1. Raimo Laus Head of IT Department
IT in EHIF
Raimo Laus
Head of IT Department

2. Video
E-STATE ARCHITECTURE

3. E-Health architecture
PHARMACIES AND FAMILY DOCTORS 2009
X-Road, ID-card, State IS Service Register
HEALTH CARE BOARD
- Health care providers
- Health professionals
- Dispensing chemists
STATE AGENCY OF MEDICINES
- Handlers of medicines
- Coding Centre
POPULATION REGISTER
PHARMACIS
2010 january
BUSINESS REGISTER
HOSPITALS
2009
FAMILY DOCTORS
SCHOOL NURSES
2010 september
EMERGENCY MEDICAL SERVICE
2011
NATION- WIDE HEALTH INFORMATION EXCHANGE
PLATFORM 2008
PRESCRIPTION CENTRE
2010
PATIENT PORTAL 2009
X-ROAD GATEWAY SERVICE 2009
HEALTH
INSURANCE
REGISTER
2005

4. X-Road OPERATOR FOR INFRASTRUCTURE PROBLEMS EHIF landscape
STATE PORTAL
PATIENT
DRUG STORE SYSTEM
EMPLOYER
FAMILY PHYSICIAN SYSTEM
CENTRAL SYSTEM
MESSAGING SERVER
PHYSICIAN WITHOUT AN INFORMATION SYSTEM
UNIVERSAL PORTAL(s)
X-Road
BUSINESS WAREHOUSE
HOSPITAL SYSTEM
REGISTRIES
(PHYSICIANS
Tax and Customs Board etc)

5. Participants Governmental Iniformation systems Primary Care IS
Perearst2 – 80%
Watson- 15%
Medicum - 4%
Arstiportaal – 0,1 %
Hospitals IS
eHealth
PerhIS
Liisa
Ester3
Dental Care
Dentas
Hammas
Pharmacys
Hansasoft
Noom

6. How did it started 2003 – first e-service: insurance check
- 80 % of hospitals had IS
- poor cumputerization
- uncontrolled data Exchange
- data processing and correction in EHIF
- reimbursment in 60 days.
2004 – new eInvoicing system („pipeline“):
- Dataexchange over https
- Hundreds of data quality checks
- data processing in origin source
- reimbursment in 60 days
- explosion of computerization.

7. EHIF IS arcitecture - timeline
… „homemade“ IS components, not integrated,
2002- strategic decision: build up new IS
Standard platform
Standard data Exchange channel (x-road)
webServices (SOAP, not HL7 etc)
Governmental portal
2003- strategic decision: build up new IS
Tender
New strategic platform : SAP

8. EHIF IS arcitecture - with SAP
2003- SAP ERP for Finance
2004- SAP ERP for Invoicing
2005- SAP CRM for Insurance Register
SAP CRM for diferent benefiits in cash
2010 SAP ERP for digitaal prescription.
: all data excange between SAP and x-road: trough SAP PO (Process Integrator)
: all data are syncronized to data warehouse: comprehensive and with high quality data mining
2017- all SAP system migrated to SAP HANA (inmemory database)

9. IS arcitecture- web service-based data exchange
Governmental service catalogue:
Online fact sheet:
2 governmental database:
Health insurance register: 53 services
Digital prescription database:38 services
Mostly SOAP-XML messages
Optimized querys
HL7 only in some cases
No document digital signing (all x-road messages are timestamped)
Next - Insurance register service porfolio examples:

10. Primary care e-services:
Functionality
Service name
Patient List
Patient_list
patient_list_changes
adding_to_list
patient_list_remove_patient
insurance_check
RiskPatient
riskpatient_list
riskpatient_add_data

11. Services for insured persons:
Functionality
Service name
Master Data
Patient_data
change_bank_account
Invoicing
Invoicing_data
Drug Benefits
Additional_drug_benefit control
Additional_drug_benefit_application

12. Benefit of incapacity of work:
Functionality
Service name
Benefit of incapacity of work
tvl_list_patient
tvl_list_doctor
tvl_list_employee
tvl_sending
tvl_validate
tvl_add_data

13. Dental care e-services:
Functionality
Service name
DentalCare
dentalcare_invoice_info
dental_compensation_limit
dental_compensation_invoice_send
dentude_invoice
dentude_limit_control
invoice_confirm
aggregated_invoices_data

14. Development process: Analysis, Order to IT
Service description for partners
WSDL files pubishing
Implementing in EHIF, in partner IT company
Testing in EHIF
Testing with IT partner
Testing with hospitals
GoLive

15. Perfomance statistics about e-prescription:

16. Future challenges: Clinical Decision Support system
Integrated Planning in SAP
New Invoicing system
Referral letter, e-Consulting
Quality Measurement System. ..

17. Thank you!