geneva, switzerland, 26-27 april 2012 state of interoperability in the czech republic towards...
TRANSCRIPT
Geneva, Switzerland, 26-27 April 2012
State of Interoperability in the Czech Republic
Towards Personal Health Record
Miroslav Bursa,CTU in Prague, FEE, Dept. of Cybernetics, BioDat Research
Joint ITU-WHO Workshop on e-Health Standards and Interoperability
(Geneva, Switzerland, 26-27 April 2012)
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Patient ID
Encoded birth date, sex and identifierconsistency check (mod 11)error-proneduplications might exist
Considered sensitive information (!)Some hospitals create their own ID
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Standards
Many local standards existInteroperable standards
DICOM/PACS
Mutually incompatible HIS are usedNo standard(s) for signal data, often proprietary closed format
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Health Record
Usually in paper formOften held in paper and el. form
Entered into HIS during night shiftFree text, duplicationsSignals, reports only in paper form
Statistics must be provided to state agency
tendency to fulfill the requirements only
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EHR
First attempt (IZIP) done via state-owned health-insurance company
Suspended fundingNot based on interoperable standardInconsistent with European efforts to interoperabilityNow called ‘health-book’
Smaller projects exist
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EP
In a pilot stage8 doctors, 8 pharmacies
Still have to printInsurance companies: no access
Runs since 2009, first EP on 04/2011
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Legislation
3rd party has right to look at the documentation
problem: doctor has internal notes
Question Owner of the data? Permission to use in research? Has the hospital right to obtain human-readable data for processing? Raw data?
Draft on health documentation under discussion. Does not cover EHR.
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Usual (mythic) reasons to reject EHR
MDs do not need computer to heal a patient40 % MDs do not have a computerMDs do not want to be restricted by computerMDs are afraid of easier liability claimsIT wants things that are not present in paper form
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Age Structure of MDs in Czech Rep.
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Age Structure of DDs in Czech Rep.
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Age Structure of PDs in Czech Rep.
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Conclusions and Recommendations
No fully interoperable EHREP running in pilot stageProblem of integration: no efforts‘Crisis problem’: Cheap appliancesLoosing data for long-term studiesIsolated solutions (reinventing wheel)No force to unify standards