www.lknoe.at ihe in austria ihe success stories, missing links and gaps dipl.-ing. dr. alexander...
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www.lknoe.at
IHE in Austria
IHE Success Stories, missing links and gaps
Dipl.-Ing. Dr.
Alexander SCHANNER
Vienna, February 13th 2014
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Agenda
1. Success-Stories in Austria
2. Missing Links
3. Gaps in IHE Profiles & Domains
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Decision of Federal Health Commission (BGK), May 2007
International standards for EHR (=ELGA) in Austria:
▪ IHE Frame-Work with domain
- IT Infrastructure
- Patient Care Coordination
- Laboratory
- Radiology
▪ HL7 CDA 2.0 as document standard
▪ LOINC (area laboratory data)
▪ DICOM 3.0 incl. WADO (area radiology)
▪ HL7 (in Version 3 with RIM as prospective data model)
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Implementation of
▪ a nationwide central Index of Health Service Providers
▪ a nationwide central Patient Index
▪ a nationwide System for eMedication
▪ appropriate pilot projects in order to evaluate the architecture of ELGA as already presented
▪ These tasks have to implemented on the basis of the decision of the Federal Health Authority of May 4th, 2007 concerning the applicable standards and the IHE framework. Furthermore, this decision has to complied with in all other eHealth applications of the federal entity, the provinces and the Social Security.
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Decision of Federal Health Commission (BGK), December 2008
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IHE Affinity Domains in Austria as Part of ELGA:
• Lower Austria
• Tyrol
• eGOR
• Upper Austria
• Vienna
• Styria
• Carinthia
• AUVA
• Salzburg
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Hospitals in Lower Austria
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Inpatient Treatments
383.654
Inpatients 269.830
Outpatient Treatments
2.866.952
Outpatients 1.236.017
Employes 15.429
Year Patients Reports DICOM Studies
Number of Accesses
01/2011 1.1 Mio 3,2 Mio - 354
01/2012 1.4 Mio 5,1 Mio - 2.361
01/2013 1.6 Mio 5,7 Mio 850.000 13.800
01/2014 1.8 Mio 8,9 Mio 1.865.000 21.084
XDS & XDS-I Environment, Using XDW
Numbers of Lower Austria (2012)
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Agenda
1. Success-Stories in Austria
2. Missing Links
3. Gaps in IHE Profiles & Domains
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Availability vs. Real World Implementations of IHE-Profiles
▪ Existing Profiles and Use Cases
- Final Text, Date
- Supplement for Trailimplementation
▪ Adoption of Profiles &Use Cases by Vendors
- Testet Systems at CAT
- Available Products on market
▪ Adoption of Profiles and Use Cases by Users
- Requirements in RFPs
- Real World Implementations
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FT
CAT
RWI
ST
PROD
RFP
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Open Issues
▪ Migration from HL 7 v2.x-World to Webservices
- Cross Community Profiles are based on Webservices (HL 7 v3)
• PIX/PDQ, XCPD (HL7 v 3.0)• XDS, XDS-I, • DSUB, DRR• XDW (inside XDS or via XCA?)• HPD (Role in Context to PIX, XDS, XDW, PCC, ..)• PCC-Content-Profiles
- Intra Community Profiles based on HL 7 v 2.x
• PAM [IT-I, ..]• PIR [RAD, ..] [IT-I]?• ORM [RAD, ..] [IT-I, PCC]?• CHG [RAD] [IT-I, PCC, QRPH]?
▪ New Domain for Reimbursement and Insurance-Processes?
▪ Restructuring of Ordermanagement and Referal?
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Patient Identity Management : PDQ -- PIX -- PAM
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▪ IHE Transactions - Patientendata- Patient Identity Feed [ITI-8], [ITI-44, HL7 V3]
- Patient Identity Management [ITI-30]
- PIX Query [ITI-9], [ITI-45, HL7 V3]
- PIX Update Notification [ITI-10], [ITI-46, HL7 V3]
- Patient Demographics Query [ITI-21], [ITI-47, HL7 V3]
- Patient Demographics and Visit Query [ITI-22],
▪ Corresponding HL 7 v2.x Messages - Search
• Find candidates QBP^Q22
• Find candidates response RSP^K22
- Feed & Update
• Insert Patient ADT – A28
• Update Patient ADT – A31
• Merge Patient ADT – A40
Well adaopted by Web-Services
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Patient Encounter Management : PAM
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▪ IHE Transactions – Patientendata:- Patient Encounter Management [ITI-31]
- Patient Demographics and Visit Query [ITI-22],
▪ Corresponding HL 7 v2.x Messages - ADT_A01 Admission
- ADT_A02 Transfer
- ADT_A03 Discharge
- ADT_A04 Outpatient Treatment
- ADT_A06 Outpatient Inpatient
- ADT_A07 Inpatient Outpatient
- ADT_A08 PV-Data-Change
- ADT_A11 Storno Aufnahme
- ADT_A12 Storno Verlegung
- ADT_A13 Storno Entlassung
Still missing Web-Services
Candidates for new Services:• Confirmation of treatment-relation• Query for Insurance status
• PDQIDQ?IDQ = Insurance Data Query
• Conformation of Insurance
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IHE Problems in ELGA
▪ Content of PDQ & PIX – Anwser
- Some Dataelements in PDQ should be optional or handled as national extensions
▪ Image-Transfer across Enterprises
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Accounting
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▪
▪ IHE Transactions - Accounting
- Account Management [RAD-35]
- Charge Posted [RAD-36]
▪ Reporting of procedures and Diagnoses
- BAR_P05 (PR1-Segment)
- BAR_P05 (DG1-Segment)
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Order Management
Use Cases
▪ Inside Enterprise Ordering
- End to End
- Provider unknown
▪ Across Enterprise Ordering
- End to End
- Provider unknown
Requirements
▪ Integration HPD in XDS-Environment (XCA, XCPD)
▪ Providing detailed Catalogs by SVS
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THANK YOU FOR YOURATTENTION!
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