1st estandards conference: next steps for standardization in large scale ehealth deployment: use...

eStandards eHealth European Interoperability Framework

Use cases Extension Karima Bourquard, IHE-Europe

21 April 2015 - Berlin 643889

H2020-PHC-2014

April 21, 2016 ConHIT -Berlin 1

Objective

• Interoperability is a key challenge of Healthcare IT in the coming years

• Standards and profiles in healthcare are essential and are now ready for deployment

• The link between the user needs and the implementation in IT solutions is not obvious for an end-user

Guidance and tools were developed for bridging

business processes to technical steps and implementation


Introduction

• The eHealth European Interoperability Framework (eEIF) was published in 2012 where 1O use cases and its related profiles and standards were described

• It was refined in the Antilope project (January 2015): The Antilope Refined eEIF consists on

• A refined model for interoperability • A set of templates for uniform description of use cases • A set of use cases as the basis for interoperability projects • A glossary of healthcare interoperability terms and

definitions


Introduction


• From Antilope to – The adoption by the eHN of the common

Refined framework for managing interoperability and standardisation challenges in the eHealth domain in Europe

– The eStandards extension of the EIF use cases

Nov 2015

Jan 2016

The Refined EIF


Provide to healthcare providers (national/regional or local projects) a set of tools and guidance to implement exchanges or sharing health data in their projects based on

• Use cases describe the user needs in specific domain • Realisation scenarios describe interoperable architecture based on profiles and standards

Use Cases

• Easy for a clinician or patient to describe their needs with natural language

• Formalise the process using the template provided by the ReEIF

High level description

Request and results distribution workflow for Laboratory within the Hospital Test results from clinical laboratory services may be requested and should be made available to medical caregivers who work in multiple medical departments within the hospital organisation on a need-toknow basis. This use case should ensure the availability of timely, complete and consistent patient information as well as avoidance of potential duplicate testing within the hospital organisation.


Realisation Scenario

Translation of the use case in technical process steps and delivery of a selection of supporting profiles and standards (high level description)

• Technical process steps:

– Order placer requests laboratory tests through electronic testing and adds relevant medical information

(Laboratory assistant takes a blood sample from the patient, and brings it to the laboratory) (Blood sample is analyzed in the Laboratory Information System) – Results are stored in the Laboratory Information System – Results are copied to the Hospital Information System (internal link) – HP views the laboratory results in the HP EHR system

• Selection of profiles and standards – Patient and professionals identification: PAM,PIX, PDQ, HPD – Worflow and terminology: LTW, LCSD – Security: ATNA, CT


Benefit for Users

• Harmonisation of the use cases description by using common templates

• Repository of existing analysed use cases as a starting point for a new project wanted to specify its own implementation

• Offer facilities to share its own experience with other projects

Facilitate common understanding and acceptance of profiles and standards by sharing same process of

project description


eStandards extension

• ReEIF describes 10 uses cases at different scales: intra-organisation, regional/national and Europe

• Current Use cases cover different domains: – Medication, Radiology and laboratory – Patient Summary, Referral and discharge

reporting – Participatory Healthcare, multidiciplanary

consultation – Telemonitoring


New Use cases and realisation scenarios

• The new needs were collected among divers stakeholders: – eHealth Stakeholders group (Europe – DG-CNECT) – HOPE (European Hospital and healthcare

federation) – Eu projects: VALUEeHEALTH, OpenMedecine,

Decipher, Trillium Bridge,… – ESR/ECR: European Society of Radiologist – Partners of the eStandards project (Danish use

cases for example) • Profiling organizations: IHE, CHA


Selection of Use Cases/Realisation Scenarios (1/2)

• eS1: Integrated neonatal care – This use case is related to the summary of the antepartum ambulatory

care (Accessibility of the Antepartum information from the perspective of the clinical care needs for a future baby and its mother)

• eS2 : Mobile services to empower patient with heart failure (realization) – This is a realisation scenario of the ReEIF Use Case 6: Involvement of

chronic patients in electronic documentation of healthcare information. • eS3: Exchange of Patient Summaries across Atlantic (realization):

– This is a realisation scenario of the ReEIF Use Case 4 Patient summary sharing on a cross-border scale extended to the Cross Atlantic (EU/US exchanges)

• Use case eS4: Structured report in radiology ((realization): – This scenario is updated and the IHE MRRT profile (Management of the

Radiology report Manager) is added – In this scenario, the requesting and performing of the diagnostic study is

done within a healthcare institute, and the viewing of the results is done from outside the healthcare institute.


Selection of Use cases/Realisation Scenarios

• eS5 : Monitoring the radiation exposure (realization) – This is a new of realisation scenario of the ReEIF Use Case 2 request and results of

sharing workflow for radiology. – In this scenario, the dose information is collected when the exams in an imaging

XRay modalities or equipment are performed for a specific patient. • eS6: Immunization use case

– This use case is a new use case related to a new domain: Public Health. – Healthcare professionals need to determine if a vaccination should be

administered at the time of a clinical encounter. The reporting to public health that a vaccination has been administered to a patient

• eS7 : Healthcare Provider (realization) – Transversal and is related to all use cases. As for Patient identification

Management use cases that are made generic and present everywhere, the healthcare provider will also be part of all realisation scenario. The profile used is HPD.

• eS8 : Workflow care plan management (realization ) – This use case is a support to several realisation scenarios already developed in the

ReEIF when a care plan shall be developped and maintained (for example follow-up of chronic patients with heart diseases by a care manager)


Use Case Repository https://usecase-repository.ihe-europe.net/


Use case Repository: Realisation scenarios


Link to the list of IHE profiles for referencing in public procurement


On 28 July 2015 the European Commission announced that 27 IHE Profiles are eligible for referencing in public procurements as technical specifications. Official Journal of the European Union: http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=OJ:JOL_2015_199_R_0011

http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=OJ:JOL_2015_199_R_0011



Lessons learned

• Integration of new Use Cases and implementation scenarios with the support of the Antilope templates

• Same health information exchange architecture serves several use cases as demonstrated by the selection of common set of profiles and standardisation in different use cases

• Finally, by building a database repository, we expect an easy access of the use cases from stakeholders wanting to design their own infrastructure or implement profiles and standards.

A step forward for increasing the deployment of interoperable solutions in order to increase the development of a single digital market in Europe


QUESTIONS ?


1st estandards conference: next steps for standardization in large scale ehealth deployment: use...

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