A-1020 Vienna, Schiffamtsgasse 15 Applying the XDS profile - Best Practice in Austria Presented at World of Health IT 2007 IHE-Europe Session, Vienna

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 2 Agenda 1.Introduction 2.ELGA = Austrian’s EHR 3.XDS in Lower Austria 4.IHE Austria

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 3 Task Force Electronic Health Record - Arge ELGA - Arbeitsgemeinschaft Elektronische Gesundheitsakte 1.Decision of Federal Health Commission (BGK) from July 2006 concerning establishment of Arge ELGA and financial remuneration 2.Working basis of Arge ELGA is an agreement between 1.Federal Government 2.Provinces and 3.Social Insurance Institutions 3.Since September 2006 ARGE ELGA is acting operationally Location: A-1020 Vienna, Schiffamtsgasse 15

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 4 Definition of ELGA 1.ELGA contains relevant multimedia-based and health related data and information referring to a precisely identified person. 2.Data und information originate from 1.different health service providers and 2.from the patient himself/herself and are stored in one or several different information systems (virtual health record). 1.Data are available independently of place and time (7x24) 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

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 5 Federal Health Agency (BGK) – decision (1/3) ELGA Architecture consists of the following basic components 1.Master Patient Index 2.Health Service Provider (HSP) Index (global directory of healthcare providers) 3.Registry 4.Authorization System 5.Portal ELGA provides in the first phase of implementation the core applications 1.discharge Summary 2.e-Report - radiology 3.e-Report - laboratory 4.e-Medication

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 6 International standards for ELGA in Austria: 1.IHE Frame-Work with domain 1.IT Infrastructure 2.Patient Care Coordination 3.Laboratory 4.Radiology 2.HL7 CDA 2.0 as document standard 3.LOINC (area Laboratory data) 4.DICOM 3.0 incl. WADO (area radiology) 5.HL7 (in Version 3 with RIM as prospective data model) Federal Health Agency (BGK) – decision (2/3)

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 7 Detailed planning and first piloting (2007 / 2008) 1.Concretion Basic Components and Master Plan 2.Project 1 – Master Patient Index 3.Project 2 – HSP Index 4.Project 3 – Document Registry 5.Project 4 – Authorization System 6.Project 5 – Portal 7.Project 6 – Main Application first phase of implementation 8.Project 7 – Acceptance Management Acceptance of each project after the presentation of an organizational and financial concept through BGK Federal Health Agency (BGK) – decision (3/3)

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 8 Agenda 1.Introduction 2.ELGA = Austrian’s EHR 3.XDS in Lower Austria 4.IHE Austria

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 9 Overview System Architecture Portal HSP System Consumer Source Pat - Index Repository HSP - Index Autohorization System Document Registry Audit System External Registries (base identifi- cation number,...) ELGA Context

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 10 Interoperability – Standards and Catalogs 1.Technical (syntactical) interoperability 2.Content wise (semantical) interoperability Requirement: Assortment of international standards 1.Standards rise quality and reduce costs! 2.Standards promote competition!

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 11 HIS Patient Identify Source 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 Standard Non Standard Why Standards ?

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 12 Technical framework for ELGA: IHE Profile XDS

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 13 Agenda 1.Introduction 2.ELGA = Austrian’s EHR 3.XDS in Lower Austria 4.IHE Austria

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 14 NÖGUS ( Lower Austrian health and welfare fund NÖ Landeskliniken-Holding ( going there …… Project Patienten-Index

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 15 Lower Austria Federal state of Lower Austria  approx. 1.6 million inhabitants  27 hospitals  approx beds  approx general practitioners Vienna

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 16 Starting Point Hospitals in Lower Austria Situation Locations 2.22 Organizational Units 3.18 Different Owners IT Systems supplied by 70 Manufacturers Mistelbach Hainburg Hollabrunn St. Pölten Lilienfeld Amstetten Waidhofen an der Thaya Gmünd Krems Tulln Korneuburg Stockerau Melk Scheibbs Waidhofen an der Ybbs Zwettl Horn Eggenburg Allentsteig Gugging Mauer Mödling Baden Hochegg Wiener Neustadt Neunkirchen Klosterneuburg

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 17 Global Aims of NÖGUS 1.Creation of a central and integrative information and communication platform to meet the patient-related requirements of healthcare and welfare in Lower Austria. 2.To make all relevant medical data of a patient available at any location and at any time for authorized persons or organizations to the extent required, thus providing quicker and more efficient medical assistance. 3.Synergy and cost efficiency in the acquirement and operation of IT systems.

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 18 Patient Demographics embedded in HIS IHE: Patient Demographics Consumer Local Client Connector HL7 Server NÖMED Patient Index IHE: Patient Cross Reference Manager IHE: Patient Demographics Supplier Query KIS: Patientensuche Result Retriev e Find Patients in HIS plus Index Admission in HIS

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 19 Document Consumer embedded in HIS

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 20 Document Consumer Web Application

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 21 Already used PIX PDQ EUA ATNA PWP XDS.a XDS.b IHE Profiles in Lower Austria XDS-I RFD BPPC XUA XCA Planned for future

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 22 Agenda 1.Introduction 2.ELGA = Austrian’s EHR 3.XDS in Lower Austria 4.IHE Austria

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 23 IHE Austria will cover some add-ons 1.Support development of requirements and specifications for ELGA and other health IT Projects 2.Coordinate with IHE international 1.Develop „national extensions“ 2.Contribute to international work on the profiles 3.Take care for „certification“ of software products 1.This is more than interoperability! 2.QA, security audits, load balancing, …, 3.Cooperate with IHE international, Eurorec, CCHIT, … 4.Make sure that vendors can use „ELGA certificates“ in international markets, too.

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 24 Tasks of IHE Austria 1.Manage project groups 1.For use cases, specifications, international contacts 2.Provide „ELGA-thon“ 1.What exactly is this? Concept work 2.Build up infrastructure 3.Keep everybody informed 1.Website, communication platform, events, …

Dipl.-Ing. Dr. Alexander SchannerXDS and other related profiles in AustriaPage 25 Thank you for your Attention!