A Slovenian Experience in Certification and Quality Labelling of EHRs Leo Ciglenečki EuroRec, vice-president Prorec.SI, director leo.ciglenecki@siol.net

Focus on SLO experience/workshop Content Prorec Slovenia & Q-REC project Workshop with SW industry: Assisted self validation of SW Q-criteria validation Results Plans Focus on SLO experience/workshop Portorož, May 5th, 2008

Prorec Slovenia (Ustanova Prorec.SI) Since 2003 Links with all relevant stake holders (authorities, users, industry). Industrial forum - recent activities A member of the Q-REC project consortia, together with partners from 12 EU countries Portorož, May 5th, 2008

Project Q-REC Project Q-REC – Quality Labeling and Certification of Electronic Health Record Systems. Started in 2006. Suported by EC under FP6 IST Programme The main objective: create an efficient, credible and sustainable mechanism for the certification of EHR systems in EU and in its member states. Portorož, May 5th, 2008

Workshop (1) A workshop for SW vendors organized in April 2008 Aim: Q-REC criteria validation Assisted self-validation of the SW Participation in the interest of both: SW vendors and Prorec.SI Portorož, May 5th, 2008

Workshop (2) Portorož, May 5th, 2008

Workshop (3) Participants: Three SLO major SW companies (HI) (Infonet/SRC d.o.o., List d.o.o., Nova Vizija d.o.o.) SW supporting Medication management functionality (primary HC) The workshop led by Prorec.SI representatives Portorož, May 5th, 2008

Workshop (4) Pre-agreed: "This is only a test of Q-criteria, NOT a certifying exercise – no certificate issued“ "Possible unfavourable results will NOT be published“ "Possible favourable results MAY be promoted, but without claiming any official Q-Rec/Eurorec/Prorec.SI seal or statement“ “Note: the tested Q-criteria are not yet fully refined/grouped/indexed” Portorož, May 5th, 2008

Workshop (5) Input: Business function "A10 Medication management / Upravljanje z zdravili" 226 fine-grained statements from A10.0 – A10.6 A10.0 - Selection & Item Content A10.1 - Production of a prescription, its dispensing and administration A10.2 - Decision support & medication care quality surveillance A10.3 - Display, structuring and management of medication A10.4 - Medication administration A10.5 - Medication effects A10.6 - Regulatory & administrative aspects Some examples of the fine-grained statements: Portorož, May 5th, 2008

Workshop (6) The system ENABLES TO ENTER medication items (GS001549.03) The system enables to enter that a patient takes NO MEDICATION at all (GS001584.01) The system allows FREE TEXT OR UNCODED medication items if and ONLY IF the medicinal product isn't available in the coded list of medicinal products (GS001581.01) The system CALCULATES THE TOTAL price at the point of prescription and presents that information (GS002464.01) Portorož, May 5th, 2008

Workshop (7) Translations: Approx half of the statements already translated in Slovenian language Dictionary/Thesaurus emerging A challenge for future activities in SLO health informatics overall Portorož, May 5th, 2008

Workshop (8) Assisted self-validation of the SW and Q-criteria validation: Each vendor assessed conformance of their SW against Q-REC criteria. Possible replies: YES, NO, PARTIALY, N/A Active dialog with other participants. In parallel: Comments on Q-criteria noted and Individual terms added to Dictionary/Thesaurus Portorož, May 5th, 2008

Workshop (9) Results: SW assessment No major SW insufficiencies noticed Most of the 'NO‘ replies due to absence of conditions, where SW producers have no hold on them (state institutions, purchasers, infrastructure, code-lists, …) The overall result satisfying Portorož, May 5th, 2008

Workshop (10) Results: SW assessment-statistics 3 x YES: 26% 3 x NO: 20% Portorož, May 5th, 2008

Workshop (11) Results: Q-criteria evaluation Many new ideas occured to the participants. Extra functionalities to be built in their SW. “Too many ideas!“ Additional grouping/indexing needed (to avoid duplications etc..) Portorož, May 5th, 2008

Workshop (12) Some statements need explanations (e.g. does a statement refer to the application or to the code-list...) Some terms need definitions (idealistically data/object model) Precise quality metrics needed : is it sufficient when SW only enables a functionality or… does it also have to provide all required data / knowledge bases.. ... Portorož, May 5th, 2008

Workshop (13) Results: Certification Organisation and Process issues The participants suggested: Pre-assessment to be performed as self-assessment Main assessment to be performed by an independent, state accredited institution SW providers willing to pay for the process Correlation with results of the earlier promotion / questionnaire Portorož, May 5th, 2008

Plan To stay in the focus of the EU developments Assess possibilities for EHRs Q-labeling and certification in Slovenia Promotion with health care providers, authorities… accreditation? Portorož, May 5th, 2008

Thank you! leo.ciglenecki@siol.net Portorož, May 5th, 2008