESSAGES, ARCHIVES, BeHealth, NURSING, LABELLING

5 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) “Patient-centered Care, Continuity of Care, Individualized Care, Mobility,...” ICT for Health –C = Communication (across boundaries) Exchange of data Linkage of data –Interoperability (cf. eHealth Action Plan CEC/EU) Standardisation Health Personal Identifiers, Summary- and Emergency- Health Records… (cfr. verwijzings-repertoria…)

6 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) The e-Europe Action Plan (2005) – By the end of 2005: EU member states must define national and regional e-health strategies (deployment of e-health systems, use of electronic health records, interoperability and re-imbursement of e-health services) – By the end of 2006: identification of interoperability standards for health data messages, electronic health records, taking into account best practices and relevant standardisation efforts – By the end of 2009: EU member states and the EC will set the baseline for standardised provision of e-health services in clinical and administrative settings E-Health identified as one of the EC priorities, with as deadlines:

7 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Interoperability: General Definitions ISO 2002:12 : Interoperability refers to the ability of two or more systems (computers, communication devices, networks, software and other information technology components) to interact with one another and exchange information according to a prescribed method in order to achieve predictable results CEN/ISSS 2005 : Interoperability is a state which exists between two application entities when, with regard to a specific task, one application entity can accept data from the other and perform that task in an appropriate and satisfactory manner without the need for extra operator intervention NAHIT (US) : Interoperability is the ability of different information technology systems, software applications and networks to communicate, to exchange data accurately, effectively and consistently, and to use the information that has been exchanged (March 09,2005)

8 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Interoperability: Types Technical interoperability Organisational interoperability Functional interoperability Syntactic interoperability Semantic interoperability Political interoperability Legal interoperability Social interoperability Inter-standard interoperability

9 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) EHR & interoperability Bio-Medical Informatics HealthGrid Deployment Applied/ Industrial R&D Basic Research Decision Support Systems Support to eHealth “Action Plan” Health Info Networks & Services Personal Health Systems (Wearables) General issues: EHR, Security, Interoperability I II III Time

10 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Implementation I eHealth ERA I2HEALTH Certification EHR QREC Certification EHR QREC Interoperability TMA Bridge Interoperability TMA Bridge RIDE Interoperability RIDE Interoperability SHARE Healthgrid SYMBIOMATICS BMI ERA Pilot STEP VH CA INFOBIOMED BIOPATTERN SEMANTIC MINING Semantic Health Interoperability Semantic Health Interoperability II III Short time research Long time research

11 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Examples of ongoing R&D or Deployment Projects At European level: QREC (http://www.eurorec.org )http://www.eurorec.org At Belgian level: HEPI-GO (http://www.health-telematics.be )http://www.health-telematics.be At Regional level: COPLINTHO (https://coplintho.ibbt.be )https://coplintho.ibbt.be

12 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) EuroRec – The « European Institute for Health Records » – A not-for-profit organization, established April 16, 2003 – Mission: the promotion of high quality Electronic Health Record systems (EHRs) in Europe – Federation of national ProRec centres in Europe

13 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) ProRec CENTRES Centres Belgium Bulgaria Denmark France Italy Germany Ireland Romania Slovenia Spain Applicants Norway Greece Hungary Portugal Poland Sweden The Netherlands United Kingdom Slovakia “ Differences in languages, cultures and HC-delivery systems ”

14 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) EUROREC: Organisation PROREC - CENTRES … (Complementarity / Languages) ( Economy of scale / Synergy) EUROREC Healthcare Authorities … Users (Clinicians, Citizens) EHRs - Vendors Purchasers, Payers

15 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) TRENDS in EHRs (1) – transmural / virtual – multidisciplinary and interactive Administrative Records Patient Health Diaries Medical Records Nursing Records ! Integration with other health care software applications...! EHRs become

16 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) TRENDS in EHRs (2) -Medical and Bio-Medical data -Security: Privacy Enhancing Techniques -Semantic Interoperability: Ontology based approaches -Added value of EHRs: eg. Decision Support Systems -Grid Technology: HealthGrid “The PHENOMES will meet the GENOMES in the EHRs of the Future”

17 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) QREC: FP6-IST4 Results of the 4 th Information Society Technology (IST4) Call for Proposals under the EU’s 6 th Research Framework Programme (FP6): – 276 new research projects – With EUR 1 billion in EU funding QREC-project on « Quality Labelling and Certification of EHR systems in Europe » is a Specific Support Action (SSA) with EUR 1.3 million in EU funding.

18 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) QREC: Main Objectives To develop formal methods and to create a mechanism for the quality labelling and certification of EHR systems in Europe, in primary- and in acute hospital-care settings EuroRec Institute is coordinating partner QREC has 12 partners and 2 subcontractors

19 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) EUROREC: GOALS – Support to ProRec centres – Inform users of current trends in EHRs and express their needs – Help public authorities to define and implement strategies – Defend the EHRs-industry (ROI) – Promote research, education and development in EHRs – Foster international co-operation (eg. CCHIT in the US…)

20 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) QREC: ORIGIN Several EU-member states (Belgium, Denmark, UK, Germany, …) have already proceeded with quality labelling and certification schemes, but they differ in scope, in legal framework under which they operate, in policies, in organization, in the choice of quality conformance criteria for benchmarking and testing… These differences represent a risk of further market fragmentation: harmonization efforts should help to avoid this!

21 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Benefits for the Stakeholders Industry Quality Labelling / Certification Market & R.O.I. Quality and SafetyEfficientie and Cost Savings Clinicians, Patients, Public Health Health Authorities

22 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) EHRs Certification: Expected Impacts – to reduce EHRs investment risk for buyers/purchasers – to foster availability, accessibility, inter-operability and portability of the patient records no matter where the patients are located or are travelling... – to stimulate confidence and increased investment in EHRs – to guarantee better return on investment (ROI) for vendors – to induce cost savings in healthcare – to improve the quality of care and safety of patients – to encourage patients to play a greater role in managing their own health information – to provide valuable population health information

23 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) QREC: Core Tasks (1) 1.Study of current EHRs « Quality Labelling and Certification » -systems: (State-of-the-Art Report) 2.Assay of the requirements amongst all stakeholders across Europe, covering both current and planned EHRs certification activities (Survey) 3.In-depth analysis of the ways to classify and profile EHR systems (Profiling and Indexing) 4.Comparison of various possible EHR certification systems (Methodology)

24 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) QREC: Core Tasks (2) 5.Definition of a model (a common European Template) with harmonized guidelines and procedures for EHRs quality labelling and certification 6.Benchmarking process Manual for EHRs certification 7.Business Plan

25 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) QREC: Main WorkPackages WP 1: Consortium Management, Project Co-ordination and Quality Assurance WP 2 : EHR systems Quality Labelling and Certification Development WP 3 : Resources for EHR Interoperability WP 4 : Benchmarking Services WP 5 : Communication and Dissemination Activities

26 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) QREC: WP 3 WP 3 : Resources for EHR Interoperability T3.1Register of Conformance Criteria and Guidance Documents T3.2Inventory and Register of EHR Archetypes and Guidelines for their Use T3.3Register of Health Coding Systems in Use in Europe T3.4Inventory of Relevant Standards for EHR systems T3.5Register of XML Schemas and Open Source Components for EHR systems

27 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Definitions Archetype (in eHealth): A uniquely identified, reusable and formal expression of a specific health concept, expressed by means of an Archetype Definition Language and composed of descriptive data, constraint rules and ontological definitions. Archetypes can be specializations of other archetypes.

28 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) QREC: WP 3/ T3.3 T3.3Registration of Health Coding Systems in Use in Europe Implementation of the European Standard EN 1068 EuroRec has been appointed as the Registration Authority and has been mandated by CEN/BT and /TC 251

29 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) QREC: Concrete Results The Quality Labelling system will act as a filter, enabling: Potential buyers to identify their needs, requirements (including Contexts of Use, EHRs modules,…) and to find TEST PLANS with APPROPRIATE SCENARIOS and CRITERIA against which a number of existing EHRs will be tested; Vendors to check their own systems in order to get a quality label or certification.

30 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) The HEPI-GO project: “a Proof of Concept Project” Start: 1 Dec.2005 End : 1 Jul – Het Persoonlijk Gezondheids- Identificatienummer – Situering in juridisch kader – Voorstel van cryptografische omzettingsmethode – Voorstel van implementatiemodel – Testen op kleine schaal (pilots)

31 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Use of Data –Who? Qualifications –What? Type of data –Why? Finality “Importance of a legal framework” “Importance of definitions (personal, sensitive, medical, social...)”

32 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Identifiers –RRN –INSZ (RRN, KSZ) –PGIN (HEPI) “Towards a comprehensive solution for the care settings: hospitals, ambulatory care, homecare…)”

33 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Choice of Identifiers: a selection of criteria ref. ASTM “Standard Guide for Properties of a Universal Healthcare Identifier” –Unique (collision free) –Permanent (from cradle to grave and beyond) –Meaningless –Processable –Accessible –Governed –Usable (automated and manual) –...

34 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Primary and Secondary Uses INSZ Research AdministrativeHEPI ID x ID y ID z TSP TSP y TSP z Care Marketing Int. Research TS x TSP ID a TSP x Social/ Management

35 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Microsoft’s Identity Meta-system –interoperable architecture for digital identity –connecting existing and future identity systems Infocards - Identity Selector –providing a consistent user-experience for Identity Management Innovative approaches for dealing with sensitive data (e.g. Health) in a service oriented environment, require complex Identity and Credential management. The end-user experience offered by “Infocards” could facilitate the adoption of such new approaches. INFOCARDS

36 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) COPLINTHO: IBBT project (Vlaanderen) “Proof of Concept” project voor Interactieve eThuiszorg eThuisZorg omgeving Start: 1 January 2005 End: 31 December 2006

37 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Valorisation ProjectMarkt ConceptOntwerpGebruiker Lab testVeld test Testprogramma Evaluatie-plan Product Pre-valorisatie

38 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) COPLINTHO (IBBT): eHomeCare Services –e-Scheduling –e-Work-planning –e-Record keeping and exchange –e-Prescription (and medication folders) –e-Learning –e-Entertainment –e-Alarming –e-Monitoring, Telemetry –e-Decision support –Voice and Video communication –(e-Medicine) Users – Nurses and other Care-Givers – Patients chronically ill (diabetics,…) palliative patients post-hospital discharge revalidation/ rehabilitation pregnant (at risk) – Healthy citizens (prevention) – Disabled and Elderly – General Practitioners – Medical Specialists Applications Data, voice and video

39 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Legal Issues

40 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) COPLINTHO: Individueel Netwerk voor Interactieve eThuiszorg eThuisZorg omgeving Alarmcentrale (ALA) Mantelzorger (MAZ) Ziekenhuis (ZH) Specialist (SPE) Huisarts (HA) Breedband Netwerk

41 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Clusters

42 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Flexibility GET Loc. EHR A Record A EHR locations B is DOC A C is trust person A Portal / Provider Doc. B Record X EHR locations... Record Y EHR locations... GET EHR A Requestor is B B has access to REC A B is Doc

43 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) eHealth High Level Conference (Malaga, May, 2006) (strategic/ political...)

44 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) Medical Informatics Europe (Maastricht, August, 2006) (scientific/ academic...)

45 Dag voor de Gezondheidszorg Microsoft Executive Circle Forum Prof. Dr. G. De Moor (Gent, 09/03/2006) World of Health IT 2006 (Geneva, October, 2006) (industrial...)


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