1. www.lknoe.at IHE in Austria IHE Success Stories, missing links and gaps Dipl.-Ing. Dr. Alexander SCHANNER Vienna, February 13 th 2014

2. IHE Requirements from an Austrian View www.lknoe.at Agenda 1.Success-Stories in Austria 2.Missing Links 3.Gaps in IHE Profiles & Domains 2

3. IHE Requirements from an Austrian View www.lknoe.at Decision of Federal Health Commission (BGK), May 2007 International standards for EHR (=ELGA) in Austria: ▪IHE Frame-Work with domain -IT Infrastructure -Patient Care Coordination -Laboratory -Radiology ▪HL7 CDA 2.0 as document standard ▪LOINC (area laboratory data) ▪DICOM 3.0 incl. WADO (area radiology) ▪HL7 (in Version 3 with RIM as prospective data model) 3

4. IHE Requirements from an Austrian View www.lknoe.at Implementation of ▪a nationwide central Index of Health Service Providers ▪a nationwide central Patient Index ▪a nationwide System for eMedication ▪appropriate pilot projects in order to evaluate the architecture of ELGA as already presented ▪These tasks have to implemented on the basis of the decision of the Federal Health Authority of May 4 th, 2007 concerning the applicable standards and the IHE framework. Furthermore, this decision has to complied with in all other eHealth applications of the federal entity, the provinces and the Social Security. 4 Decision of Federal Health Commission (BGK), December 2008

5. IHE Requirements from an Austrian View www.lknoe.at IHE Affinity Domains in Austria as Part of ELGA: Lower Austria Tyrol eGOR Upper Austria Vienna Styria Carinthia AUVA Salzburg 5

6. IHE Requirements from an Austrian View www.lknoe.at Hospitals in Lower Austria 6

7. IHE Requirements from an Austrian View www.lknoe.at 7 Inpatient Treatments 383.654 Inpatients269.830 Outpatient Treatments 2.866.952 Outpatients1.236.017 Employes15.429 XDS & XDS-I Environment, Using XDW Numbers of Lower Austria (2012)

8. IHE Requirements from an Austrian View www.lknoe.at Agenda 1.Success-Stories in Austria 2.Missing Links 3.Gaps in IHE Profiles & Domains 8

9. IHE Requirements from an Austrian View www.lknoe.at Availability vs. Real World Implementations of IHE-Profiles ▪Existing Profiles and Use Cases -Final Text, Date -Supplement for Trailimplementation ▪Adoption of Profiles &Use Cases by Vendors -Testet Systems at CAT -Available Products on market ▪Adoption of Profiles and Use Cases by Users -Requirements in RFPs -Real World Implementations 9 FT CAT RWI ST PROD RFP

10. IHE Requirements from an Austrian View www.lknoe.at Open Issues ▪Migration from HL 7 v2.x-World to Webservices -Cross Community Profiles are based on Webservices (HL 7 v3) PIX/PDQ, XCPD (HL7 v 3.0) XDS, XDS-I, DSUB, DRR XDW (inside XDS or via XCA?) HPD (Role in Context to PIX, XDS, XDW, PCC,..) PCC-Content-Profiles -Intra Community Profiles based on HL 7 v 2.x PAM [IT-I,..] PIR [RAD,..]  [IT-I]? ORM [RAD,..]  [IT-I, PCC]? CHG [RAD]  [IT-I, PCC, QRPH]? ▪New Domain for Reimbursement and Insurance-Processes? ▪Restructuring of Ordermanagement and Referal? 10

11. IHE Requirements from an Austrian View www.lknoe.at Patient Identity Management : PDQ -- PIX -- PAM 11 ▪IHE Transactions - Patientendata -Patient Identity Feed [ITI-8], [ITI-44, HL7 V3] -Patient Identity Management [ITI-30] -PIX Query [ITI-9], [ITI-45, HL7 V3] -PIX Update Notification [ITI-10], [ITI-46, HL7 V3] -Patient Demographics Query [ITI-21], [ITI-47, HL7 V3] -Patient Demographics and Visit Query [ITI-22], ▪Corresponding HL 7 v2.x Messages -Search Find candidates QBP^Q22 Find candidates response RSP^K22 -Feed & Update Insert Patient ADT – A28 Update Patient ADT – A31 Merge PatientADT – A40  Well adaopted by Web-Services

12. IHE Requirements from an Austrian View www.lknoe.at Patient Encounter Management : PAM 12 ▪IHE Transactions – Patientendata: -Patient Encounter Management [ITI-31] -Patient Demographics and Visit Query [ITI-22], ▪Corresponding HL 7 v2.x Messages -ADT_A01 Admission -ADT_A02 Transfer -ADT_A03 Discharge -ADT_A04 Outpatient Treatment -ADT_A06 Outpatient  Inpatient -ADT_A07 Inpatient  Outpatient -ADT_A08 PV-Data-Change -ADT_A11 Storno Aufnahme -ADT_A12 Storno Verlegung -ADT_A13 Storno Entlassung  Still missing Web-Services Candidates for new Services: Confirmation of treatment-relation Query for Insurance status PDQ  IDQ? IDQ = Insurance Data Query Conformation of Insurance

13. IHE Requirements from an Austrian View www.lknoe.at IHE Problems in ELGA ▪Content of PDQ & PIX – Anwser -Some Dataelements in PDQ should be optional or handled as national extensions ▪Image-Transfer across Enterprises 13

14. IHE Requirements from an Austrian View www.lknoe.at Accounting 14 ▪ ▪IHE Transactions - Accounting -Account Management [RAD-35] -Charge Posted [RAD-36] ▪Reporting of procedures and Diagnoses -BAR_P05 (PR1-Segment) -BAR_P05 (DG1-Segment)

15. IHE Requirements from an Austrian View www.lknoe.at Order Management Use Cases ▪Inside Enterprise Ordering -End to End -Provider unknown ▪Across Enterprise Ordering -End to End -Provider unknown Requirements ▪Integration HPD in XDS-Environment (XCA, XCPD) ▪Providing detailed Catalogs by SVS 15

16. IHE Requirements from an Austrian View www.lknoe.at THANK YOU FOR YOUR ATTENTION! alexander.schanner@holding.lknoe.at 16