The Way to the Electronic Health Record in Austria 2 nd eHealth and eGovernment Conference 25th Apri

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The Way to the Electronic Health Record in
Austria2 nd eHealth and eGovernment
Conference25th April, 2007Theresa Philippi,
LL.M, MASDeputy Programme-ManagerTask Force
Electronic Health Record
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Introductory remarks

• ELGA does not substitute the doctors diagnosis
  and cure
• ELGA aims at facilitating work within the health
  system
• Institutions vary from country to country
• Implementation takes time!

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Agenda

• Starting Point
• Basic Components and Main Applications
• Data Protection
• Arge ELGA (Task Force Electronic Health Record)

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Starting Point

• Political target using IT for the establishment
  of integrated medical care (communication between
  hospitals, GPs and other Health Service
  Providers)
• Agreement between federal entity and regions
• Feasibility study by Federal Health Agency
• e-health initiative
• STRING commission (standards and guidelines for
  introduction of information technology in the
  Austrian health sector) / data protection
  commission
• IT forum
• e-card

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Definition of ELGA

• ELGA contains relevant multimedia-based and
  health related data and information referring to
  a precisely identified person.
• Data und information originate from
• different healthcare providers and
• from the patient
• and are stored in one or several different
  information systems (virtual health record).
• Data are available independent of place and time
  (cost-saving) at the place of treatment for all
  authorized persons according to their tasks and
  data protection conditions in a way that meets
  the requirements.

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Agenda

• Starting Point
• Basic Components and Main Applications
• Data Protection
• Arge ELGA

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Overview of Basic Components and Main Applications
ELGA Core Applications First Implementation Phase
ELGA Basic Components
Preconditions for ELGA
Storage and Filing
Citizen / Patient
ELGA Basics
Patients Index nationwide compatible with EU

• Portal
• Health Information
• Current Topics
• HCP Information
• Health Promotion
• Portal Applications

Documents Registry centralized
Legal Measures Data Protection
e-Medication (doctor, hospital, pharmacy)
e-Report (radiology)
HCP Index roles authorizations access protocols
Consumers Acceptance Management
e-Report (laboratories)
e-Medical Summary
Storage of individual documents decentralized
Network
Organisational Measures
Standards
Portal
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Framework Architecture and Main Applications
A hyper-index with sophisticated search
functions
ELGA
Doctor
Portal
HCP Index
Citizen Card with PIN
Registry
Authorization System
Patients Index
reading
writing
Adaptor
Adaptor
Adaptor
e-Report (radiology, laboratories)
e-Medical Summary

e-Medication
Data Sources
Adaptors Interfaces which make existing
applications compatible with ELGA
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ELGA View on Data
HCP
HCP Index
Patient
Central Storage of Data
Patients Index
Registry
Authorization System
HCP - Local Storage of Data
Radiology Findings
Laboratory Findings
Medication
Medical Summary
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Hierarchical View on ELGA
HCP Index
Authorization System
Patients Index
Central Storage of Data
ELGA Visibility
Registry
Signature, Entry in Registry
HCP - Local Storage of Data
Findings Laboratory
Medical Summaries
X-ray
Precise link to a document, URL
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Writing and Reading in ELGA
HCP Index
Authorization System
Doctor
Doctor
Hospital
Hospital
Patients Index
Registry
lesend
reading
writing
reading
writing
Data Sources
Data Sources
Findings Laboratory
Medical Summaries
X-ray
Storage
Log in Patients Identification
Search for documents, URL
Registration
Access to documents
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The current eHealth Network in Austria
Health Intranet
Citizen
A-Trust
Internet z.B. xDSL, UMTS
Self-help- groups
Portals
e-SV
help.GV.at
Private Portals
HealthRing
Hospital
Hospital
Hospital Association A
Pharma Industry
Hospital Association B
Hospital Association C
Hospital
Hospital
Private Corporate Networks
Hospital
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International StandardsOverview and
Classification
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International Standards

• Strategy
• established, internationally used standards
• Hospital Information System (KIS) Providers have
  to comply with the international market,
  Austrias operating companies focus on
  internationally widespread KIS
• HL7 RIM (Health Level 7 Reference Information
  Model) and CDA (Clinical Document Architecture)
  are preferred candidates for data model and
  document configuration
• IHE XDS (Cross Enterprise Document Sharing)
  including PCC (Patient Care Coordination) for
  document exchange.

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Agenda

• Starting Point
• Basic Components and Main Applications
• Data Protection
• Arge ELGA

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Information Path in IHE XDS with Patient Care
Coordination (PCC)
HCP Index
Authorization System
Doctor
Doctor
Hospital
Patient Index
Patients Index
Hospital
Dokumentenregister
Registry
lesend
reading
writing
reading
writing
Data Source
Data Source
After storage and registration specific
information to another HCP with transmission of
registry data (URL)
Storage
Log in Patients Identification
Search for Documents, URL
Registry
Access to Documents
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Agenda

• Initial Situation
• Basic Components and Main Applications
• Data Protection
• Arge ELGA (Task Force Electronic Health Record)

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Data Protection and Data Security

• Data protection is an indispensable precondition
  for the success of ELGA
• Close cooperation with all groups of society
• Legal implementation along technical
  implementation
• Rules of consent and objection have to be
  evaluated and determined
• Roles and authorization system
• Gapless logging

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Arge ELGAArbeitsgemeinschaft Elektronische
Gesundheitsakte

• Decision of Federal Health Commission from July
  2006 concerning establishment of Arge ELGA and
  financial dotation
• Working basis of Arge ELGA is an civil law
  contract between
• Federal Government
• Provinces and
• Social Insurance Institutions
• Since September 2006 ARGE ELGA is up and
  running

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Organisation of Arge ELGA
Steering Committee
Social Insurance
Provinces
Federal Government
Auer Chairman
Kandlhofer
Vlasich
Völkl
Schmidl
Gaugg
Pöchacker
Gauss
Hawliczek
ELGA - operational
Dipl.-Ing. Heinz OTTER 1st Vice Program Manager
Mag.a Theresa PHILIPPI LL.M, MAS 2nd Vice
Program Manager
DI Dr. Alexander SCHANNER Program Manager
Monika Posch Assistant to Program Management
Mag.a (FH) Angela LUKASCHEK Project Assistant
Dr.med.univ. Martin HURCH Senatsrat
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Target of Arge ELGA according to Agreement

• The objective of the ELGA Task Force is to drive
  the connection of existing and future electronic
  information and documentation systems in the
  Austrian health care system within the scope of a
  multi-project management.
• The main target is the establishment of the so
  called electronic health record (ELGA) in order
  to increase quality and efficiency of the health
  care system.

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Tasks of Arge ELGA according to Agreement

• Among others
• Assistance to the Federal Health Agency
  concerning controlling and coordinating
  activities
• Definition of strategic priorities for the
  establishment of ELGA and of the roadmap for its
  implementation
• Planning of detailed concepts and implementation
  of projects to introduce ELGA as well as the
  development of financing proposals
• Demand of necessary legal amendments and the
  binding use of approved standards
• Crisis and escalation management
• Evaluation of project results.

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Basic Applications of ELGA

• Medical care
• Patients management
• Organisation of treatment processes
• Information for patients

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Future Applications of ELGA

• Management tool for public health
• Self-contained health related activities of the
  patient
• Financial and administrative processes
• Monitoring of healthcare system
• Science and research
• Target avoid parallel structures!

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• Thank you for your Attention!