EHR S ystems U se and Q uality in Austria

EHR EHR SSystems ystems UUsese and and QQualityuality in in Austria

EHR Systems Quality Labelling and Certification21 - 22 November 2011, Belgrade

FH-Prof. DI Dr. Stefan Sauermann

UAS Technikum WienProgram Director, Biomedical Engineering Sciences ProRec Austria

Myself: Myself:

Communications engineer, ◦ 15 years MedUni Vienna, BME

Head of national CEN ISO mirror „Medical Informatics“

Founding member of IHE AustriaConsulting ELGA

◦ CDA harmonisation of the Lab ReportResearch project in personal healthcare

◦ www.healthy-interoperability.at


Health Care in AustriaHealth Care in Austria

Insurance based system◦~25 public insurances

15000 GPs◦many with social security contracts

Hospitals: mostly provincial holdings◦Additional private hospital groups

Many legacy IT systems◦Big and small


EHR EHR systemsystems:s: market (estimates) market (estimates)

Software use◦ 80-90% of GPs use software

◦ Nearly all hospitals use EHRs

Number of products◦ Many GP systems! (> 100 vendors)

◦ >10 hospital products (>10 vendors)

Market shares◦ 4 GP software vendors cover 60% of market

◦ 4 Hospital products cover 75% of market

market stable over last five years


Existing law: enables treatmentExisting law: enables treatment

Laws for the medical professions

eGovernment law

Data protection law

Enables point-to-point data exchange

Not suited for single access all data for one

patient


National EHR lawNational EHR law: : expected within months expected within months

Enables sharing of patient related data

Data protection is primary concern

◦Access only in context of treatment

◦Patients have control on who may access what

Storage

◦What, how long

...


EHR systemsEHR systems:: quality assessment quality assessment

Existing GP software certification (in discussion)

◦ Approval of reimbursement for treatment (eCard)

◦ Reimbursement (Social insurance)

◦ Standardised data export (Chamber of doctors)

No incentive for using quality assessed / certified

EHR systems


„Affinity domain“ (Build by HCP or vendor)

Local Document Registries with

Repositories

National EHR National EHR ELGAELGA: : growing!growing!

Follows IHE IT Infrastructure (XDS, ATNA, BPC, ... )


Central components (Built by ELGA)

Master Patient Index

Healthcare Provider Index

GP SWCIS

GP SWCIS

GP SWCISGP SW,

CIS

Domain …Domain B

ELGA Timeline (roughly)ELGA Timeline (roughly)

Master patient, HCP index availableHarmonised CDA availableeMedication in pilotSecurity system in procurementConformant affinity domains existing

◦ Reference domain in procurement

Reference domain go live expected 2012/13All hospitals integrated 2014GPs integration in full swing 2015


Highlight: Clinical Documents Highlight: Clinical Documents (Real beauties!!)(Real beauties!!)

http://www.elga.gv.at/index.php?id=28

Discharge informationRadiology and Lab

reports◦ HL7 CDA

Content harmonized ◦ >120 medical experts◦ Implementations already

available

Usability guided design


„Affinity domain“ (Build by HCP or vendor)

Local Document Registries with

Repositories

Possible steps Possible steps to certificationto certification

Security first? Then affinity domain connection? Then GP/CIS connection?


Central components (Built by ELGA)

Master Patient Index

Healthcare Provider Index

GP SWCIS

GP SWCIS

GP SWCISGP SW,

CIS

Domain …Domain B

Certification prioritiesCertification priorities

Without access rights /security there is no data exchange

This is a task in Europe

May this be a first „eHealth Certificate“ on European level?


Looking forward Looking forward to hear from you!to hear from you!

Stefan Sauermann◦ University of Applied Sciences

Technikum Wien◦ [email protected]

The Austrian national EHR: ◦ www.elga.gv.at


EHR S ystems U se and Q uality in Austria

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