1. EuroRec (http://www.eurorec.org )
The « European Institute for Health Records »
A not-for-profit organisation, established April 16, 2003
Mission: the promotion of high quality Electronic Health Record systems (EHRs) in Europe
Federation of national ProRec centres in Europe
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2. ProRec Centers Centres Applicants Belgium United Kingdom Bulgaria
Denmark
France
Italy
Germany
Ireland
Romania
Slovenia
Spain
Slovakia
Applicants
United Kingdom
Serbia
The Netherlands
Poland
Norway
Greece
Hungary
Portugal
Sweden
“ Differences in languages, cultures and HC-delivery/funding systems ”
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3. EHRs: TRENDS EHRs start to become: transmural, virtual
multidisciplinary and interactive
longitudinal and intelligent
Administrative
Records
Medical
Records
Nursing
Records
Personal Patient
Records
! Integration with other eHealth applications ...!
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4. Coordinator: Prof. Georges De Moor
Q-REC
European Quality Labelling and Certification of Electronic Health Record systems (EHRs)
Duration:
Contract No: IST SSA
Coordinator: Prof. Georges De Moor
EHR-Implement
National policies for EHR implementation in the European area: social and organisational issues
Duration:
Contract No: IST SSA
Coordinator: Dr. Laurence Esterle
RIDE
A Roadmap for Interoperability of eHealth Systems in Support of COM 356 with Special Emphasis on Semantic Interoperability
Duration:
Contract No: IST
Coordinator: Prof. Asuman Dogac
22/10/2007

5. QREC’s Objective
To develop formal methods and to create a mechanism for the quality labelling and certification of EHR systems
in Europe, in primary- and in acute hospital-care settings
EuroRec Institute is coordinating partner
QREC has 12 partners and 2 subcontractors
Project duration is 30 months (1/1/ /6/2008)
22/10/2007

6. QREC: ORIGIN
Several EU-member states (Belgium, Denmark, UK, Ireland, …) have already proceeded since years with (EHRs-) quality labelling and/or certification (more often in primary care) but these differ in scope, in legal framework under which they operate, in policies and organisation, and perhaps most importantly in the quality and conformance criteria used for benchmarking …
These differences represent a richness but also a risk: harmonisation efforts should help to avoid further market fragmentation in Europe
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7. Central Repository
EuroRec will install a central repository of validated quality criteria and other relevant materials that can be used to harmonise European testing, quality labelling and procurement specification of EHR systems.
It will not impose particular certification models or specific criteria on any member country but will foster, via ProRec centres and other channels, the progressive adoption of consistent and comparable approaches to EHR system quality labelling.
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8. Q-REC Rationale –Certification is Essential
To assure the quality of EHR systems, e.g., patient safety may be at risk due to:
system design, specification and functional inadequacies,
poor or confusing presentation of clinical relevant information.
Sharing of information requires a quality assessment of EHR products with a view to ensuring interoperability with other systems because:
healthcare information, in particular clinical information, is often scattered over a number of informatics systems
the structures of these EHRs may significantly differ from one system to the other, depending on the creator and the purpose.
more and more incentives are being given to share patients’ medical data to support high quality care and “continuity of care” in a seamless way.
Certification of EHRs is essential for purchasers and suppliers
to ensure that EHR systems are robust enough to deliver the anticipated benefits as EHR systems and related product quality (data portability and interoperability are difficult to judge).
To reduce the risk for purchasers and therefore accelerate the adoption of high quality and more interoperable EHRs.
22/10/2007

9. The EuroRec Repository: Introduction
The Q-Rec repository will comprise several kinds of artefacts relating to the quality labelling and benchmarking of EHR systems:
EHR system requirements
EHR system conformance criteria
EHR system test plan items
An inventory of quality labelled (certified) EHR systems
An inventory of EHR related standards
An inventory of terminology and coding schemes
A directory of certified EHR archetype repositories
A directory of reviewed open source specifications and components
The year 1 priority
22/10/2007

10. EHRs Criteria: Business Cases
A purchaser wishing to procure an EHR system module
An e-Health programme wishing to ensure consistent EHR system functionality nationally
A vendor wishing to (re-)develop an EHR system module
Developers wishing to interface to a given EHR system module across multi-vendor systems
All may be:
seeking design guidance
wishing to obtain quality labelling certification
searching for trustworthy products
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11. EuroRec Repository
Repository Workflow
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12. Typology of EHR System Statements
Source Statements
faithfully extracted from original EHR system specifications and test plans
translated if necessary
Fine Grained Statements (FGS)
usually derived from source statements
made more generic, decomposed, reworded, corrected
Good Practice Requirements (GPR)
recomposed from FGS into the more common useful building blocks
may enhance or extend the scope of FGS: “push the boat out a bit”
Generic Test Criteria
derived from FGS and/or GPR
formally worded as testable functions
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13. EuroRec Repository
Repository Workflow
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14. Indexing the statements (1)
Multiple indexing of each statement
to maximise the likelihood of finding all relevant statements when searching via the indices
Business Function (50 in 8 subcategories)
Care Setting (18 in 3 subcategories)
Component Type (18 in 4 subcategories)
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15. Some statistics
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16. EuroRec Repository Maintenance Tools
Creation of Fine Grained Statements
Creation of Good Practice Requirements
Indexing statements
Linking statements
Maintenance and update of Fine Grained Statements
Maintenance and update of Good Practice Requirements
Translation functions
Access management
Versioning and audit functions
Overviews and statistics
22/10/2007

17. 1. From Reference Statements to Fine Grained Statements: selecting the Reference Statement
Reference statements frequently include multiple functions. Extract of the Irish 2007 criteria for General Practitioners
22/10/2007

18. Indexing Editor Linking an existing FGS 22/10/2007
2. From Reference Statements to Fine Grained Statements: editor and linkage and indexing FGS
Editor
Linking an
existing FGS
Indexing
22/10/2007

19. 22/10/2007 4. Fine Grained Statement: maintenance interface
Linked to 4 reference statements
Included in 1 Good Practice Requirement
Version and translation management
Editing area
22/10/2007

20. 5. Fine Grained Statement: similar view of attributes of a FGS
Linked to 4 reference statements
Included in 1 Good Practice Requirement
Applicable indexes
Area with comments from outside, if any
22/10/2007

21. 22/10/2007 6. Fine Grained Statement
View of a Fine Grained Statement with link to the Source Statements and the
Good Practice Requirements.
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22. 22/10/2007 12. Overview of Good Practice Requirements
List of Good Practice Requirements, with
number of Fine Grained Statements included
number of EuroRec Baskets with this GPR selected
view icon on indexes
display icon of links and indexes
icon enabling the user to give comments
view icon on the translations
maintenance icon
22/10/2007

23. 22/10/2007 13. Good Practice Requirement View The statement
Five Fine Grained Statements included
The indexes for that Good Practice Requirement
Area with comments from outside, if any
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24. Example of Good Practice Requirement in
16. Multilingual Good Practice Requirement
Example of Good Practice Requirement in
English, Bulgarian, German, Danish, French, Dutch, Romanian and Slovenian
22/10/2007

25. EuroRec Languages (non-exhaustive list)
English (default language)
Bulgarian
Danish
Dutch
French
German
Romanian
Slovenian
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26. EuroRec Use Tools The EuroRec Composer ™
To compose user defined, re-usable and exchangeable baskets of Fine Grained Statements.
The EuroRec Certifier ™
To format a EuroRec Basket content to obtain the basic layer for the certification of EHR systems. This is done by adding structure and attributes to the selected Fine Grained Statements.
The EuroRec Documentor ™
To document EHR systems and their functions, enhancing their understanding and comparability by using the EuroRec statements.
The EuroRec Procuror ™
To list and describe, for purchase purposes, required functionalities and product characteristics using EuroRec statements.
The EuroRec Scriptor ™
To produce and link Test Scenarios to EuroRec Baskets for Certification, Documentation and/or Procurement purposes.
22/10/2007

27. EuroRec
Baskets
Certification
Documentation
Procurement
Test Criteria
Sets
Test
Scenarios
Test
Procedures
22/10/2007

28. EuroRec Services
An Inventory of Certification Criteria for EHR systems
An Inventory of Standards relevant for EHR systems
EHR Archetypes
Open Source Components and XML Schemas
EHR Tutorials
Register of Health Coding Systems in use in Europe
Events
22/10/2007

29. Events at WHIT 2007 Tuesday, 23 October 13:30–14:30 Location: room 1
TL7 - Thought Leader Session
EHRs Certification: Global Issues
Wednesday, 24 October
11:30–12:30 Location: room 3
ES34 – Integrating IT Leadership to Improve Healthcare Delivery and Performance
Certification of EHRs: Criteria, Procedures and Tools
EuroRec will present an update on the development of its certification criteria repository, as well as on its recommended procedures, including the use of its EHR profiling tool.
17:15–18:00 Location: product tutorial theatre - booth 1021
Demo of the EuroRec Tools
EuroRec EHR certification and documentation
New era in certification - Real time demo
Thursday, 25 October
09:00–10:00 Location: room 2
ES44 – Integrating IT Leadership to Improve Healthcare Delivery and Performance
EHR in Europe: A new paradigm. Archetypes: a Revolution
Three new CEN European standards constitute a new paradigm. The Archetype paradigm enables 'plug-and-play' semantic interoperability between EHR systems. Via the process of 'creative destruction' new ICT vendors will enter the market using this new exciting paradigm. These European standards help fulfill the ambitious 2010 goals, as accepted by the European Commission.
22/10/2007

30. Thank you for your attention!
22/10/2007