tomaz vindonja

eHealth around the world

Challenges of EHR Implementation in Slovenia

Tomaž Vidonja, CMO, ICT Technology Network Institute

5th Sep 2014, Kolkata, India

12014 All Rights Reserved!

ICT Technology Network Institute.

Same Simple Population Questions

How many patients have been diagnosed with Sickle Cell disease last year?

How many diabetes patients are controlling their sugar?

What is the percentage of patients with high BMI?



Real value of health IT …

… is in:

• well-structured,

• reliable health data

based on

• open clinical data models!



Key Requirements

Meaning preservation Vertical semantic framework from DB to GUI

Sharing – moving the dataAbility to merge data from multiple sources - Solid data standards & protocols

Aggregation – putting the data together Semantic merging using shared content models

Portable querying

Evolution – of systems Separate the semantics from the software



5

Vendor-Neutral Data

Images -> PACS

Documents –> CDA/IHE

Structured Data - ???

Options-> HL7v3 RIM

-> openEHR

2014 All Rights Reserved! ICT Technology Network Institute.

openEHR

An open, domain-driven platform for developing flexible e-health systems• Separation of content and

technology• Computable data• Two-level modeling

– Archetypes – maximal data set

– Templates - data set for use case

• Multi-lingual



What is OpenEHR?

A community - based on years of international

collaboration in research, focused engineering

7

http://openehr.org/


http://openehr.org/

Why OpenEHR?

design and real-world implementation

experience



Widely adopting the OpenEHR

Healthcare Providers and Authorities (21)

Funded Research Projects(1 - EU)

Non-profit and Open Source Organisation (2)

Governments (10)

Academic Research (19)



http://www.openehr.org/who_is_using_openehr/healthcare_providers_and_authorities

http://www.openehr.org/who_is_using_openehr/funded_research_projects

http://www.openehr.org/who_is_using_openehr/nonprofit_and_open_source_organisation

http://www.openehr.org/who_is_using_openehr/governments

http://www.openehr.org/who_is_using_openehr/academic_research

What we did in Slovenia?

Smart Healthcare & Wellbeing Cluster… to deliver the VALUE.



Cluster & the Open Data Platform

Community

Cluster

Platform

• Open Community

• Business & Tech

• Users & Apps

• Platform – The Tool

• Development

• Innovation

• OpenEHR

• Global & Research

• Foundation



Where it is used today?

Children's Hospital, Ljubljana, Slovenia• Think!EHR Platform as vendor-neutral clinical data

repository based on openEHR specification is used in Think!Med Clinical (clinical information system) for longitudinal EHR at the 220 bed.

A national open health data repository • In operational environment as part of the Slovenian

interoperability backbone providing solution to eHealthapplications such as eReferral, ePrescription, eVaccinatonand national clinical registries.



Who else outside Slovenia … ?



City of Moscow eHealth

Moscow city - 780 medical facilities, including:

• 149 hospitals, 76 health centers, 428 policlinic institutions

Volume:

• Patients- 12 million, Beds in hospitals – 83,000

• Physicians – 45,000, all users – 130,000

• Patient visits/year - 161 million

• Documents/year - 1 Billion, 25TB

Based on IHE and Think!EHRTM Platform

Pilot live at 6 clinics as of Aug 2013!



Lifetime Health Records

Separate the semantics from the software

How will we read EHR data 50 years from now?


15

Why?

• Reduce Time to Market

• Lower development cost

• Enable higher quality, more functionality

• Build a solid foundation for next-generation applications



Think!EHRTM Platform

Think!EHRTM Platform is a vendor-independent, big-data, high-performance Clinical Data Repository designed to

store, manage, query, retrieve and exchange

structured electronic health record data based on open standards

Think!EHRTM Platform includes:

Think!EHR Server, Think!EHR Explorer, Think!EHR Integration, Think!EHR EventTracker, Think!EHR Development Toolkit



The Clinical Process


18

Building Global Community

Governments and eHealth Programmes• require to capture data from disparate sources in

various formats and store it in a common, context-sensitive form

Vendor/developers • require a seamless solution that will enable them to

develop and deliver next generation health care applications, fast and efficent.

Health systems and care providers • require centralized vendor-neutral, lifelong open data

health platform for EHRs, other disparate applications and health apps with the ability to enhance research capabilities



Beyond the Clinical Data Repository

(1) a comprehensive web-based EHR Explorer empowering developers to build forms, views, queries and rules using simple drag-and-drop features; (2) storage of designed and generated artifacts within the platform; (3) rich set of interfaces including REST, Harvard-MIT SMART API (smartplatforms.org), HL7 FHIR and IHE.XDS; (4) CTS2 interface for standardized integration with external terminology server needed to properly include terminologies like ICD, LOINC and SNOMED-CT; (5) all data is versioned, each data entry can be accessed using a stable URI.



Instead of conclusion …

WHY NOT?

Start creating and growing The OpenEHR Community in India …

Let‘s move now!



Share your ideas & thoughts …

ICT Technology Network Institute

Smart Healthcare & WellBeing Cluster

[email protected]

www.ict-slovenia.net

+386 40 272118



mailto:[email protected]

http://www.ict-slovenia.net/

tomaz vindonja

Healthcare

open clinical data models

open data platform11

reliable health data

clinical termstemplates

national clinical registries

ehr platform

openehran open

openehr specification