1. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 1 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Thanks to Pr Christian Lovis, MD, MPHI Head, Unit of Clinical Informatics Electronic Health Record and Supply Chain Data... Standards Electronic Health Record and Supply Chain Data... Standards

2. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 2 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 What do we mean with EHR? individual patient's medical record in digital format that can be shared in different health care settings inside a single hospital, inside a hospital group, inside a country, across the globe. collection of electronic medical record (EMR) out of different organisations out of different encounters

3. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 3 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 EHR from US DoD* / 1 (encounter / location) Previous Encounters Location Additional Selection Criteria *DoD: US Department of Defense

4. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 4 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 EHR from US DoD / 2 (encounter / location) Previous Encounters Location

5. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 5 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 EHR from US DoD / 3 (document) Documengt History Discharge Letter

6. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 6 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 EHR from US DoD / 4 (structured document) Documents History Location

7. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 7 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 EHR from US DoD / 5 (meds history) Medications dispensed by DoD, VA* & retail pharmacies VA: Veteran Affairs, the US federal hospital for military staff

8. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 8 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 EHR…. Connecting the dots Supply Chain … connecting to EHR EHR differs from paper-based files Data are stored electronically, Preferrently in a structured format Preferrently by referring to common agreed semantics, including images, lab results, etc. EHR belongs to the clinical IT Supply Chain data belong to an other “silo”?

9. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 9 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Supply Chain data in Hospital IT

10. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 10 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Supply Chain meeting Clinical IT

11. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 11 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Drugs, laboratory samples, etc, … Care, acts, actions, … Supply Chain and Clinical IT University hospitals of Geneva Pediatry Dept, mai – october 2007 – 6’786 episodes, 93’294 medical acts Medication 25% Medication Nursing acts Medication Medications Care Laboratory Radiology Consultations Other 93’294 medical acts 2’900’000 nursing acts

12. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 12 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Supply chain as bridging processes and silos EHR Supply Chain Care Accounting From Product to Patient

13. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 13 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Supply Chain and EHR: different time scales ? 1971 1978

14. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 14 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 …over generations 2009

15. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 15 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Supply Chain Data … in clinical IT Supply Chain Data... As identification keys...attributes for traceability Smooth linkage between two environments HL7 and GS1 collaborating to make this as interoperable as possible

16. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 16 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 HL7’s Mission HL7 is an international community of healthcare subject matter experts and information scientists collaborating to create standards for the exchange, management and integration of electronic healthcare information. HL7 promotes the use of such standards within and among healthcare organizations to increase the effectiveness and efficiency of healthcare delivery for the benefit of all. HL7’s strategy is innovation – both by ourselves and by our users

17. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 17 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Supply Chain Data … into Clinical IT Location GLN 7601001370500 GS1 xml message Identifier Authority: EAN.UCC

18. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 18 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Supply Chain Data … into Clinical IT Location HL7 CDA message GLN 7601001370500 OID : 1.3.88

19. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 19 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 ePrescription

20. Atenolol 50mg Tablet (Cox) X28 (AMPP ) Atenolol 50mg Tablet x28 (VMPP) Atenolol 50mg Tablet (COX) (AMP) Atenolol 50mg Tablet (VMP) Atenolol (drug product) (VTM) IS_A Cardioselective beta-blocker IS_A Beta-blocker drug etc IS_A Snomed CT drug core NHS dm+d Dm+d and SNOMED CT Source: Paul Frosdick, Bpharm, NHS, 2005

21. Added value in NCRS and systems Adapted* from: Paul Frosdick Bpharm, NHS, 2005 07640134320013* 07680382100258*

22. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 22 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 A tentative to visualise GS1 in HL7’s Model shape EntityRole Participation Clinical Acts Entity (GTIN, GLN, etc. ) Participation (attributes as serial #, dates,) Acts (Value, Transaction, involved parties)

23. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 23 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Continue working in meeting Health IT requirements GSMP « Patient & Caregiver ID » : gap analyse and searching solutions

24. © Medinorma LLC Switzerland www.medinorma.biz Medinorma LLC www.medinorma.net Slide 24 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 EHR and Supply Chain Standards … Christian Hay Partner Medinorma LLC www.medinorma.net hay@medinorma.ch