1. EHR Systems Use and Quality in EHR Systems Use and Quality in Austria EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade FH-Prof. DI Dr. Stefan Sauermann UAS Technikum Wien Program Director, Biomedical Engineering Sciences ProRec Austria

2. Myself: Communications engineer, ◦15 years MedUni Vienna, BME Head of national CEN ISO mirror „Medical Informatics“ Founding member of IHE Austria Consulting ELGA ◦CDA harmonisation of the Lab Report Research project in personal healthcare ◦www.healthy-interoperability.at EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

3. Health Care in Austria Insurance based system ◦~25 public insurances 15000 GPs ◦many with social security contracts Hospitals: mostly provincial holdings ◦Additional private hospital groups Many legacy IT systems ◦Big and small EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

4. EHR systems: market (estimates) Software use ◦80-90% of GPs use software ◦Nearly all hospitals use EHRs Number of products ◦Many GP systems! (> 100 vendors) ◦>10 hospital products (>10 vendors) Market shares ◦4 GP software vendors cover 60% of market ◦4 Hospital products cover 75% of market market stable over last five years EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

5. Existing law: enables treatment Laws for the medical professions eGovernment law Data protection law Enables point-to-point data exchange Not suited for single access all data for one patient EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

6. National EHR law : expected within months Enables sharing of patient related data Data protection is primary concern ◦Access only in context of treatment ◦Patients have control on who may access what Storage ◦What, how long... EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

7. EHR systems: quality assessment Existing GP software certification (in discussion) ◦Approval of reimbursement for treatment (eCard) ◦Reimbursement (Social insurance) ◦Standardised data export (Chamber of doctors) No incentive for using quality assessed / certified EHR systems EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

8. „Affinity domain“ (Build by HCP or vendor) Local Document Registries with Repositories National EHR ELGA: growing! Follows IHE IT Infrastructure (XDS, ATNA, BPC,... ) EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade Central components (Built by ELGA) Master Patient Index Healthcare Provider Index GP SW CIS GP SW CIS GP SW CIS GP SW, CIS Domain … Domain B

9. ELGA Timeline (roughly) Master patient, HCP index available Harmonised CDA available eMedication in pilot Security system in procurement Conformant affinity domains existing ◦Reference domain in procurement Reference domain go live expected 2012/13 All hospitals integrated 2014 GPs integration in full swing 2015 EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

10. Highlight: Clinical Documents (Real beauties!!) http://www.elga.gv.at/index.php?id=28 Discharge information Radiology and Lab reports ◦HL7 CDA Content harmonized ◦>120 medical experts ◦Implementations already available Usability guided design EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

11. „Affinity domain“ (Build by HCP or vendor) Local Document Registries with Repositories Possible steps to certification Security first? Then affinity domain connection? Then GP/CIS connection? EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade Central components (Built by ELGA) Master Patient Index Healthcare Provider Index GP SW CIS GP SW CIS GP SW CIS GP SW, CIS Domain … Domain B

12. Certification priorities Without access rights /security there is no data exchange This is a task in Europe May this be a first „eHealth Certificate“ on European level? EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

13. Looking forward to hear from you! Looking forward to hear from you! Stefan Sauermann ◦University of Applied Sciences Technikum Wien ◦stefan.sauermann@technikum-wien.atstefan.sauermann@technikum-wien.at The Austrian national EHR: ◦www.elga.gv.at EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade