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Business Information Systems
Overview
- Introduction
– The Swiss health system
- Goals of Medicoordiation
- Concrete steps
– Interviews – Scenario for a prototype
- Conclusions
MediCoordination: A practical approach to interoperability in the - - PowerPoint PPT Presentation
MediCoordination: A practical approach to interoperability in the - - PowerPoint PPT Presentation
Business Information Systems MediCoordination: A practical approach to interoperability in the Swiss health system Henning MLLER, Michael SCHUMACHER, David GODEL, Abu Khaled OMAR, Francois MOOSER, Sandrine DING HES SO, Switzerland
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SLIDE 3
Business Information Systems
Introduction
- Most European countries have eHealth
strategies for interoperability
– Health cards, direct communication between partners, …
- Many independent partners are involved
– Association of GPs, association of hospitals, health insurances, …
- Very political subject as all citizens are
concerned about their health data
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Business Information Systems
The Swiss Health System
- Extremely scattered as health
is in the responsibility of the 26 cantons
– Much varies from one canton to another – Very little can de decided centrally – Decisions may take a long time
- eHealth is a political subject (here as well)
– Partners have conflicting interests
- Comparably small market
– Limited interest of the large companies
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Business Information Systems
The Swiss eHealth strategy
- Coordination in several sectors connecting interest
groups and experts
– Work on recommendations for interoperability standards, teaching, legal issues
- Very little legal power, recommendations only
- Strategy over the next 10 years with clear goals
- Bring together partners regularly
– To agree on steps and standards – Keep all partners informed
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Business Information Systems
Goals of Medicoordination
- No basic research but a practical approach
– No strategy but concrete prototypes
- Get opinion of all partners in the health system
– Through interviews – Indentify areas of high added value
- Concentrate on smaller, regional hospitals that
have less resources for implementation
– And on the Swiss French part
- Base everything on the Swiss eHealth strategy
– Standards, …
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Business Information Systems
First steps: identify partners in health
- Two large University hospitals, two private
hospitals
- Six medium size regional hospitals
- Two independent laboratories, a radiology lab for
medical imaging
- One insurance company
- One producer of a GP medical record and two GPs
- One producer of a clinical information system
- The Swiss society for GPs
- Several regional health boards
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Business Information Systems
Questions asked
- Qualitative survey, around 45-90 minutes
- Which electronic patient record is used and what
exactly is digital?
- Which standards and terminologies are used, or
even entire data models (such as HL7 RIM)?
- What is your attitude towards interoperability and
data exchange? What is the potential and where are the risks?
- Which scenarios would help you concretely in
exchanging data with external actors?
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Business Information Systems
Results
- Partners were very cooperative
– Much information was exchanged – Different opinions on risks became clear
- Everyone has a high interest in electronic
data exchange
– Potential benefits are very important
- Concrete advantages need to be shown
– Not only discussions on costs and abstract estimations of gains
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Business Information Systems
Use cases chosen
- Interoperability of hospitals with external actors
was the goal
- Chosen scenarios were:
– Quick electronic release note – Electronic discharge summary – Transmission of the operation protocol – Transmission of laboratory results – Transmission of images
- Simple transmission of PDF was regarded
sufficient (ID information in XML)
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Business Information Systems
Use case for the interoperability
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Business Information Systems
Steps to create the discharge summary
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Business Information Systems
Overall security model
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Business Information Systems
Current implementation state
- Servers are installed in the DMZ in the two
participating hospitals (Sion, Fribourg)
- A directory is permanently controlled for arriving
files (XML and PDF)
- New files are imported into a database
- An external GP can access a connector and
download files attributed to him
– Simple authentication – Transfer in HL7 XML format – Not tested on real data, only test data sets
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Business Information Systems
Overview of the current system
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Business Information Systems
Obstacles in the process
- Management of a server in the DMZ of hospitals
is not easy (responsibilities)
– Security is the most important aspect
- PDF was chosen over more structured data
– Hospitals do not control the entire info system – Not all data is acquired in structured form
- Standards are sometimes complex
- Many people are involved in the process
- Identification of patients is not easy
– Will change with the Swiss health card
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Business Information Systems
Conclusions
- eHealth and interoperability will become
increasingly important in most European countries
- Data availability will improve care and
administrative processes
- Overall gain is much higher than questions of
individual actors in the health system
- Concrete examples need to show benefit of
eHealth instead of extremely large system
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Business Information Systems
Next steps
- Test the system with real data
– With few test patients – With larger amount of data
- Show the added value to the partners
– Prepare cantonal tests – Public private partnerships
- Collaborate with networks such as eToile in
Geneva
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Business Information Systems
Questions?
- http://www.medicoordination.ch/