1. Standardization Roadmap in EE Janek Metsallik Chief Architect Estonian eHealth Foundation

2. Topics Standardization Context Current Practice Next Generation

3. Historic Context Estonian Ministry of Social Affairs – ICD10, NCSP Estonian Health Insurance Fund – Healthcare Services Price list, DRG Health Care Board – List of Health Care Professionals State Agency of Medicines – Classification of Medicinal Products, ATC Statistics Estonia – Classification of Estonian administrative units and settlements – Estonian classification of economic activities – others Others – Dr. Kalev Karu, SNOMED rationale

4. Towards EHR ICD10 – in wide use since 1997 “6th of May Act” – Healthcare documentation content regulation – and related code lists 2000 eHealth planning begun – Including standardizations 2003-2005 EHR project preparation 2006-2008 EHR project, HL7 2008 National EHR documentation content Act 2009 EHR in production 2010 SNOMED NRC, eLabs & LOINC

5. Standardization is base for services Central EHR Health Portal Registries Integration Standardization Personal Guidelines Care Paths Service Brokering Integrated Statistics Social Networking Simulation Environment Tracking Behaviour Tracking Online Intervention Lifestyle Value Added Information Exchange Decision Support Selfcare Time Impact

6. CURRENT PRACTICE

7. EHR Service Development Message HL7 Template (500) HL7 Template (500) OID Code List (300) Code List (300) Interface Content Service Data Model Classifi- cation Compo- nent Use Case (30) Use Case (30)

8. Data Model Structured text documentation Mostly document-exchange oriented structure Some status exchange messages described (case management) Some hints about related processes and timing included Prepared by HCI’s business analysts Linked to established classifications Project based version control of the specification http://www.e-tervis.ee/images/stories/dokumendid/digihaigusloo%20teatis.doc

9. Template Model UML model of document and message structures Prepared by IS analysts Base for interface specification generation System based version control

10. HL7 mapping of Templates

11. http://pub.e-tervis.ee/

14. NEXT GENERATION

15. Change Drivers Enable transformation of Business Process – Impact analysis and Full Roundtrip Modeling Improve efficiency of modeling – Automate transformation between tools (State Information Systems Registry, Testing, Publishing, Code Generation) Enable effective communication – Common meta-model Prepare for new services and service changes – Integrate and bring models online – International integration (code systems, structure) – Ready-made components integration

16. Standardization Evolution Project Based System Based Community Based

17. Shared UML Repository

18. Simplified Notation

19. Seeking for better tools Message HL7 Template HL7 Template OID Code List Interface Content Service Data Model Compo- nent UML Model Process Model Ontology Classifi- cation Termono -logy ? Use Case SNOMED NRC eLab & LOINC Processing Rule

20. THANK YOU! There will be an eHealth conference with a practical focus in Tallinn from October 13-15. Conference will include lecture sessions with corresponding site visit modules where participants can see how various eHealth solutions work in practice. Conference programme can be viewed: www.ehealthtallinn2010.org Please come and join us for an eExperience in Estonia!www.ehealthtallinn2010.org Please come and join us for an eExperience in Estonia!