Lower Austria regional eHealth Integrator Thomas Gitter, md product Manger Int. Cc health Services Rennweg 97-99

Lower Austria regional eHealth Integrator

• Thomas Gitter, MD Product Manger Int. CC Health Services Rennweg 97-99

• 1030 Vienna, Austria

• [e-mail]

“Lower Austria”….

Prerequisites Situation of healthcare in Austria

• Hospital and Primary Care landscape in Austria

• Primary Care doctors are independent, most of them having conctracts with one or more insurances
• Hospitals are owned mostly by regional authorities or clerical; few private
• High frequency out-patient clinics in most of the hospitals

• Insurance and healthcare – finanzing

• „Dual“ financing: Different payors for in/out – patients
• Patient is at risk to get „ping-pong“ subject
• eCard: Recently rolled out for prove of eligibility

• Patient identification

• No unique Identification of patients (nor inhabitants)
• Insurance – number good for search and matching
• not necessarily unique
• not from birth.

eHealth Existing regional examples

• Addressed point-to-point delivery of discharge letters and reports

• Using kind of mail-box-systems
• Recipient known at time of delivery

• Portals for admission

• Still only few, individual

• Teleradiology

• Gains ground
• Point-to-point
• Images less problematic compared to reports.

eHealth Aspects

• The 10 e's in “e-health” (Gunther Eysenbach)

• Efficiency
• Enhancing quality of care
• Evidence based
• Empowerment of consumers and patients
• Encouragement of a new relationship patient and health professional
• Education of physicians through online sources
• Enabling information exchange and communication in a standardized way between health care establishments
• Extending the scope of health care beyond its conventional boundaries
• Ethics
• Equity.

eHealth Integrator Features

• Functional scope

• Patient Index
• Medical History Index (Admissions, visits, document registry)
• Integration interfaces for connecting participants
• Implemented business processes
• Web Application

• Future Extensions

• Clinical Repository
• Increased collaborative processes between healthcare facilities

Healthcare Record Approach: Product and Solution

Duties: (some)

• Duties: (some)

• Steering of healthcare providing

• Investments

• Structural improvements

• Defining of guidelines for economical behavior of hospitals

• Ongoing improvement of service-oriented finanzing

• Setting up appropriate acute-care capacities

• Extension of alternative care-institutions

• Coordination and planning of structures of care

• Balancing of service offerings between hospitals

A distributed lifetime electronic medical history

• A distributed lifetime electronic medical history

• requires a strict Separation of:

• MAKE = Creation of Documents
• STORE = Archiving of Documents
• SEARCH = Looking for Documents resp. dedicated content
• VIEW = Presentation of documents

Patient and Medical History Index. Overview – Data Management.

NÖMED WAN. Patient and Medical History Index. Process Example: Index Query, Patient Data Transfer.

NÖMED WAN Patient and Medical History Index Process Example: Medical History Query.

“Master Patient”

• Matching algorithm

• Patient demography
• Social insurance number
• Remote ID`s kept in central index system

• Reconciliation tool

• Part of contract
• Compliant with regional/national/international law (?)
• Data security / privacy issues

Projekt NÖMED WAN Timeline

• Step 1 – Patient Index

• Index went live January 2006
• Initial Load of patient data (demography) from pilot - hospitals
• Integration with SAP Patient Management/ i.s.h.med at ZK St.Pölten

• Step 2 – Patient History

• Enrichment of Index by: Admissions, Document-MetaData: June 06
• Initial Load from pilot hospitals
• Integration with SAP Patient Management/ i.s.h.med at ZK St.Pölten

• Future Scope

• Connection with decentralizd Document repositories
• Direct Document retrival from respective archive.

Projekt NÖMED WAN Technical Architecture

Backup….

NÖMED WAN the Healthcare-Network

• NÖMED WAN = Family of projects to establish a state-wide network across all Healthcare providers in Lower Austria

• General Conditions:

• Countrywide Applicability (Austria)
• Conformity with International Standards
• Consideration of National Healthcare reform-programs
• Healthcare Agency / Platform
• Regional Concepts
• Electronic Healthcare Record (ELGA)
• Consideration of the e-Health Europe action plan (EU-Target)
• Consideration of chip-card for Healthcare Services (e-card)

Global Aims

• Global aims

• Creation of a central and integrative information and communication platform to meet the patient-related requirements of healthcare and welfare in Lower Austria.
• To make all relevant medical data of a patient available at any location and at any time for authorized persons or organizations to the extent required, thus providing quicker and more efficient medical assistance.
• Synergy and cost efficiency in the acquirement and operation of IT systems.