the international experience in interoperability of health information 170505
TRANSCRIPT
The international experience in interoperability of Health Information Systems
George Kakoulidis CEO, Apollo SA
8th WORLD HELLENIC BIOMEDICAL CONGRESS
in this Presentation HL7 Hellas
Interoperability definitions
HL7 Standards
Interpretability Tools
The Future
Health Care Industry
Health Care is an industry where a diverse set of players must collaborate to provide a wide array of
services
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Primary Hospital
Doctor’s OfficePharmacy
Employee Employer
Chem Lab
Secondary HospitalNursing Home CareHome Health Care
Insurance
PATIENT DATA
HealthCare Enterprise
involve complex processes involve clinical and administrative
tasks large volumes of data large numbers of patients and
personnel performed either by humans or by
automated systems
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Definition
What is computer interoperability?
"The ability of two or more systems or components to exchange information and to use the information that has been exchanged.“
[Institute of Electrical and Electronics Engineers IEEE Standard Computer Dictionary: A Compilation of IEEE Standard Computer Glossaries, IEEE, 1990]
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Definition
What is application integration?
"The way to create interoperability solutions in HealthCare Information Systems "
" The successful integration of disparate systems, applications, data, vendors, functions"
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Historical need for Integration
Main
frames
No need
Min
i - Lan
Som
e Interfaces
LAN
/ WA
NA
lot WA
N
EA
I
1960 1980 1990 2000
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Problems in HealthCare IT
Hospitals never had a lot of money Lots of Departments with unique IT solution Multiple proprietary systems, varying
platforms, different languages Local data /Lack of Standards Structured and Unstructured data (free text) All systems Must work together
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What need integration ?
Hospital service-related functions, as ADT, Order Entry, Result Reporting, Materials Management, Patient Accounting, Medical Chart
Departmental systems, as Clinical Laboratory, Pharmacy, Radiology, Pathology
Resource management, scheduling, physician billing
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Interoperability
“Interoperability” can only be achieved through the use of data standards and clinical terminologies.
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Standards
Why Standards ?
HealthCare information is increasingly transmitted electronically
In order to exchange information using common data format cost effective
Examples (Mobile –GSM, ATMs,)
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What standards are needed?
Communication standards Data interchange standards Information model standards Vocabulary standards Security standards
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Standards – HL7
HL7 provides a set of communication standards as a cost-effective approach for connecting disparate information systems in health.
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HL7
Health Level Seven is an ANSI Standards Developing Organization
Mission :"To provide a comprehensive framework and related standards
for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services. Specifically, to create flexible, cost effective standards, guidelines, and methodologies to enable healthcare information system interoperability and sharing of electronic health records.“
(Source: HL7 Mission statement, revised 2001)
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HL7 History
1987 : Start work as a standard
1990 : First standard (v2.1)
1993/94: First International Affiliates join.
1994: HL7 becomes ANSI-accredited.
August 2001: 1st V3 Draft is released.
June 2003: HL7 V2.5 released.
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HL7 Organization
ANSI-approved Standards Developing Organisation (SDO).
Not-for-profit.
>2200 members.
>500 corporate members.
Local organisations in more than 27 countries.
www.HL7.org
www.hl7hellas.org
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Why HL7 ?
International Standard since 1991 International Standard since 1991
Used Worldwide (27 HL7 Affiliates) Used in EU (Germany, Holland, Finland, Italy
etc) HL7 HL7-TC251 Task Force ANSI Standard ANSI Standard Used in Real-life for more than 10 years Open Standard continuously updated Latest Version 2.5 (Conformance Statements)
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HL7 Facts
HL7 is not a software application The HL7 standard is a ‘book of rules’ prime objective of HL7 is to simplify the
implementation of interfaces between healthcare software applications
HL7 has grownup and become the de facto model for the entire healthcare industry’s data exchange challenges.
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Interoperability & HL7 Considerations
HL7 is not a plug and play
Not all the Health Information Systems have HL7 interface
Complex data exchanges needs special software applications like “Interface Engines”
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Interface Engines
Mission Critical Component
Formatting Messages and Routing them
Complex data exchanges needs special software applications like “Interface Engines” or “Integration Engines”
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Interface Engines
Hospital’s Clinical Data “Telephone Exchange”
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Interface Engines
Past complicated issue required extensive programming expertise from IT stuff hard to deal with different HL7 versions and formats different communication points complicated administrative tasks maintenance and support was very complex
Today Graphical UI Easy of use Ready Protocol Libraries (HL7 Versions) Different ways to Communicate
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Large Scale Implementation HL7 Hellas
Health Regional SystemHealth Regional SystemCDR
ERP
Scheduling
Integration Engine
Hospital 1Hospital 1
HIS
LAB
IE
Hospital 10Hospital 10
HIS - ERP
LAB
IE
……
PortalPortal
Scheduling
Reg.CentersReg.Centers
ERP - MR
Sub-SystemsSub-Systems
MIS
PACS
ADT
Integration strategy
Integration Engine on its own is not enough!
Need Master Patient Index for validation
Need highly skilled IT resources
Need money to invest in integration (not a given today)
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HealthCare Interoperability the FutureWhat we expect ?
HL7 v3.0 Promise of plug and play interoperability Robust approach to development Widespread support
Open Systems Integration of Services and Technologies Use of new Technologies in Software
Integrations Web Services Service Oriented Architecture
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8th WORLD HELLENIC BIOMEDICAL CONGRESS
HL7 Hellas, Apollo SA