1... Networked Healthcare Systems... IT-Platforms help to improve efficiency in Healthcare Sofia, June 27th, 2006

2 eHealth: another Buzzword? Internet/Extranet/Intranet Bioinformatics system Hospital Information System Consumer Health Systems eLearning Systems Clinical Decision Support Systems Clinical Trial System ADT System Electronic Medical Records Clinical Data Repositories Data Integration Computer-Telephony Integration Electronic Commerce Integrated Medical Devices Workflow Technologies Imaging Telemedical Technologies Workforce Enabling Technologies Research Systems Expert System Communication Server ePrescription Service Networks/Connectivity eProcurement Laboratory Systems eHealth Clinical DWH Departmental Systems Practice Management System Pharmacy System Radiology Information System PACS Card Management System Patient Registry Health Provider Registry Health Professional Registry Patient Card Health Professional Card

3 Siemens coverage of all key-stakeholders in healthcare Patient’s home Patient Physician Private Healthcare Teaching Hospital Rehab Center Self-help Group Pharmacy Health authority Nursing Home ambulance/ transport service Community Care Healthcare system Health Insurance/ payer Insurance cardholders

4 NÖMED WAN Patient- and Medical History Index: Overview Client Lower Austrian Health and Welfare Fund Area of Health Federal state of Lower Austria Lower Austria: Approx. 1.5 million inhabitants 22 hospitals, Approx beds, 5 different HIS Approx general practitioners, 40 different PMS Currently: own patient identifier each, medical record on their own devices, exchange of information only on request, few reuse on clinical documentation … Pilot Project Objective of step1 is to set up a Master Patient index and Medical History Index and lookup services to identify on which place relevant medical information is stored. Document exchange via already existing secure . In Step2 we will provide direct access to clinical documents at the local document repositories by using standardized IHE XDS integration profiles.

5 … NÖMED WAN Patient- and Medical History Index: Overview – Data Management … Patient Master (MID) Copy of Local Patient Record (LID) Doc 1Doc n HIS 1HIS n

6 NÖMED WAN Patient- and Medical History Index: Benefits Improved patient identification and patient demographics data management by a central master patient index system  more efficiency on patient admittance process Patient centered storage of medical history  access to all patient related data, improved quality of care Access to medical history at any point of care, anytime  improved quality of care Access to already existing clinical documents reduces the need for repeated examinations  less exposure on the patient, cost reduction Basis for secondary use Retrospective studies on anonymized data  evidence based medicine, cost reductions Disease Management  prevention, cost reductions Epidemics / Outbreak management  efficient healthcare management

7 Replacement of health insurance voucher (paper) with a smartcard solution Assured high quality data for surrounding processes and further applications Robust, secure, high-available scalable, and future proven infrastructure rolled out for practitioners, cards Simple and fast checking of insurance claims to achieve appropriate user acceptance eCard: Overview

8 Central Services Medical Practice / Hospital Medical Practitioner Software Solutions of 3rd Party Vendors Main Association of Social Security Agencies Card System Call Center and Social Security Agencies GINA GIN eCard: Solution Overview and Integration Landscape

9 eCard: Benefits Eligibility Check Service, process integration into PMS, no more paperwork (replacement of 42 Mio paper vouchers / year)  process efficiency, lower administration costs Smartcard based Patient identification managed by a central Patient Registry system  more efficiency on patient admittance process Drug approval Service  process efficiency, no more fax and paperwork, faster service, lower administration costs Infrastructure Rollout, Secure Connector, improved bandwidth on practice access  future proof infrastructure also for direct image access, encapsulated security layer for simple PMS or HIS connectivity, performance The Patient Card is also able to be used as a Signature Card for eGovernment Basis for additional eHealth services like Electronic Prescription Electronic Health Record Electronic Exchange of Referrals, Clinical Documents & Images …

10 National eHealth architectures Applications and communication infrastructures  a clear architectural blueprint based on international standards is a prerequisite to build a national eHealth infrastructure

11 Document Consumer Document Repository Document Consumer IHE: Cross-Enterprise Clinical Documents Sharing (XDS) Document Source Document Registry Patient Identity Source MPI MPI Master Patient Index EPR-I EPR-I Electronic Patient Record - Index Document Source Document Repository 1 Provide & Register 2 Register 3 Query 4 Retrieve STORE VIEW SEARCH MAKE

12 eHealth-applications: Main non functional requirements Security Customizability / Extendibility / Localization Support of health-standards Scalability (regional - national) Interoperability (regional - national) Support of patient registers Support of health professional registers Single Sign On Smart Card Support 24x7 Operation, High Availability Performance Lifetime readable eHR data (140 years)  a reliable and proven IT-Framework is necessary to build eHealth applications …

13 eHealth: Functionalities & Process Integration ePrescription eMedication eHealthRecord eReferral eEmergencyData eLaboratory eEligibility eAppointment eOrdering eVaccination e…  besides applications, integration is a big issue experienced professional service staff for process integration and integration of IT-systems is important

14 Secure E-Health Network and Integration Infrastructure Primary Care Systems, Patient Registries, Health Care Professional Registries, Provider Registries eHealth Applications, eHealthRecord, ePrescription, … Disease Management, Surveillance & Analysis Patient Self-Service Portals eHealth: Foundation

15... Networked Healthcare Systems... БЛАГОДАРЯ ВИ ЗА ВНИМАНИЕТО ! Franz Krenn, SIEMENS AG Austria Program and System Engineering Gudrunstraße 11, A-1100 Vienna