dutch interoperability development: lessons learned

Dutch Interoperability Development: Lessons Learned

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Jan-Eric SLOT MB MSc MBA CHCIO

Principal advisor Outcome Data (VBHC) Health Information Exchange

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Welcome

Principal AdvisorOutcome Measures (VBHC) Health Information Exchange

Ministry of Health the Netherlands


40 yrs in Healthcare IT- SMS, Digital Equipment

20 yrs as CIO/ CMIO- Amsterdam UMC- Bernhoven Hospital

CEO SNOMED InternationalVBHC at National Institute of Health& Dutch Ministry of Health

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WorldMap

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The Netherlands

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Conflict of Interest


Has no real or apparent conflicts of interest to report.

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Agenda

• Introduction of the National Program

• From Idea to Legislation

• Search & Development of the DIMM, Dutch Interoperability Maturity Model

• Lessons Learned from double Pilot

• Q&A

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Learning Objectives

• Describe the purpose of the Law and the function of a Maturity Model

• Comprehend the complexity and the need to predict the maturity of the Information Exchange

• Apply the knowledge to similar interoperability questions

• Break down the ideas and compare, distinguish and differentiate DIMM from their personal setting

• Appraise and compare the model for application in different settings

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Further digitalization in the Netherlands is needed

Dutch news item:nurses are tired of faxingand retyping information

https://www.informatieberaadzorg.nl/publicaties/videos/2019/07/10/e-overdracht-ziekenhuis-bovenij-en-zonnehuis-amstelveen

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National program for Health Information Exchange

• Framework law to make Health Information Exchange mandatory

• Legislation for data exchange per use case• Digital Prescription• Patient Summary• Image Transfer• Nursing Transfer

• Setting up an approach for next use cases

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Heath Information Exchange in the Netherlands; from Idea to legislation

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Framework Law

• If Health Care Providers are exchanging information about a patient, the

legislation is telling how data will be exchanged by semantical en syntactical

demands• Exchanging electronically via an electronic infrastructure (track 1)• Striving to a data exchange that is normalized and certified (track 2)

• Scope of the Law: only data exchange between care providers, not with

patients

• Rules about consent for the exchange are contained in other laws

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Approach ‘from Idea to legislation’

• If Umbrella Healthcare Organizations have an Idea for a mandatory data exchange:

• The use case is being investigated before the MoH actually makes legislation:• Is there a support base for legislation?

• Are there sufficient umbrella organizations who want this?

• What is the Added Value for the Society in the next 15 years• Executing a social-cultural business case

• What is the implementation readiness of Healthcare providers at the moment?• Executing a Maturity Scan

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Maturity Scan for HIE use cases

• A generic scan that can be repeated for every HIE that the government

wants to make mandatory by legislation

• The scan must give insight into the extent that care institutes and caregivers

are ready for the different aspects of the use case (score)

• The scan must give insight into what care institutes and caregivers need to do

before they can electronically exchange the specific data (gap)

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Dutch Interoperability Maturity Model

• Developed together with HIMSS and Nictiz

• Based on the ReEIF

• Goal per layer

• Every question has a maturity structure in the answers

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DIMM pilots

• Two pilots to validate if DIMM is the right instrument• A representative group is selected• Usecases: Patient summary and image exchange• The model will be refined for further use

From Idea to legislation: an approach for data exchange towards a next level

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Dutch Interoperability Maturity ModelLearning Assessments Report

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With thanks to Frank Fritzs cheResearch and Advisory Services ManagerHIMSS Analytics Europe

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Table of Content

1. Background

2. Project Timeline

3. Dutch Interoperability Maturity Model (DIMM)

4. Methodology & Scoring Tutorial

5. Evaluation Pilot 1 - Summary Care Record (BgZ)

6. Evaluation Pilot 2 - Image Exchange (Beelduitwisseling)

7. DIMM Review

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Background• The Ministry of Health, Welfare and Sport in The Netherlands (VWS) aims on further developing legislation that supports Health

Information Exchange capabilities on defined use cases among healthcare providers responsible for delivering care in The

Netherlands. As part of the preparatory work needed to develop the legislation, VWS wishes to understand the readiness

from healthcare providers to share information through an assessment from the various care fields in the Dutch regions.

• VWS has approached HIMSS to request support in achieving the above objectives. In a joint development between VWS,

HIMSS and NICTIZ (Dutch competence center for electronic exchange of health and care information) the Dutch

Interoperability Maturity Model (DIMM) was created. The assessment tool bases on the 5-layer framework for information

exchange from NICTIZ.

• VWS and HIMSS determined the implementation of pilot evaluations for two use cases in order to improve model validity

before applying it to all use cases. The results of both pilot evaluations should provide further insights into the readiness level

and capabilities of care providers to exchange data in the different areas of investigation and identify what gaps need to

be mitigated in order to be ready to electronically exchange data and how this will inform the creation of the legislation

around data exchange. 16

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Project Timeline

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Data capture, quality assurance and data analysis until June 14th 2020.

Includes findings from both assessments until July 9th 2021.

Reviewing and proofing approach, compliance statements & response options, algorithm

Rollout to other healthcare provider and use casesReport Generation

DIMM Maintenance

Development of Survey Tool

Pilot 1 – Summary Care Record

Pilot 2 – Image ExchangeSetting up a survey tool including scoring algorithm until April 8th 2021.

Data capture, quality assurance and data analysis until May 17th 2020.

Workshop

Workshop

May 18th

June 15th

DIMM Surveys for other use cases

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• DIMM is a framework to evaluate the health information exchange capabilities of healthcare providers in the Netherlands.

• The model consists of 5 stages (0-4) and identifies the levels of HIE capabilities from six different perspectives: Laws and Regulation, Organization, Care Process, Information, Application and IT Infrastructure.

Dutch Interoperability Maturity Model (DIMM)

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Gecertificeerde beveiliging; nationale innovator; meervoudige gestandaardiseerde gegevensuitwisselingen; wijdverspreide integratie; op standaards gebaseerde terminologie; ICT-strategie van de onderneming

Wettelijke kaders; overeenkomsten en beleid; kwaliteitsnormen; risicobeoordelingen; gestandaardiseerde codering; gestructureerde gegevens; geavanceerde infrastructuurarchitectuur

Gedeeltelijke naleving van regelgeving; beleidsovereenkomsten; opkomend bestuur; koppeling van toepassingen; peer-to-peer verbindingen

Niet-gedocumenteerde overeenkomsten, voornamelijk intern; ad hoc risicobeoordelingen; basisinformatie-uitwisseling; niet-specifieke infrastructuur

Kennis van wet- en regelgeving en gegevensuitwisseling; informatie niet gestructureerd; infrastructuur beperk

Dutch Interoperability Maturity Model

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DIMM Domains and Sub-Domains

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ORGANISATIEBELEID

ZORGPROCES

INFORMATIE

APPLICATIE

IT-INFRASTRUCTUUR

WET- EN REGELGEVING

ORGANISATORISCH

SEMANTISCH

TECHNISCH

JURIDISCH

De zorgaanbieder volgt de landelijke en regionale afspraken over gegevensuitwisseling en heeft deze

geïmplementeerd.De zorgaanbieder heeft de processen voor

gegevensuitwisseling beschreven en geïmplementeerd en de zorgprofessional(s) getraind

in het gebruik van deze processen.De zorgaanbieder bewaart en hergebruikt gegevens op een gestructureerde wijze ten behoeve van

meerdere doeleinden en doet dit op basis van ZIB'sen (inter) nationale classificaties.De zorgaanbieder heeft afspraken met ICT-

leveranciers en heeft deze geïmplementeerd om op gestructureerde wijze informatie uit te wisselen op

basis van landelijke normen en standaarden.De zorgaanbieder maakt gebruik van landelijke of regionale infrastructuren en communiceert

informatie op een passend beveiligingsniveau.

De zorgaanbieder voldoet aan NEN 7510, 7512 en 7513 en aan de WABVPZ en AVG.

DOMEIN SUB DOMEIN DOEL VAN DE GEGEVENSUITWISSELING PER SUB-DOMEIN

Presenter

Presentation Notes

DIMM consists of four domains and six sub-domains.

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Methodology• The questionnaire comprises 37 compliance

statements

• Laws and regulation – 3 compliance statements

• Organisation – 9 compliance statements

• Care Processes – 7 compliance statements

• Information – 4 compliance statements

• Application – 10 compliance statements

• Infrastructure – 4 compliance statements

• Each compliance statement was rated on a 5-point

scale

• Each option of the 5-point scale corresponds to a

DIMM Stage (from Stage 0 to Stage 4)

• Each compliance statement has the same weight in

both evaluation pilots

• In a workshop setting, initial responses have been

discussed with stakeholders from each healthcare

provider

• The data were analyzed using the DIMM algorithm

• Final achievements have been calculated and

findings have been prepared and shared with the

client

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Score

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Stage% Bereikt

Stage 4

Stage 3

Stage 2

Stage 1

30%

50%

60%

70%

144%

Highest Stage achieved

% accomplishment against entire DIMM

70%+ to achieve a Stage

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Pilots DescriptionsSummary Care Record (Pilot 1)

• 18 surveys were issued

• 16 providers responded, of which 13 hospitals, 2 tertiary providers

and 1 radiotherapy institute provided a complete survey

• 6 providers participated in pilot 1 and pilot 2

• 2 compliance statements of sub-domain “Care Process” were

dropped from the survey (Compliance Statement ID 16 and ID 19)

• All responses of 1 compliance statement in sub-domain “Care

Process” (ID 13) and “Information” (ID 20) were changed to the

lowest compliance level since the addressed standard is not yet

available for this use case

• Overall responses from 35 instead of 37 compliance statements

were included in the analysis

Image Exchange (Pilot 2)

• 18 surveys were issued

• 16 providers responded, of which 13 hospitals, a screening center,

diagnostic provider and a radiotherapy institute provided a

complete survey

• 6 providers participated in pilot 1 and pilot 2

• All responses of 1 compliance statement in sub-domain “Care

Process” (ID 13) and “Information” (ID 20) were changed to the

lowest compliance level since the addressed standard is not yet

available for this use case

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Pilot 1 – BgZ – Overall Results

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Summary Pilot 1 (BgZ – Summary Care Record)

• With an average Score of 1.6 the 16 participants achieve DIMM Stage 1 with 53%

compliance against the entire model criteria.

• The capabilities vary between healthcare organizations (minimum Stage 0, maximum

Stage 4) and sub-domains (minimum Care Process, maximum IT-Infrastructure).

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• Through the survey, areas were identified in which the majority of participants has no

or very low capabilities. The TOP 5 development areas derive from 3 sub-domains:

Care Process, Information, and Organization.

• In order to progress through the DIMM Stages the healthcare provider need to

prioritize efforts to close gaps around data exchange quality & information standards,

risk assessments, speed of HIE, and sharing of costs of common infrastructure.

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• For several compliance statements health information exchange capabilities are in

place. Participants should continue to build on existing skills and close existing gaps to

reach higher DIMM Stages. The TOP 5 areas where improvements are needed come

from 2 sub-domains: Application, Laws and regulation.

• In order to further progress through the DIMM Stages the healthcare provider need to

reduce existing gaps and extend existing capabilities around the use of standardized

medical coding systems, use of applications supporting data exchange as well as

compliance with NEN 7510, 7512, and 7513.

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Overall Compliance

• The 16 participants achieve on average DIMM

Stage 1 (Score 1.6) with 53% compliance

against the entire model criteria.

• The stage achievement varies strongly among

the care organizations (2# Stage 0, 6# Stage

1, 6# Stage 2, 1# Stage 3, 1# Stage 4).

• 4 out of 6 sub-domains score 50% or more,

apart from “Care Process” (38%) and

“Information” (42%).

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54%

56%

38%

42%

58%

59%

Wet- & regelgeving

Organisatiebeleid

Zorgproces

Informatie

Applicatie

IT-Infrastructuur

53%Percentage Prestatie

AlgemeenNiveau Prestatie

1st Pilot

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Overall Compliance

• Large variance in capabilities across all sub-

domains, especially for “Applicatie” and “Wet-

& regelgeving”

• Variance between capabilities is lowest in sub-

domain “Organisatiebeleid” if outliers are

excluded

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1st Pilot

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• Health information sharing processes and

capabilities covered in sub-domains

“Zorgproces” and “Informatie” are on

average the weakest sub-domains

• Sub domains “IT Infrastructuur” and “Wet- &

Regelgeving” score highest and on DIMM

Stage 2

• With regards to sub-domains

“Organisatiebeleid” and “Applicatie”, the

care organizations are close to DIMM Stage 2

with 69% compliance.

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Wet- & regelgeving

Organisatie-beleid Zorgproces Informatie Applicatie IT-

Infrastructuur

Niveau 2 1 0 0 1 2

% Bereikt 54% 56% 38% 42% 58% 59%

Niveau 4 15% 28% 14% 16% 31% 31%

Niveau 3 38% 50% 35% 36% 49% 45%

Niveau 2 71% 69% 45% 52% 69% 73%

Niveau 1 94% 78% 60% 64% 83% 86%

Conformiteit per Sub-Domein

1st Pilot

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Make a StartProgress through the DIMM Stages by prioritizing efforts to close following gaps:

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1st Pilot

1 Care Processes

2 Information

3 Organisation

4 Organisation

5 Organisation

The data exchange quality standard is implemented in the care process of the healthcare provider.

100% - No quality standard for data exchange av ailable0% - An agreed plan exists but implementation not yet started0% - Implementation of data exchange quality standards in process0% - Implementation completed for at least 5 data exchanges0% - Implementation completed across all data exchanges

The healthcare provider applies an information standard for this data exchange.

100% - No0% - The information standard is in dev elopment0% - the HIE is not yet based on the information standard0% - Yes, the HIE is partially based on the information standard0% - Yes, the HIE is qualified

The healthcare provider has a policy that ensures that the costs of common infrastructure are shared between the cooperation partners.

50% - No policy in place19% - Need for a policy agreed, but no progress made13% - Work on the policy has begun0% - Yes, a policy is in place but not yet activ e19% - Yes, the policy is in place and costs are being shared

There are board level agreements about the exchange of data between healthcare providers or other organisations that enable health information exchange.

44% - No agreements to exchange data0% - Agreement in place between clinicians13% - Agreements in place between sev eral local healthcare prov iders38% - Agreements in place between local and regional healthcare prov iders6% - Agreements in place between local, regional and national healthcare prov iders

44% - No25% - Need for an agreement established, but no progress made13% - Work on the agreement has begun6% - Yes, a agreement is in place but not yet activ e13% - Yes, the agreement is in place and fully activ e

The healthcare provider has made agreements with healthcare insurers about the exchange of information.

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Improve and ExtendFurther progress through the DIMM Stages by reducing existing gaps and extend existing capabilities.

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1 Application

The care provider uses standardized medical coding systems (e.g. ICD, UCUM, G-standard, etc.) and terminology systems (e.g. SNOMED CT, LOINC, etc.) which support the exchange of structured and standardized data.

0% - No, own coding lists31% - Own coding lists are partially mapped in the background to standardized systems (<50%)50% - Own coding lists are primarily mapped in the background to standardized systems (51 – 90 %)0% - Own coding lists are completely mapped in the background to standardized systems (91 – 100 %)19% - Only standardized systems are used

2 Laws and regulation

The healthcare provider works in accordance with NEN 7510 (information security).

6% - No 25% - Working on it31% - Partially19% - Healthcare provider is compliant, self-declaration19% - Healthcare provider is certified


The healthcare provider works in accordance with NEN 7512 (security HIE).

6% - No 25% - Working on it31% - Partially25% - Healthcare provider meets all criteria13% - Healthcare provider is compliant


The healthcare provider works in accordance with NEN 7513 (logging).

6% - No 19% - Working on it38% - Partially25% - Healthcare provider meets all criteria13% - Healthcare provider is compliant

5 ApplicationThe healthcare provider has applications that support data exchange, specifically for receiving the information to be exchanged.

6% - No application available in the market31% - Available but not purchased/connected/implemented (0%)25% - Receiving - Limited operational (25%)13% - Receiving - Not fully operational (26-90%)25% - Receiving - Fully supported (91-100%)

1st Pilot

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Pilot 2 – Beelduitwisseling – Overall Results

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Summary Pilot 2 (Beelduitwisseling - Image Exchange)

• With an average Score of 1.4 the 16 participants achieve DIMM Stage 1 with 54%

compliance against the entire model criteria.

• The capabilities vary between healthcare organizations (minimum Stage 0, maximum

Stage 3) and sub-domains (minimum Information, maximum Application and IT-

Infrastructure).

• Compared by healthcare organization Catharina Ziekenhuis Eindhoven, Sint

Maartenskliniek, and Bevolkingsonderzoek Nederland (BVO-NL) achieve the highest

compliance level against the entire model.

• Most opportunities exist for Stichting Annadal Kliniek, Stichting Reumazorg Zuid West

Nederland, and Radiotherapeutisch Instituut Friesland.33

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• Through the survey, areas were identified in which the majority of participants has no

or very low capabilities. The TOP 5 development areas derive from 3 sub-domains:

Care Process, Information, and Organization.

• In order to progress through the DIMM Stages the healthcare provider need to

prioritize efforts to close gaps around data exchange quality & information standards,

the use of “ZIB’s”, agreements with insurers about HIE, and the sharing of costs of

common infrastructure.

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#HIMSS21


• For several compliance statements health information exchange capabilities are in

place. Participants should continue to build on existing skills and close existing gaps to

reach higher DIMM Stages. The TOP 5 areas where improvements are needed come

from 3 sub-domains: Care Process, Information, and Application.

• In order to further progress through the DIMM Stages the healthcare provider need to

reduce existing gaps and extend existing capabilities around periodically risk

assessments, training policy regarding process-oriented work, exchange of structured

data, use of communication standards like FHIR, use of standardized medical coding

systems.

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Overall Compliance• The 16 participants achieve on average DIMM

Stage 1 (Score 1.4) with 54% compliance against the entire model criteria.

• The stage achievement varies among the care organizations (3# Stage 0, 5# Stage 1, 6# Stage 2, 2# Stage 3, 0# Stage 4).

• The Sub-domains “Applicatie” and “IT-Infrastructuur” (each 66% compliance), “Organisatiebeleit” (58%), and “Wet- & regelgeving” (55%) score highest.

• The lowest compliance level was measured for “Informatie” with 20%.

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55%

58%

46%

20%

66%

66%

Wet- & regelgeving

Organisatiebeleid

Zorgproces

Informatie

Applicatie

IT-Infrastructuur

54%Percentage Prestatie

AlgemeenNiveau Prestatie

2nd Pilot

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Overall Compliance

• Large variance in capabilities in sub-domain

“Wet- & regelgeving” and “IT-Infrastructuur”

• The majority of organizations has limited

capabilities in sub-domain “Informatie”

• The majority of organizations has advanced

capabilities in sub-domain “Applicatie”. Few

organizations are outliers with limited

compliance in this DIMM sub-domain

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2nd Pilot

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Conformiteit per Sub-Domein

Wet- & regelgeving

Organisatie-beleid Zorgproces Informatie Applicatie IT-

Infrastructuur

Niveau 1 1 1 0 2 2

% Bereikt 55% 58% 46% 20% 66% 66%

Niveau 4 15% 32% 10% 3% 38% 38%

Niveau 3 38% 51% 36% 8% 58% 53%

Niveau 2 67% 67% 62% 22% 76% 84%

Niveau 1 100% 81% 79% 47% 91% 91%

2nd Pilot

• Health information sharing processes and

capabilities covered in sub-domains

“Applicatie” and “IT-Infrastuctuur” are on

average the strongest sub-domains and score

on DIMM Stage 2.

• Sub domains “Organisatiebeleid”, “Wet- &

Regelgeving”, and “Zorgproces” score on

DIMM Stage 1 with a compliance level close

to Stage 2.

• Across all organizations surveyed, sub-domain

“Informatie” remains on DIMM Stage 0 offering

most development potential.

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Make a StartProgress through the DIMM Stages by prioritizing efforts to close following gaps:

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1 Care Process The data exchange quality standard is implemented in the care process of the healthcare provider.

100% - No quality standard for data exchange available0% - An agreed plan exists but implementation not yet started0% - Implementation of data exchange quality standards in process0% - Implementation completed for at least 5 data exchanges0% - Implementation completed across all data exchanges

2 Information The healthcare provider applies an information standard for this data exchange.

100% - No0% - The information standard is in development0% - the HIE is not yet based on the information standard0% - Yes, the HIE is partially based on the information standard0% - Yes, the HIE is qualified

3 Information The healthcare provider uses clinical information models (CIMI’s) for this data exchange.

81% - No relevant CIMI available19% - CIMI development in progress0% - Yes, partial based on CIMI < 50%0% - Yes, the HIE is mostly (51 - 90%) based on the CIMI standard0% - Yes, the HIE is fully based on the CIMI

4 Organisation The healthcare provider has made agreements with healthcare insurers about the exchange of information.

50% - No31% - Need for an agreement established, but no progress made13% - Work on the agreement has begun0% - Yes, a agreement is in place but not yet active6% - Yes, the agreement is in place and fully active

5 OrganisationThe healthcare provider has a policy that ensures that the costs of common infrastructure are shared between the cooperation partners.

44% - No policy in place13% - Need for a policy agreed, but no progress made13% - Work on the policy has begun0% - Yes, a policy is in place but not yet active31% - Yes, the policy is in place and costs are being shared

2nd Pilot

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Improve and ExtendFurther progress through the DIMM Stages by reducing existing gaps and extend existing capabilities.

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1 Care Process The healthcare provider has an active training policy regarding process-oriented work according to organisational agreements.

0% - No policy and no training25% - Learning from colleagues56% - There is a manual with tasks6% - New employees are trained once13% - Involved co-workers need to prove they are trained

2 Care Process

The healthcare provider has set up a process within its own organisation to periodically assess the risks and impact of changes in standards for the data exchange and to adapt work processes accordingly.

31% - Data exchanges are not supported by risk assessments19% - Risk assessments only occur when things go wrong50% - Risk assessments are both ad hoc and planned0% - More than 75% of data exchange processes are risk assessed every 12 months0% - All data exchanges are risk assessed every 12 months by an independent survey body and form part of an ongoing audit cycle.

3 Information The healthcare provider uses structured data exchange.

19% - Not structured63% - At document level (e.g. PDF, via e-mail or message)6% - At section level (within a document, standardised sections are used, e.g. HASP guideline)13% - At concept level (standardised data elements are used, e.g. CIMI)0% - Concept Level (CIMI) + Use of standard terminology (SNOMED)

4 Information The healthcare provider uses specified communication standards such as HL7 CDA or FHIR.

13% - No, only vendor-specific protocols19% - Specified, other then CDA or FHIR50% - Uses HL7 CDA6% - Uses FHIR13% - Supporting both (HL7 CDA, FHIR)

5 Application

The care provider uses standardized medical coding systems (e.g. ICD, UCUM, G-standard, etc.) and terminology systems (e.g. SNOMED CT, LOINC, etc.) which support the exchange of structured and standardized data.

19% - No, own coding lists44% - Own coding lists are partially mapped in the background to standardised systems (<50%)25% - Own coding lists are primarily mapped in the background to standardised systems (51 – 90 %)0% - Own coding lists are completely mapped in the background to standardised systems (91 – 100 %)13% - Only standardised systems are used

2nd Pilot

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Dutch Interoperability Maturity Model Review

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First impressions• The partnership appears to have good start. Confidence in the model and the initial findings appear to align reasonably closelyr

with reality.• The DIMM requires further modification in terms of the question wording and response options. Further tests for ‘logic should take

place prior to further roll-out.• There appears to be a clear case for the Dutch MoH to recommend data exchange standards (transport FHIR, DICOM and also

content, HL-7) and to monitor the use thereof. Data exchange standards to be mandated over time.• The Dutch MoH should introduce a national clinical coding classification (ICD-10, LOINC, SNOWMED CT) for diagnoses and

procedures. The absence of a unified vocabulary leads to miscommunication.• The MoH should encourage health care providers to share IT infrastructure and people in order to reduce duplication and costs,

consolidate capacity and skills and obtain economy of scale. The common shared IT infrastructure would be network, storage, platform, security, logging, billing, backup system, and data center.

• HIE capabilities should be contained within a legal framework to support procurement activities to ensure that all new systems are compliant.

• All care providers should be encouraged and incentivized to submit electronic activity data to payers and insurers thereby improving data quality and reimbursement times.

• The Dutch MoH should agree a national data set in order to populate key performance indicator requirements. Care providers would electronically populate the national data set at the end of every month.

• National guidelines will help maintain clinical coding standards. The guidelines may include coder per episode ratios, audit cycles, training, quality standards and qualification requirements.

• The Dutch MoH may consider a national system to set information governance standards, training requirements, compliance targets, local registers and reminder systems.

• The MoH may consider national indicators to manage system performance and access including staff satisfaction surveys.

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Highest scoring activities

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1 OrganisatiebeleidDe zorgaanbieder heeft een actief beleid met betrekking tot het pro-actief verkrijgen van patiënttoestemming voor het uitwisselen van gegevens.

0% - Nee6% - Niet bekend6% - Mee bezig te ontwikkelen19% - Bezig met implementeren van beleid69% - Volledig geimplementeerd en actief

2 Organisatiebeleid De zorgaanbieder heeft ICT-strategie en beleid verankerd in de organisatie.

0% - Nee er is geen beleid6% - Er wordt aan gewerkt maar nog geen overeenstemming13% - Ja, maar niet geïmplementeerd31% - Ja en geïmplementeerd en in samenhang met bestaand beleid50% - Ja, het is organisatie-breed geïmplementeerd en wordt periodiek geëvalueerd

3 ZorgprocesDe zorgaanbieder heeft een proces ingericht voor het opslaan en gebruik van identificatiegegevens van patiënten (bijv. BSN, identificatie).

0% - Nee6% - Interne afspraken6% - BSN wordt geverifieerd bij SBV-Z63% - BSN wordt gevalideerd (ID controle)25% - Naast verificatie en/of validatie ook NAW en overlijdens check bij Basisregistratie Personen (BRP)

4 ApplicatieDe zorgaanbieder is in staat de gewenste informatie voor de gegevensuitwisseling beschikbaar te stellen uit de bronsystemen.

6% - De gewenste informatie wordt niet volledig (gestructureerd) vast gelegd bij de zorgaanbieder 0% - De gewenste informatie wordt vastgelegd bij de zorgaanbieder, maar kan niet beschikbaar worden gesteld voor uitwisseling19% - De gewenste informatie kan minimaal beschikbaar worden gesteld voor uitwisseling (< 25% data gegevensuitwisseling) 44% - De gewenste informatie kan beperkt beschikbaar worden gesteld voor uitwisseling (26 -90% data gegevensuitwisseling)31% - De gewenste informatie kan volledig beschikbaar worden gesteld (91% - 100%)

5 Organisatiebeleid

Er zijn samenwerkingsafspraken met andere zorgaanbieders of met organisaties die gegevensuitwisseling faciliteren, waar informatie mee wordt gedeeld, om de privacy en gegevensbeveiliging te waarborgen.

6% - Nee6% - Nog niet, noodzaak wordt gezien25% - Er is een start gemaakt19% - Grotendeels afspraken gemaakt44% - Ja, samenwerkingsafspraken zijn ondertekend

1st Pilot

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6 Applicatie De applicatie van de zorgaanbieder is in staat, om elektronisch gegevens uit te wisselen.

19% - Nee0% - Via (zorg)mail13% - Via één –op- één uitwisseling13% - Via regionaal uitwisselingssysteem56% - Via landelijk uitwisselingssysteem

7 Organisatiebeleid De zorgaanbieder is actief betrokken bij regionale en / of landelijke transmurale activiteiten.

0% - Nee / niet relevant voor bedrijfsproces van de instelling0% - Volgend, niet actief betrokken50% - Ja, actief deelnemer25% - Ja, actieve promotor25% - Ja, zorgaanbieder is actief betrokken en wordt gezien als nationale innovator en voorloper

8 IT-Infrastructuur De elektronische gegevensuitwisseling vindt beveiligd plaats volgens de daarvoor geldende normen en standaarden.

13% - Niet0% - Beperkt: alleen routering19% - Redelijk: bovenstaande + authenticatie en logging38% - Goed: bovenstaande + encryptie en sealing31% - Maximaal: bovenstaande + VPN, secure sockets etc.

9 ApplicatieDe zorgaanbieder heeft afspraken met de ICT-leveranciers voor het gebruik van actuele informatiestandaarden en het beheer van wijzigingen hierop.

13% - Niet aanwezig13% - Er lopen gesprekken6% - Er zijn mondelinge / informele afspraken38% - Het is individueel met ICT-leveranciers geregeld31% - Dit is standaard dienstverlening van de ICT-Leveranciers

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IT-Infrastructuur De zorgaanbieder maakt gebruik van een infrastructuur voor de gegevensuitwisseling.

13% - Niet elektronisch 13% - Via internet25% - Rechtstreeks naar individuele organisaties via eigen verbinding (peer-to-peer) 13% - Via een regionale infrastructuur 38% - Via een landelijke infrastructuur

1st Pilot

#HIMSS21


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1 OrganisatiebeleidDe zorgaanbieder heeft een actief beleid met betrekking tot het pro-actief verkrijgen van patiënttoestemming voor het uitwisselen van gegevens.

0% - Nee0% - Niet bekend25% - Mee bezig te ontwikkelen6% - Bezig met implementeren van beleid69% - Volledig geimplementeerd en actief

2 ApplicatieDe zorgaanbieder heeft applicaties waarmee de gegevensuitwisseling ondersteund wordt, voor het verzenden of publiceren van de uit te wisselen informatie.

0% - Nee, geen applicatie beschikbaar op de markt19% - Beschikbaar maar niet aangeschaft/aangesloten/geimplemteerd (0%)0% - Verzenden beperkt operationeel (25%)6% - Verzenden is nog niet volledig operationeel (26-90%)75% - Verzenden wordt er volledig mee ondersteund (91-100%)

3 IT-Infrastructuur De elektronische gegevensuitwisseling vindt beveiligd plaats volgens de daarvoor geldende normen en standaarden.

0% - Niet0% - Beperkt: alleen routering19% - Redelijk: bovenstaande + authenticatie en logging25% - Goed: bovenstaande + encryptie en sealing56% - Maximaal: bovenstaande + VPN, secure sockets etc.

4 Organisatiebeleid

Er zijn samenwerkingsafspraken met andere zorgaanbieders of met organisaties die gegevensuitwisseling faciliteren, waar informatie mee wordt gedeeld, om de privacy en gegevensbeveiliging te waarborgen.

0% - Nee0% - Nog niet, noodzaak wordt gezien19% - Er is een start gemaakt38% - Grotendeels afspraken gemaakt44% - Ja, samenwerkingsafspraken zijn ondertekend

5 ApplicatieDe zorgaanbieder is in staat de gewenste informatie voor de gegevensuitwisseling beschikbaar te stellen uit de bronsystemen.

19% - De gewenste informatie wordt niet volledig (gestructureerd) vast gelegd bij de zorgaanbieder 0% - De gewenste informatie wordt vastgelegd bij de zorgaanbieder, maar kan niet beschikbaar worden gesteld voor uitwisseling0% - De gewenste informatie kan minimaal beschikbaar worden gesteld voor uitwisseling (< 25% data gegevensuitwisseling) 13% - De gewenste informatie kan beperkt beschikbaar worden gesteld voor uitwisseling (26 -90% data gegevensuitwisseling)69% - De gewenste informatie kan volledig beschikbaar worden gesteld (91% - 100%)

2nd Pilot

#HIMSS21


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6 Applicatie De applicatie van de zorgaanbieder is in staat, om elektronisch gegevens uit te wisselen.

0% - Nee6% - Via (zorg)mail31% - Via één –op- één uitwisseling13% - Via regionaal uitwisselingssysteem50% - Via landelijk uitwisselingssysteem

7 ZorgprocesDe zorgaanbieder heeft een proces ingericht voor het opslaan en gebruik van identificatiegegevens van patiënten (bijv. BSN, identificatie).

0% - Nee0% - Interne afspraken6% - BSN wordt geverifieerd bij SBV-Z88% - BSN wordt gevalideerd (ID controle)6% - De betrokkenen moeten aantonen dat ze juist zijn opgeleid en er is periodieke scholing

8 ApplicatieDe zorgaanbieder heeft applicaties waarmee de gegevensuitwisseling ondersteund wordt, specifiek voor het ontvangen van de uit te wisselen informatie.

6% - Nee, geen applicatie beschikbaar op de markt13% - Beschikbaar maar niet aangeschaft/aangesloten/geimplemteerd (0%)6% - Ontvangen beperkt operationeel (25%)25% - Ontvangen is nog niet volledig operationeel (26-90%)50% - Ontvangen wordt er volledig mee ondersteund (91-100%)

9 IT-Infrastructuur De zorgaanbieder maakt gebruik van een infrastructuur voor de gegevensuitwisseling.

0% - Niet elektronisch 13% - Via internet25% - Rechtstreeks naar individuele organisaties via eigen verbinding (peer-to-peer) 19% - Via een regionale infrastructuur 44% - Via een landelijke infrastructuur

10

OrganisatiebeleidEr zijn bestuurlijke afspraken over het uitwisselen van gegevens tussen zorgaanbieders of met organisaties die gegevensuitwisseling faciliteren.

6% - Geen afspraken 13% - Afspraken tussen individuele zorgverleners of maatschappen6% - Afspraken op lokaal niveau tussen zorgaanbieders44% - Afspraken op zowel lokaal als regionaal niveau31% - Afspraken op zowel lokaal, regionaal als landelijk niveau

2nd Pilot

#HIMSS21

Questions

Please ask anything you like:

from Cheese making to Interoperability Maturity Models

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#HIMSS21

Thank you!

[email protected]

Linkedin.com/jan-eric-slot-mb-mba-msc-chcio-917a5

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dutch interoperability development: lessons learned

Documents