IHE in Austria IHE Success Stories missing links

IHE in Austria IHE Success Stories, missing links and gaps Dipl. -Ing. Dr. Alexander SCHANNER Vienna, February 13 th 2014 www. lknoe. at

Agenda 1. Success-Stories in Austria IHE Requirements from an Austrian View 2. Missing Links 3. Gaps in IHE Profiles & Domains 2 www. lknoe. at

Decision of Federal Health Commission (BGK), May 2007 International standards for EHR (=ELGA) in Austria: IHE Requirements from an Austrian View ▪ IHE Frame-Work with domain - IT Infrastructure - Patient Care Coordination - Laboratory - Radiology ▪ HL 7 CDA 2. 0 as document standard ▪ LOINC (area laboratory data) ▪ DICOM 3. 0 incl. WADO (area radiology) ▪ HL 7 (in Version 3 with RIM as prospective data model) 3 www. lknoe. at

Decision of Federal Health Commission (BGK), December 2008 IHE Requirements from an Austrian View Implementation of ▪ a nationwide central Index of Health Service Providers ▪ a nationwide central Patient Index ▪ a nationwide System for e. Medication ▪ 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 4 th, 2007 concerning the applicable standards and the IHE framework. Furthermore, this decision has to complied with in all other e. Health applications of the federal entity, the provinces and the Social Security. 4 www. lknoe. at

IHE Requirements from an Austrian View IHE Affinity Domains in Austria as Part of ELGA: • • • Lower Austria Tyrol e. GOR Upper Austria Vienna Styria Carinthia AUVA Salzburg 5 www. lknoe. at

IHE Requirements from an Austrian View Hospitals in Lower Austria 6 www. lknoe. at

IHE Requirements from an Austrian View Numbers of Lower Austria (2012) Inpatient Treatments 383. 654 Inpatients 269. 830 Outpatient Treatments 2. 866. 952 Outpatients 1. 236. 017 Employes 15. 429 XDS & XDS-I Environment, Using XDW 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 7 21. 084 www. lknoe. at

Agenda 1. Success-Stories in Austria IHE Requirements from an Austrian View 2. Missing Links 3. Gaps in IHE Profiles & Domains 8 www. lknoe. at

Availability vs. Real World Implementations of IHE-Profiles ▪ Existing Profiles and Use Cases IHE Requirements from an Austrian View - Final Text, Date - Supplement for Trailimplementation ▪ Adoption of Profiles &Use Cases by Vendors ST - Testet Systems at CAT - Available Products on market ▪ Adoption of Profiles and Use Cases by Users PROD - Requirements in RFPs - Real World Implementations FT RWI CAT RFP 9 www. lknoe. at

Open Issues IHE Requirements from an Austrian View ▪ Migration from HL 7 v 2. x-World to Webservices - Cross Community Profiles are based on Webservices (HL 7 v 3) - • PIX/PDQ, XCPD (HL 7 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, . . ] ORM [RAD, . . ] CHG [RAD] [IT-I]? [IT-I, PCC, QRPH]? ▪ New Domain for Reimbursement and Insurance-Processes? ▪ Restructuring of Ordermanagement and Referal? 10 www. lknoe. at

Patient Identity Management : PDQ -- PIX -- PAM IHE Requirements from an Austrian View ▪ ▪ IHE Transactions - Patientendata - Patient Identity Feed [ITI-8], [ITI-44, HL 7 V 3] - Patient Identity Management [ITI-30] - PIX Query [ITI-9], [ITI-45, HL 7 V 3] - PIX Update Notification [ITI-10], [ITI-46, HL 7 V 3] - Patient Demographics Query [ITI-21], [ITI-47, HL 7 V 3] - Patient Demographics and Visit Query [ITI-22], Corresponding HL 7 v 2. x Messages - Search • Find candidates QBP^Q 22 • Find candidates response RSP^K 22 - Feed & Update • Insert Patient ADT – A 28 • Update Patient ADT – A 31 • Merge Patient ADT – A 40 Well adaopted by Web-Services 11 www. lknoe. at

Patient Encounter Management : PAM ▪ IHE Requirements from an Austrian View ▪ IHE Transactions – Patientendata: - Patient Encounter Management [ITI-31] - Patient Demographics and Visit Query [ITI-22], Corresponding HL 7 v 2. x Messages - ADT_A 01 Admission - ADT_A 02 Transfer - ADT_A 03 Discharge - ADT_A 04 Outpatient Treatment - ADT_A 06 Outpatient Inpatient - ADT_A 07 Inpatient Outpatient - ADT_A 08 PV-Data-Change - ADT_A 11 Storno Aufnahme - ADT_A 12 Storno Verlegung - ADT_A 13 Storno Entlassung Candidates for new Services: • • • Confirmation of treatment-relation Query for Insurance status • PDQ IDQ? IDQ = Insurance Data Query Conformation of Insurance Still missing Web-Services 12 www. lknoe. at

IHE Problems in ELGA ▪ Content of PDQ & PIX – Anwser IHE Requirements from an Austrian View - ▪ Some Dataelements in PDQ should be optional or handled as national extensions Image-Transfer across Enterprises 13 www. lknoe. at

IHE Requirements from an Austrian View Accounting ▪ ▪ IHE Transactions - Accounting ▪ - Account Management [RAD-35] - Charge Posted [RAD-36] Reporting of procedures and Diagnoses - BAR_P 05 (PR 1 -Segment) - BAR_P 05 (DG 1 -Segment) 14 www. lknoe. at

Order Management Use Cases IHE Requirements from an Austrian View ▪ ▪ 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 15 www. lknoe. at

IHE Requirements from an Austrian View THANK YOU FOR YOUR ATTENTION! alexander. schanner@holding. lknoe. at 16 www. lknoe. at