... Networked Healthcare Systems ...

... Networked Healthcare Systems ... IT-Platforms help to improve efficiency in Healthcare Sofia, June 27th, 2006

eHealth: another Buzzword? Card Management System Patient Card Patient Registry Health Professional Card Clinical Trial System Health Provider Registry Electronic Commerce Hospital Information System Networks/Connectivity Practice Management System Communication Server Bioinformatics system Clinical Decision Support Systems eHealth Pharmacy System Health Professional Registry Imaging ePrescription Service Laboratory Systems Radiology Information System Internet/Extranet/Intranet Telemedical Technologies PACS Consumer Health Systems eProcurement Departmental Systems Clinical Data Repositories ADT System Expert System Computer-Telephony Integration Integrated Medical Devices Clinical DWH Data Integration Research Systems eLearning Systems Electronic Medical Records Workforce Enabling Technologies Workflow Technologies

Siemens coverage of all key-stakeholders in healthcare Hospital ambulance/ transport service Private Healthcare Patient’s home Physician Healthcare system Health authority Community Care Teaching Hospital Pharmacy NursingHome Self-help Group Patient Rehab Center Health Insurance/ payer Insurance cardholders

NÖMED WAN Patient- and Medical History Index:Overview • Client • Lower Austrian Health and Welfare Fund Area of Health • Federal state of Lower Austria • Lower Austria: Approx. 1.5 million inhabitants • 22 hospitals, Approx. 8000 beds, 5 different HIS • Approx. 3000 general practitioners, 40 different PMS • Currently: own patient identifier each, medical record on their own devices, exchange of information only on request, few reuse on clinical documentation … • Pilot Project • Objective of step1 is to set up a Master Patient index and Medical History Index and lookup services to identify on which place relevant medical information is stored. Document exchange via already existing secure eMail. • In Step2 we will provide direct access to clinical documents at the local document repositories by using standardized IHE XDS integration profiles.

Patient Master (MID) Copy of Local Patient Record (LID) HL7 … NÖMED WAN Patient- and Medical History Index:Overview – Data Management Citizen Registry … Doc 1 Doc n HIS 1 HIS n

NÖMED WAN Patient- and Medical History Index:Benefits • Improved patient identification and patient demographics data management by a central master patient index system more efficiency on patient admittance process • Patient centered storage of medical history  access to all patient related data, improved quality of care • Access to medical history at any point of care, anytime improved quality of care • Access to already existing clinical documents reduces the need for repeated examinations less exposure on the patient, cost reduction • Basis for secondary use • Retrospective studies on anonymized data  evidence based medicine, cost reductions • Disease Management  prevention, cost reductions • Epidemics / Outbreak management  efficient healthcare management

eCard: Overview Replacement of health insurance voucher (paper) with a smartcard solution Simple and fast checking of insurance claims to achieve appropriate user acceptance Assured high quality data for surrounding processes and further applications Robust, secure, high-available scalable, and future proven infrastructure rolled out for 12.000 practitioners, 8.000.000 cards

Main Association of Social Security Agencies Card System GIN GINA Central Services Medical Practitioner Software Solutions of 3rd Party Vendors Medical Practice / Hospital Call Center and Social Security Agencies eCard: Solution Overview and Integration Landscape

eCard: Benefits • Eligibility Check Service, process integration into PMS, no more paperwork (replacement of 42 Mio paper vouchers / year)  process efficiency, lower administration costs • Smartcard based Patient identification managed by a central Patient Registry system more efficiency on patient admittance process • Drug approval Service process efficiency, no more fax and paperwork, faster service, lower administration costs • Infrastructure Rollout, Secure Connector, improved bandwidth on practice access  future proof infrastructure also for direct image access, encapsulated security layer for simple PMS or HIS connectivity, performance • The Patient Card is also able to be used as a Signature Card for eGovernment • Basis for additional eHealth services like • Electronic Prescription • Electronic Health Record • Electronic Exchange of Referrals, Clinical Documents & Images • …

external public services Practices Reimbursement Trust Center Hospitals Public Registers(Providers, Professionals,Citizens) Prescriptions & Referrals Pharmacies Referral Letters Firewall/VPN/Connector Providers Broadband Network User Management Citizens/Patients Medicationhistory,adv. Drug Reactions SmartcardTerminals ArchivingService Payers Emergency Record Smartcards CommunicationServer Patient Record GovernmentInstitutions NetworkManagement ... ... PrimaryInformation Systems Secure Communication Network Common ApplicationServices ApplicationServices National eHealth architecturesApplications and communication infrastructures • a clear architectural blueprint based on international standards is a prerequisite to build a national eHealth infrastructure

Document Consumer Document Source DocumentRepository PatientIdentitySource Document Consumer Document Registry Document Repository Document Repository Document Source IHE: Cross-Enterprise Clinical Documents Sharing (XDS) SEARCH MPIMaster Patient Index MAKE EPR-IElectronic Patient Record - Index 3 Query VIEW 2 Register 1 Provide & Register 4 Retrieve STORE

eHealth-applications: Main non functional requirements • Security • Customizability / Extendibility / Localization • Support of health-standards • Scalability (regional - national) • Interoperability (regional - national) • Support of patient registers • Support of health professional registers • Single Sign On • Smart Card Support • 24x7 Operation, High Availability • Performance • Lifetime readable eHR data (140 years)  a reliable and proven IT-Framework is necessary to build eHealth applications …

eHealth: Functionalities & Process Integration • ePrescription • eMedication • eHealthRecord • eReferral • eEmergencyData • eLaboratory • eEligibility • eAppointment • eOrdering • eVaccination • e… • besides applications, integration is a big issue experienced professional service staff for process integration and integration of IT-systems is important

eHealth: Foundation PatientSelf-Service Portals Disease Management,Surveillance & Analysis eHealth Applications, eHealthRecord, ePrescription, … Primary Care Systems, Patient Registries, Health Care Professional Registries, Provider Registries Secure E-Health Network and Integration Infrastructure

... Networked Healthcare Systems ...БЛАГОДАРЯ ВИ ЗА ВНИМАНИЕТО ! Franz Krenn, SIEMENS AG Austria Program and System EngineeringGudrunstraße 11, A-1100 Vienna franz.krenn@siemens.com +43 676 5680040

... Networked Healthcare Systems ...