Benelux Ehealth Interoperability - Summit

Luc NicolasHealth Telematics, Informatics and Communication UnitPublic Federal Service Public Health

Ehealth Roadmap

Hub-metahub: system to system communication

Current situation in ambulatory care

Approach for institutions

Some roads for tomorrow

eHealth certification in Belgium

Gregory•<GP> <Specialist>

<Imaging> <Prescriptions>

<Chapter 4> <Pharmacist>

<MyCarenet> <DMG>

<Laboratory> <Status

handicaped> <work

incapacity>

Emily

<Homecare> <MRS> <Belrai>

<Clinical path>

<Hospitalisation> <Dentist>

<Sumehr> <multidisciplinary

collaboration> <Paliative care>

< Home Hospitalisation>

Hillary<Psychiatry> <Méthadone>

<CPAS> <Ambulance> <Emergency> <Laboratory>

<Imaging> <Sumehr> <DMG> <Wachtpost>

Mona<Auto monitoring> <Tele

consultation> <Tele monitoring> <Sumehr>

<Personal health record> <Electronic Prescription>

<eFact> <eBirth>

<Hospitalisation> <Implant> <Laboratoire> <Imaging>

<Sumehr> <Therapeutic scheme> <MyCarenet> <Register>

<RHM>

Dorian

>Ehealth Roadmap (2014-2018)

Sharing data via thehubs & metahub system

2014: Consultation reports, discharge letters and surgery protocols,

other reports and corresponding data.

2015: Imaging results and reports, implants

placing

2016: Integration of data of other institutions

4

5

525/6/2010

27 Standardized web services

8

Basic serviceseHealth platform

Network

Basic services and authentic sources

Patients, healthcare providersand institutions

ADS ADSADS

Suppliers

Users

eHealth platformPortal

Health Portal

VASVASVASVAS Healthcare institution software

VASVASVASVASMyCareNet

VASVASVASVAS

Care provider software

VASVASVASVASRIZIV-INAMI

siteVASVASVASVAS

ADSADSADS

Testing and certification

- Mini « connecthatons »: - First targeted at Hubs and Metahub (Ehealth) - Opened later to other systems

- Certification of individual Hospitals by Hubs.- Certification of ambulatory care systems by

Prorec/Ehealth

Hospital EHR: Minimum data set per discipline mapped with technical and semantic standards

End 2014: • -Mapping rules to normallised clinical language for all main registers

•- Publication of functonalities referential (To be implemented by 2017)

•New standardized discharge letter

End 2015: Minimum Content

data set (implementation end

2016)

End 2016:

- Structure (instauration fin

2017)

- Schéma de médication de sortie

2017: EHR partially coded

End 2017: Compulsory system

to system communication for feeding registers

10

Global: Legal certificationTelematics CommissionEhealth Platform

SectorialLabel working-groupsUsers working-groupsProducers working-groupsFinancial incentives

> Ambulatory care systems

> Legal context

Chapitre 3 - Missions de la plate-forme eHealth

Article 5

La plate-forme eHealthest chargée des missions suivantes en vue de l'exécution de son objectif:

développer une vision et une stratégie pour une prestation de services et un échange d'informations électroniques dans les soins de santé efficaces, effectifs et dûment sécurisés, tout en respectant la protection de la vie privée et en concertation étroite avec les divers acteurs publics et privés des soins de santé;déterminer des normes, des standards et des spécifications TIC fonctionnels et techniques ainsi qu'une architecture de base utiles pour la mise en oeuvre des TIC à l'appui de cette vision et de cette stratégie;vérifier si les logiciels de gestion des dossiers électroniques de patients répondent aux normes, standards et spécifications TIC fonctionnels et techniques, et enregistrer ces logiciels;

> Content

Block 1 : CriteriaBlock 2 : Kmehr

-Technical (incl. security)-Patient data management-Key added value services (data exchange) -Usability -Customer Services criteria (incl.data portability)

Kind Messages for Electronic Healthcare RecordsBelgian Implementation Standard

> Conceptual model> Transaction types> XML implementation> Coding systems

>> Kmehr

Summarized Electronic Health Record

> Kmehr transaction> Multipurpose content> Homologation criteria> European target

>> Sumehr

- Voluntary - Organized every 2 years- Scenari and testing by PROREC (call for

tender)- (Partially)funded by industry- Link with financial incentive for users (800

€/year)- Partial consolidation of the market ongoing

Process

APPROACH FOR INSTITUTIONSACTION 2 ROADMAP

REFERENTIALS HOSPITAL EHR

– 1. Fonctionnalities: May 2014– 2. Content (exchange + registers): Ongoing– 3. Structure (recommandation): October 2014

17

FUNCTIONALITIES

18

PART 1

19

20

21

Exemple:22

CONTENT: Ongoing

2 inputs:

-> Partial normalisation linked to data exchange

Discharge letter

Labo

Specialities reports

Key (observable) data

-> Registers (action 18)

23

24

Action 18: Inventaire et consolidation des registres

End 2014: Detailed inventory of all existing registers and databases

“Cet inventaire détaillera au minimum la description précise des champs de données collectées, leur statut (facultatif ou non), leur format, les codifications (propriétaires ou non) utilisées, le type d’utilisateur et d’institutions concernés ainsi que toute autre Information contextuelle indispensable.”

2014: referential per profession/context

– Governance criteria for new registers

25

131 registres (and counting..)

1. Ambulatory Care Health Information Lab (RIZIV-INAMI) 2. Annual Hospital Statistics (FOD-SPF) 3. Antwerpen registry of congenital anomalies (EUROCAT) 4. Belgian Abortion Register (FOD-SPF) 5. Belgian AIDS-reference centres (WIV-ISP) 6. Belgian AIDS-reference laboratories (WIV-ISP) 7. Belgian alpha-1 antitrypsin deficiency registry (Alpha One International Registry (AIR)) 8. Belgian Association for Cardio-Thoracic Surgery Database 9. Belgian Cancer Register: Standard version (Belgian Cancer Registry) 10. Belgian Cystic Fibrosis registry (WIV-ISP) 11. Belgian Early Warning System for Drugs (WIV-ISP) 12. Belgian familial adenomatous polyposis registry 13. Belgian Langerhans cell histiocytosis registry (LCH) 14. Belgian Neuromuscular Disease Registry (WIV-ISP) 15. Belgian patient database for Wilson disease (EuroWilson registry) 16. Belgian Patient registry for rare bleeding disorders 17. Belgian Pediatricians Nephrology Registry (BPNR) 18. Belgian Register for Assisted Procreation (National College of Physicians in Reproductive

Medicine) 19. Belgian Register Substitution Treatment (FAGG-AFMPS) 20. Belgian registry of primary immunodeficiencies (ESID European registry) 21. Belgian registry on acromegaly, epidemiology and quality of care (ACROBEL) 22. Belgian severe chronic neutropenia patient registry (SCN international registry (SCNIR) 23. Belgian sickle cell anemia registry 24. Belgian systemic sclerosis cohort 25. Belgian Virtual Tumourbank (Belgian Cancer Registry) 26. Belgian Treatment Demand Indicator Register (WIV-ISP) 27. BINC: Begeleiding in Cijfers 28. Biobank of the pediatric granulomatous arthritis international registry (UZLeuven) 29. Birth Register (VAZG, Observatbru, DGOPLASS, ADSEI) 30. Central Register of Rare Diseases (WIV-ISP) 31. Database Farmanet (IMA-AIM) 32. Database Health Care (IMA-AIM) 33. Database Population (IMA-AIM) 34. Database Palliative care (federatie palliatieve zorg Vlaanderen) 35. Declaration of Infectious diseases (MATRA, WIV-ISP) 36. Drug Related Infectious Diseases (WIV-ISP) 37. EFFectiveness of Endometrial Cancer Treatment (EFFECT) (Belgian Cancer Registry) 38. End of career measures (FOD-SPF) 39. Electronic Patient Registration Centers Mental Health Care Flanders 40. European alternating hemiplegia and rare epilepsies registry in childhood (ENRAH) 41. European Antimicrobial Resistance Surveillance Network (WIV-ISP) 42. European network for the study of orphan nephropathies registry (EUNEFRON) 43. European patient registry and cohort for congenital disorders of glycosylation (EUROGLYCANET) 44. European Point Prevalence Survey (PPS AB & HAI; WIV-ISP) 45. European registry of human alveolar echinococcosis: Belgium (EURECHINOREG) 46. European Surveillance of Antimicrobial Consumption (ESAC-Net; WIV-ISP) 47. Flemish Renal Registry (NBVN)

1. Haemoglobinopathies - database 2. Handhygiën (WIV-ISP) 3. Head and Neck: orofarynxcarcinomen Project (Belgian Cancer Registry) 4. Healthcare Associated Infections & Antimicrobial Use in European Long Term Care Facilities

(WIV-ISP) 5. Hospital Financing (FINHOSTA, FOD-SPF) 6. Infectious diseases (sentinel laboratories) (WIV-ISP) 7. Informatiestroom tussen de ziekenhuizen en de administratie gezondheidszorg (VAZG) 8. Initiative for Quality improvement and Epidemiology in Diabetic Foot clinics (WIV-ISP) 9. Initiative for Quality promotion and Epidemiology in Diabetes care (WIV-ISP) 10. Initiative for Quality promotion and Epidemiology in Diabetes care for children and adolescents

(WIV-ISP) 11. Integrated Computerized Network, INTEGO 12. Medical Emergency Services: MUGREG (FOD-SPF) 13. Minimum Hospital Data (FOD-SPF) 14. Minimum Psychiatric Data (FOD-SPF) 15. MIRAGE database (IKAROS; Kind & Gezin) 16. Mortality Register (VAZG, Observatbru, DGOPLASS, ADSEI) 17. National Surveillance of Antimicrobial Use in Belgian Hospitals (WIV-ISP) 18. National Surveillance of Healthcare Associated Infections in Intensive Care Units (WIV-ISP) 19. National Surveillance of Influenza (WIV-ISP) 20. National Surveillance of Meticillin resistant Staphylococcus aureus (MRSA) in Belgian hospitals

(WIV-ISP) 21. National surveillance of multi-resistant micro-organisms in Belgian hospitals (WIV-ISP) 22. National Surveillance of Septicemia in the Hospital (WIV-ISP) 23. National Surveillance of Surgical Site Infections (WIV-ISP) 24. Netoverschrijdend ICT-project van de CLB's in samenwerking met het departement Onderwijs

(VAZG) 25. Newborn college Register 26. ORTHOpedic Prosthesis Identification Data (RIZIV-INAMI) 27. Pediatric granulomatous arthritis international registry 28. Permanent Sample (IMA-AIM) 29. PROCARE (Belgian Cancer Registry) 30. Prospective collection of tissue, ascites and plasma samples from patients with ovarian cancer

(UZLeuven) 31. Qermid©Coronaire stents (RIZIV-INAMI) 32. Qermid©Endoprothesen (RIZIV-INAMI) 33. Qermid©Hartdefibrillatoren (RIZIV-INAMI) 34. Qermid©Pacemakers (RIZIV-INAMI) 35. Quality Indicators Healthcare Associated Infections (WIV-ISP) 36. Register POMALYST (Celgene) 37. Register REVLIMID (Celgene) 38. Register THALOMID (Celgene) 39. Rest/care homes (FOD-SPF) 40. Robot Assisted Laparoscopic Prostatectomie (RALP) (Belgian Cancer Registry) 41. Sentinel General Practitioners (WIV-ISP) 42. Sexually transmitted infection (sentinel surveillance) (WIV-ISP) 43. Shared Arthritis File for Electronic use (RIZIV-INAMI)

Results Inventory

27

Database HD code Host Survey completedSurvey ongoingItem list completedItem list Ongoingregister in developmNO PARTICIP!Ambulatory Care Health Information Lab HD001 WIV-ISP / RIZIV-INAMI 1 1ORTHOpedic Prosthesis Identification Data HD099 WIV-ISP / RIZIV-INAMI 1 1Qermid©Coronaire stents (RIZIV-INAMI) HD104 WIV-ISP / RIZIV-INAMI 1 1Qermid©Endoprothesen (RIZIV-INAMI) HD105 WIV-ISP / RIZIV-INAMI 1 1Qermid©Hartdefibrillatoren (RIZIV-INAMI) HD106 WIV-ISP / RIZIV-INAMI 1 1Qermid©Pacemakers (RIZIV-INAMI) HD107 WIV-ISP / RIZIV-INAMI 1 1Shared Arthritis File for Electronic use HD117 WIV-ISP / RIZIV-INAMI 1 1Belgian Cystic Fibrosis registry HD008 WIV-ISP 1 1Belgian Neuromuscular Disease Registry HD012 WIV-ISP 1 1Belgian Register of Haemophilia HD131 WIV-ISP 1Central Register of Rare Diseases HD031 WIV-ISP 1 1Initiative for Quality improvement and Epidemiology in Diabetic Foot clinics HD071 WIV-ISP 1 1Initiative for Quality promotion and Epidemiology in Diabetes care HD072 WIV-ISP 1 1Initiative for Quality promotion and Epidemiology in Diabetes care for children and adolescents HD073 WIV-ISP 1 1Sentinel General Practitioners HD114 WIV-ISP 1 1European Antimicrobial Resistance Surveillance Network HD048 WIV-ISP 1 1European Point Prevalence Survey HD051 WIV-ISP 1 1European Surveillance of Antimicrobial Consumption HD053 WIV-ISP 1Handhygiën HD066 WIV-ISP 1 1Healthcare Associated Infections & Antimicrobial Use in European Long Term Care Facilities HD068 WIV-ISP 1 1National Surveillance of Antimicrobial Use in Belgian Hospitals HD083 WIV-ISP 1 1National surveillance of Gram-negative multi-resistant micro-organisms in Belgian hospitals HD084 WIV-ISP 1 1National Surveillance of Healthcare Associated Infections in Intensive Care Units HD085 WIV-ISP 1 1National Surveillance of Meticillin resistant Staphylococcus aureus (MRSA) in Belgian hospitals HD087 WIV-ISP 1 1National Surveillance of Septicemia in the Hospital HD088 WIV-ISP 1 1National Surveillance of Surgical Site Infections HD089 WIV-ISP 1 1Quality Indicators Healthcare Associated Infections HD108 WIV-ISP ?Surveillance of Clostridium difficile infections HD118 WIV-ISP 1 1HIV viral loads register HD069 WIV-ISP 1 1National Surveillance of Influenza HD086 WIV-ISP 1 1Notifiable Infectious diseases register (MATRA – BRU) HD092 WIV-ISP ? ?Notifiable Infectious diseases register (MATRA Fédération Wallonie-Bruxelles)HD093 WIV-ISP ? ?Sentinel hospitals for Severe Acute Respiratory Illness HD115 WIV-ISP 1 ?Sexually transmitted infection (sentinel surveillance) by STi clinicians HD116 WIV-ISP 1 1Surveillance of Creutzfeldt-Jakob disease in Belgium by neurologists HD119 WIV-ISP 1 1Surveillance of HIV/AIDS by Belgian AIDS-reference centres HD120 WIV-ISP 1 1Surveillance of HIV/AIDS by Belgian AIDS-reference laboratories HD121 WIV-ISP 1 1Surveillance of infectious diseases by National reference centre for humane microbiology HD122 WIV-ISP 1 1Surveillance of Infectious diseases by sentinel laboratories HD123 WIV-ISP 1 1Surveillance of Infectious diseases in Children by paediatricians and GP (PediSurv; WIV-ISP)HD124 WIV-ISP 1 1Belgian Early Warning System for Drugs HD009 WIV-ISP 1 1Belgian Register Drug Related Infectious Diseases HD016 WIV-ISP 1Belgian Treatment Demand Indicator Register HD026 WIV-ISP 1 1Brussels Registration of Tuberculosis HD030 VRGT-FARES 1 1Flemish Registration of Tuberculosis HD060 VRGT 1 1Database Birth Register (Flanders) HD033 VAZG 1 1Database Centers Mental Health Care Flanders HD034 VAZG 1 1Database Mortality Register (Flanders) HD038 VAZGDatabase Occupational health (Flanders) HD039 VAZGDatabase Pupil Guidance Centres (CLB) HD042 VAZG ?Database Studiecentrum voor Perinatale Epidemiologie HD043 VAZG 1 1Flemish population survey on breast cancer HD055 VAZG 1 1Flemish population survey on cervical cancer HD056 VAZG 1 1Flemish population survey on colon cancer HD057 VAZG 1 1Flemish population survey on congenital metabolic disorders HD058 VAZGNotifiable Infectious diseases register Flanders HD094 VAZG 1 1Vaccinnet HD127 VAZG 1 1Vesta / family care HD128 VAZG 1 1Belgian Langerhans cell histiocytosis registry HD011 UZLeuven ?Belgian Patient registry for rare bleeding disorders HD014 UZLeuven ?Belgian rituximab therapy registry for immune anemia and thrombocytopeniaHD022 UZLeuven ?Newborn college Register HD091 UZLeuven 1Pediatric granulomatous arthritis international registry HD100 UZLeuven ?Prospective collection of tissue, ascites and plasma samples from patients with ovarian cancer HD103 UZLeuven ?Haemoglobinopathies - database HD064 ULBruxelles 1 1Tissue samples of patients with primary immune deficiencies HD126 UGent ?Belgian systemic sclerosis cohort HD025 UCLouvain 1 1Belgian severe chronic neutropenia patient registry HD023 SCN international registry SCNIR 1Tellus HD125 SAW 1 1Flemish Registration of acute coronary events HD059 RACA 1 1French Registration of acute coronary events HD063 RACA ?Flemish Renal Registry HD061 NBVN 1 1Belgian Register for Assisted Procreation HD017 National College of Physicians in Reproductive Medicine1 1Biobank of the pediatric granulomatous arthritis international registry HD029 KULeuven ?Delta HD044 KULeuvenNavigator HD090 KULeuvenIntegrated Computerized Network, HD074 INTEGO KULeuven 1Database Farmanet HD035 IMA-AIM 1 1Database Health Care HD036 IMA-AIM 1 1Database Population HD041 IMA-AIM 1 1Permanent Sample HD101 IMA-AIM 1 1MIRAGE database HD082 IKAROS; Kind & Gezin 1 1French Community Renal Registry HD062 GNFB 1 1Rest/care homes HD112 FOD-SPF 1 1Annual Hospital Statistics HD002 FOD-SPF 1 1Belgian Abortion Register HD004 FOD-SPF 1End of career measures HD046 FOD-SPF 1 1Hospital Financing HD070 FOD-SPF 1 1Medical Emergency Services: MUGREG HD079 FOD-SPF 1 1Minimum Hospital Data HD080 FOD-SPF 1 1Minimum Psychiatric Data HD081 FOD-SPF 1 1e-vax HD054 Fédération Wallonie-Bruxelles 1 1Database Palliative care HD040 federatie palliatieve zorg Vlaanderen 1Walloon Registration of Tuberculosis HD129 FARES 1 1Belgian Register Substitution Treatment HD018 FAGG-AFMPS 1Notification of adverse reactions after taking a medicine for human use HD095 FAGG-AFMPS 1 1Notification of adverse reactions following the administration of blood or a blood derivativeHD096 FAGG-AFMPS 1 1Notification of adverse reactions following the use of a human body material (tissues, cells)HD097 FAGG-AFMPS 1 1Notification of adverse reactions following the use of a medical device and / or accessoryHD098 FAGG-AFMPS 1 1Belgian patient database for Wilson disease HD013 EuroWilson registry ?European patient registry and cohort for congenital disorders of glycosylation HD050 EUROGLYCANET ?Antwerpen registry of congenital anomalies HD003 EUROCAT 1 1Hainault and Namur registry of congenital anomalies HD065 EUROCAT ?European registry of human alveolar echinococcosis: Belgium HD052 EURECHINOREG ?European network for the study of orphan nephropathies registry HD049 EUNEFRON ?Belgian registry of primary immunodeficiencies HD020 ESID European registry 1 1European alternating hemiplegia and rare epilepsies registry in childhood HD047 ENRAH ?Register POMALYST HD109 Celgene ?Register REVLIMID (Celgene) HD110 Celgene ?Register THALOMID (Celgene) HD111 Celgene ?Belgian Pediatricians Nephrology Registry HD015 BPNR 1 1InterRAI Acute Care Belgium HD075 BelRAI 1InterRAI Home Care Belgium HD076 BelRAI 1InterRAI Long Term Care Facility Belgium HD077 BelRAI 1InterRAI Palliative Care Belgium HD078 BelRAI 1Belgian Registration of acetabular and pelvic fractures HD019 Belgian Orthopaedic Trauma Association (BOTA)1 1Head and Neck: orofarynxcarcinomen Project HD067 Belgian Cancer Registry 1 1Belgian Cancer Register: Standard version HD007 Belgian Cancer Registry 1 1Belgian Virtual Tumourbank HD027 Belgian Cancer Registry 1 1EFFectiveness of Endometrial Cancer Treatment (EFFECT) HD045 Belgian Cancer Registry 1 1PROCARE HD102 Belgian Cancer Registry 1 1Robot Assisted Laparoscopic Prostatectomie (RALP) HD113 Belgian Cancer Registry 1 1Belgian Association for Cardio-Thoracic Surgery Database HD006 Belgian Association for Cardio-Thoracic Surgery1 1Begeleiding in Cijfers (BINC) HD028 Agentschap Jongerenwelzijn 1 1Database Birth Register (Belgium) HD032 ADSEI 1 1Database Mortality Register (Belgium) HD037 ADSEI 1 1Belgian registry on acromegaly, epidemiology and quality of care HD021 ACROBEL ?Belgian alpha-1 antitrypsin deficiency registry (Alpha One International Registry (AIR))HD005 ?Belgian familial adenomatous polyposis registry HD010 ?Belgian Register of Gametes HD130 1Belgian sickle cell anemia registry HD024 1 1

62 30 53 34 5 5

N = 131- 62 completed web based questionnaires- 30 incomplete web based questionnaires (in progress)- 53 completed sets of parameters and list of values- 34 sets of parameters in progress- 5 registers in development- 5 registers refused participation

Info will be available in meta data portal (October 2014)

Intermediate results mapping with RHM/MZG

28

MZG parameter n MZG parameter n

1 CODE_DIAGNOSE 370 11 A2_YEAR_HOSP_IN 15

2 PATNUM 67 12 CODE_UNIT 11

3 A2_CODE_DIAG_CAUSE_DEATH

47 13 STAYNUM 8

4 M2_CODE_PROCEDUR 40 14 YEAR_SPEC_IN 8

5 A2_CODE_SEX 34 15 A2_CODE_DESTINATE 7

6 HOSPITAL 33 16 YEAR_PROCEDUR 7

7 A1_YEAR_BIRTH 32 17 A2_CODE_COUNTRY 6

8 M2_YEAR_PROCEDUR 21 18 A2_CODE_INDIC_NAT 5

9 A2_CODE_ZIP 19 19 CODE_SPEC 5

10 A2_YEAR_HOSP_OUT 19 20 S4_NUMBER_BED 5

> 700 matches between MZG and parameters of Registers

Part 3 : Structure (To come)29

- Le modèle est basé sur une façon orientée “problème” de documenter les

- Il demande aux systèmes d’être basés sur le principe de “période de soins”.

- Il implique que tous les contacts avec tous les prestataires en rapport avec une maladie soient reliés ensemble.

- Une fois implémenté il rend possible de regrouper toutes les interventions et d’évaluer les résultats atteints pour un problème spécifique – sans considération de qui a fourni le service..

Process

• - Voluntary• - Bottom-up approach for referentials• - Governance: Federating public institutions• - Exchange (Hubs-metahub) de facto compulsory• - Use of auto-certification ? (security) • - Progressive Meaningful use policy (From 2014 on)

18 Inventoryr and

consolid

ation of registers

31

2. Developpem

ent of an H

ospital E

HR

3.Data on delivered m

edicines and

medication schem

e

8. S

tand

ard

com

plex

pat

ient

s

a

nanm

ese s

et

15. Harmonisation and

administrative simplification

11. D

efin

e com

plem

entar

y def

ault

acee

s rul

es

16. Tracability of medical devices

9. Funding linked to effective meaningful use

6.  DPI minimal in each sector 5: hub-méta-hub

13. Terminology

Objective

Passer d’une vision de travail en « silo » des besoins vers une vision intégrée et inter-opérationnelle

To Be

Hospital Patient summary Snomed based CMV

rhm

Health DATA.be

ICD

-10-

CM

Sno

med

33

1. serveur terminologique

Utilisateurs

Software

SVA

…

ProcessBE administratifsou médicaux - Dossier médical, - Remboursement, - Registre du cancer, ...

<txt>FR

<txt>NL

…ICD-10ICD-9Snomeddesc.P.T.

<txt>FR

<txt>NL

…ICD-10ICD-9Snomeddesc.P.T.

Interfacesde consultation

• Load/Extract

• Requêtes

• Mapping

• Feed back

Terminologie de référence• Mises à

jour• Gestion

des versions

• Couplage, mapping

• Gestion des règles

• Validation

• Webservice / webap.

Interfacesde Gestion

Workflow de validation

• Glossaires

• Documentation et références

• Portail

Documentation

SNOMED

labo

procéd.

diagn.

...Registres

ICD10

INAMI.

Sources et classifications

ProcessBE administratifs

ProcessBE cliniques

34

2. Terminology center

3. Reference terminology (snomed.be)

ICD_10_Code SNOMEDID Snomed CT number EN_Clinical_Label Fr_Belgium Nl_Belgium

C08.9 M-81473 34603009 Basal cell adenocarcinoma adénocarcinome basocellulaire basaalcel adenocarcinoom

C16.9 M-81423 37995004 Linitis plastica linite plastique linitis plastica

C25.4 M-81513 20955008 Insulinoma, malignant insulinome malin maligne insulinoom

C25.4 M-81523 66515009 Glucagonoma, malignant glucagonome malin maligne glucagonoom

C25.4 M-81533 19756007 Gastrinoma, malignant gastrinome malin maligne gastrinoom

C44.9 M-84013 57141000 Apocrine adenocarcinoma adénocarcinome apocrine apocrien adenocarcinoom

C45.9 M-90503 62064005 Mesothelioma, malignant mésothéliome mesothelioom

C49.9 M-91333 54124005 Epithelioid hemangioendothelioma, malignant

hémangioendothéliome épithélioïde malin

hemangio-endotheliaalsarcoom

C56 M-86003 57622002 Thecoma, malignant thécome malin maligne thecoom

C69.2 M-95123 12354007 Retinoblastoma, undifferentiated rétinoblastome indifférencié ongedifferentieerd retinoblastoom

C71.9 M-938FF 115240006 Glioma gliome glioom

C71.9 M-94233 12943006 Polar spongioblastoma spongioblastome polaire polair spongioblastoom

C71.9 M-94243 78838008 Pleomorphic xanthoastrocytoma xanthoastrocytome pléomorphe xanthoastrocytoom

C71.9 M-94423 35262004 Gliosarcoma gliosarcome gliosarcoom

C71.9 M-94733 39781001 Primitive neuroectodermal tumor tumeur primitive neuro-ectodermique

primitieve neuro-ectodermale tumor

C75.5 M-86803 9903002 Paraganglioma, malignant paragangliome malin maligne paraganglioom

C75.5 M-86933 32512003 Extra-adrenal paraganglioma, malignant

paragangliome extrasurrénalien malin

maligne extra-adrenaal paraganglioom

D27 M-84600 22116003 Papillary serous cystadenoma cystadénome papillaire séreux sereus papillair cystadenoom

D27 M-90000 74739000 Brenner tumor tumeur de Brenner Brennertumor

D76.3 M-77880 15960008 Reticulohistiocytic granuloma granulome réticulo-histiocytaire reticulohistiocytair granuloom

– Context sensitive pick list– Syntactic and semantic search – Rule Based Code convertor

4. User Interfaces :

Priority Use cases

LegislationFrom common rules to law?

Standards:Progressive international alignment of Technical standards

Certification:More emphasis on meaningful use?

> Some roads for tomorrow

Luc.nicolas@health.fgov.be

www.health.fgov.be/telematics/label

Thanks