© Medinorma LLC Switzerland Medinorma LLC Slide 1 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Thanks to Pr Christian Lovis, MD, MPHI Head, Unit of Clinical Informatics Electronic Health Record and Supply Chain Data... Standards Electronic Health Record and Supply Chain Data... Standards

© Medinorma LLC Switzerland Medinorma LLC Slide 2 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 What do we mean with EHR? individual patient's medical record in digital format that can be shared in different health care settings inside a single hospital, inside a hospital group, inside a country, across the globe. collection of electronic medical record (EMR) out of different organisations out of different encounters

© Medinorma LLC Switzerland Medinorma LLC Slide 3 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 EHR from US DoD* / 1 (encounter / location) Previous Encounters Location Additional Selection Criteria *DoD: US Department of Defense

© Medinorma LLC Switzerland Medinorma LLC Slide 4 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 EHR from US DoD / 2 (encounter / location) Previous Encounters Location

© Medinorma LLC Switzerland Medinorma LLC Slide 5 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 EHR from US DoD / 3 (document) Documengt History Discharge Letter

© Medinorma LLC Switzerland Medinorma LLC Slide 6 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 EHR from US DoD / 4 (structured document) Documents History Location

© Medinorma LLC Switzerland Medinorma LLC Slide 7 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 EHR from US DoD / 5 (meds history) Medications dispensed by DoD, VA* & retail pharmacies VA: Veteran Affairs, the US federal hospital for military staff

© Medinorma LLC Switzerland Medinorma LLC Slide 8 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 EHR…. Connecting the dots Supply Chain … connecting to EHR EHR differs from paper-based files Data are stored electronically, Preferrently in a structured format Preferrently by referring to common agreed semantics, including images, lab results, etc. EHR belongs to the clinical IT Supply Chain data belong to an other “silo”?

© Medinorma LLC Switzerland Medinorma LLC Slide 9 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Supply Chain data in Hospital IT

© Medinorma LLC Switzerland Medinorma LLC Slide 10 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Supply Chain meeting Clinical IT

© Medinorma LLC Switzerland Medinorma LLC Slide 11 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Drugs, laboratory samples, etc, … Care, acts, actions, … Supply Chain and Clinical IT University hospitals of Geneva Pediatry Dept, mai – october 2007 – 6’786 episodes, 93’294 medical acts Medication 25% Medication Nursing acts Medication Medications Care Laboratory Radiology Consultations Other 93’294 medical acts 2’900’000 nursing acts

© Medinorma LLC Switzerland Medinorma LLC Slide 12 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Supply chain as bridging processes and silos EHR Supply Chain Care Accounting From Product to Patient

© Medinorma LLC Switzerland Medinorma LLC Slide 13 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Supply Chain and EHR: different time scales ?

© Medinorma LLC Switzerland Medinorma LLC Slide 14 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 …over generations 2009

© Medinorma LLC Switzerland Medinorma LLC Slide 15 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Supply Chain Data … in clinical IT Supply Chain Data... As identification keys...attributes for traceability Smooth linkage between two environments HL7 and GS1 collaborating to make this as interoperable as possible

© Medinorma LLC Switzerland Medinorma LLC Slide 16 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 HL7’s Mission HL7 is an international community of healthcare subject matter experts and information scientists collaborating to create standards for the exchange, management and integration of electronic healthcare information. HL7 promotes the use of such standards within and among healthcare organizations to increase the effectiveness and efficiency of healthcare delivery for the benefit of all. HL7’s strategy is innovation – both by ourselves and by our users

© Medinorma LLC Switzerland Medinorma LLC Slide 17 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Supply Chain Data … into Clinical IT Location GLN GS1 xml message Identifier Authority: EAN.UCC

© Medinorma LLC Switzerland Medinorma LLC Slide 18 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Supply Chain Data … into Clinical IT Location HL7 CDA message GLN OID :

© Medinorma LLC Switzerland Medinorma LLC Slide 19 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 ePrescription

Atenolol 50mg Tablet (Cox) X28 (AMPP ) Atenolol 50mg Tablet x28 (VMPP) Atenolol 50mg Tablet (COX) (AMP) Atenolol 50mg Tablet (VMP) Atenolol (drug product) (VTM) IS_A Cardioselective beta-blocker IS_A Beta-blocker drug etc IS_A Snomed CT drug core NHS dm+d Dm+d and SNOMED CT Source: Paul Frosdick, Bpharm, NHS, 2005

Added value in NCRS and systems Adapted* from: Paul Frosdick Bpharm, NHS, * *

© Medinorma LLC Switzerland Medinorma LLC Slide 22 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 A tentative to visualise GS1 in HL7’s Model shape EntityRole Participation Clinical Acts Entity (GTIN, GLN, etc. ) Participation (attributes as serial #, dates,) Acts (Value, Transaction, involved parties)

© Medinorma LLC Switzerland Medinorma LLC Slide 23 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 Continue working in meeting Health IT requirements GSMP « Patient & Caregiver ID » : gap analyse and searching solutions

© Medinorma LLC Switzerland Medinorma LLC Slide 24 Electronic Health Records and Supply Chain Data Standards GS1 Healthcare, Hong Kong, October 7 th, 2009 EHR and Supply Chain Standards … Christian Hay Partner Medinorma LLC