Christopher Reed InterSystems Corporation Swedish NPÖ National Patient Overview A Case Study for InterSystems HealthShare, Ensemble and Caché Christopher Reed InterSystems Corporation

The NPÖ in Sweden The NPÖ Project – Background & Introduction The NPÖ Health Information Exchange – Objectives Key Business & Societal Considerations Key Architectural & Technical Considerations Examples of NPÖ HealthShare Screens

Swedish National Patient Summary (NPÖ – Nationell Patientöversikt) Population 9 million 21 healthcare regions National EHR InterSystems in partnership with Tieto.

Swedish National Patient Summary (NPÖ – Nationell Patientöversikt) Tieto – Prime Contractor InterSystems HealthShare™ – Health Information Exchange Platform Health information exchange platform National Patient Viewer Service 21 Swedish healthcare regions

NPÖ Timeline 1999-2004 Planning by Municipalities, Regions and 21 County Councils 2005: Four-County Trial/Proof-of-Concept 3/2008: Contract for NPÖ awarded to Tieto & InterSystems 5/2009-8/2009: Live Pilot in Örebro Municipality 9/2009: Full Production, Örebro Municipality 11/2009: Full Production, Östergötland County 2010-2011: Remaining 19 Counties in Production

The NPÖ in Sweden The NPÖ Project – Background & Introduction The NPÖ Health Information Exchange – Objectives Key Business & Societal Considerations Key Architectural & Technical Considerations Examples of NPÖ HealthShare Screens

What does the NPÖ provide? National Patient Viewer Service: Access to patient data Historical and current Wherever sourced in Sweden For authorized healthcare and welfare professionals From anywhere With appropriate computer configuration (Identity card (“SITHS”) reader and software)

Objectives of the NPÖ The Primary Objective of the NPÖ is to Improve the Quality & Consistency of Patient Care Doctors are working from information that is: More Complete Trusted Expected Benefits Include Reduction in Preventable Medical Errors Reduction in Adverse Drug Events Improved Outcomes Cost Reductions Improved Security and Logging

The NPÖ Provides 16 Information Types Patient Demographics Encounter Allergies and Alerts Care Plan (Primary, Secondary) Community Healthcare Service Activities of Daily Life Disability Diagnoses Clinical Document Prescribed Medication Dispensed Medication (Pharmacy) Clinical Chemistry Microbiology ECG Medical Imaging Other Examination

The NPÖ in Sweden The NPÖ Project – Background & Introduction The NPÖ Health Information Exchange – Objectives Key Business & Societal Considerations Key Architectural & Technical Considerations Examples of NPÖ HealthShare Screens

Key Business & Societal Considerations Participation Governance SKL/SALAR SVR Data Sharing - Patient Data Act Access Authentication and Authorization Content Authorization Information Presentation

Data Ownership Considerations Healthcare Data is Owned by the Counties Individuals have rights to see their information Primary Version of Data is Held at Source Some Data is also Held Centrally Patient Information is Assembled at Run-Time Possible Future Enhancements: Public Health Patient Access More Information Types

The NPÖ in Sweden The NPÖ Project – Background & Introduction The NPÖ Health Information Exchange – Objectives Key Business & Societal Considerations Key Architectural & Technical Considerations Examples of NPÖ HealthShare Screens

Key technological considerations Architecture Governance Past work with integration Communication and interoperability EN 13606 Source data retrieval and handling Response times Possibilities for viewing data Design of user interface Standardized process for connecting

Security and Privacy Technologies National platform Sjunet (Seven net) – VLAN SITHS – Secure IT in Health Services HSA catalogue – Health Services Address Registry HealthShare Security Services (HSS) Authentication Authorization Consent management Encryption Logging BIF – National security services

Conceptual view Application Integration A B A B Connection Care system Patient summary service – NPO Base service Application Integration InterSystems HealthShare A B Deployment service Responsibility of supplier Responsibility of care provider Connection service (optional) A B InterSystems Ensemble Connection Care system Care system Care system

... ... Viewer HealthShare Access Gateway Hub Edge Gateway 1 Edge SI (A) Access Gateway Hub Integration services ... Edge Gateway 1 Edge Gateway n Service interface (B) SI = Service interface Connection Connection Connection ... Care provider 1 Care provider 2 Care provider 3 Care provider n

The NPÖ in Sweden The NPÖ Project – Background & Introduction The NPÖ Health Information Exchange – Objectives Key Business & Societal Considerations Key Architectural & Technical Considerations Examples of NPÖ HealthShare Screens

Summary Screen Example

Level 2 Screen Example

Level 3 Screen Example

The NPÖ in Sweden Questions and Discussion Please

Christopher Reed Director, Strategic Healthcare Projects Enquiries please call InterSystems at Tel: +7 495 967 0088 www.intersystems.com