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


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Lower Austria regional eHealth Integrator

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

  • 1030 Vienna, Austria

  • thomas.gitter@t-systems.at


“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

  • 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.


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