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The Austrian Master Patient Index: Implementation of a Central Component of the Austrian Electronic Health Record

The Austrian Master Patient Index: Implementation of a Central Component of the Austrian Electronic Health Record. ITSV GmbH _ Johann-Böhm-Platz 1 A-1020 Vienna Austria T: +43 50124 844 32 00 Thomas.Hladschik@itsv.at www.itsv.at. Bucharest , 26.5.2011 Dr. Thomas Hladschik. Agenda.

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The Austrian Master Patient Index: Implementation of a Central Component of the Austrian Electronic Health Record

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  1. The Austrian Master Patient Index: Implementation of a Central Component of the Austrian Electronic Health Record ITSV GmbH _ Johann-Böhm-Platz 1 A-1020 ViennaAustria T: +43 50124 844 32 00 Thomas.Hladschik@itsv.at www.itsv.at Bucharest, 26.5.2011 Dr. Thomas Hladschik

  2. Agenda • ITSV GmbH– IT-Services of the Austrian Social Security • Assignment of the Implementation of the Austrian MPI • MPI Use Cases • Requirements • Architecture & Technical Details • Project Information • Summary and Outlook

  3. ITSV GmbH(IT-Services of the Austrian Social Security) ITSV Key Data ITSV – Current Services • Founded 3rd of Nov 2004 as a 100% subsidiary of the Austrian Social Security. • More than 8M customers. • Headquarter in Vienna: • Johann-Böhm-Platz 1, 1020 Vienna • Additional location: • Gruberstraße 77, 4021 Linz • ~320 Employees • Key Competences: • IT Governance • Call Center • Software Development • Data Center Services • ITSV is a non-profit company. • Consolidation of Data Center Services • Coordination of IT activities of the Austrian social security institutions and setup of IT strategies, architecture and standards • Support in exchanging core applications and migration of applications to the latest standard and version • Maintenance, Development and Operation of central application • Partner in the realization and operation of the Electronic Health Record (ELGA in Austria) www.itsv.at

  4. ELGA Source: Mag. Hubert A. Eisl, CIO ELGA (IHE NL Congress, Nov 2010) http://www.ihe-nl.org/uploaded/FILES/IHE-NL_Hubert%20Eisl_ELGA.pdf

  5. ELGA Source: Mag. Hubert A. Eisl, CIO ELGA (IHE NL Congress, Nov 2010) http://www.ihe-nl.org/uploaded/FILES/IHE-NL_Hubert%20Eisl_ELGA.pdf

  6. ELGA Source: Mag. Hubert A. Eisl, CIO ELGA (IHE NL Congress, Nov 2010) http://www.ihe-nl.org/uploaded/FILES/IHE-NL_Hubert%20Eisl_ELGA.pdf

  7. ELGA Source: Mag. Hubert A. Eisl, CIO ELGA (IHE NL Congress, Nov 2010) http://www.ihe-nl.org/uploaded/FILES/IHE-NL_Hubert%20Eisl_ELGA.pdf

  8. Assignment of the Implementation of the Austrian MPI MPI includes functionality like master data management, link/merge/clearing, … ZPV (“ZentralePartnerverwaltung”(1)): Includes similar functionality than MPI  potential for synergies. ITSV has experience in developing and operating ZPV. 6.3.2009: The „Federal Health Commission“ assigned the „Main Association of Austrian Social Security Institutions “ with the realization of the MPI ITSV is responsible for the application ZPV. Synergies 23.6.2009: ITSV was assigned by the “Main Association” to conduct a planning phase for MPI. ZPV ZPI/MPI 18.11.2009: ITSV was assigned to start the implementation of the Austrian MPI. (1) A master data management system for social security topics

  9. MPI Use Cases NCP (National Contact Point) Interface to the European National Contact Point (NCP) ZPV MPI (Master PatientIndex) Linking of Patient Identities from various Affinity Domains (PDQ & PIX functionality) „Leading System“ for providing demographic data, e.g. Address, Name, Social Security Number Linking of Patient Identities from various Hospitals within one Affinity Domain LPI (Local PatientIndex) LPI (Local PatientIndex) Affinity Domain n Affinity Domain 1

  10. MPI Use Cases Request of a LPI: „In which Affinity Domains can I find Mr. Max Maier“ “ Response of the MPI: „Affinity Domain 1 and 4“. MPI „Link Group“ of one Patient Identity Affinity Domain „1“ Affinity Domain „4“

  11. MPI Use Cases • Use Case: Search Patient Data (PDQ1) • Patient goes to Hospital the 1st time • HCP asks the LPI for demographic data, the LPI (optionally) forwards this request to the MPI • For a person which has social security in Austria, the MPI will return demographics data because of the connection to ZPV • Advantage: demographics data fast and with high quality Region A Region B Aufnahme 1 Patient Demographic Query (Request of a patient´s demographics data)

  12. MPI Use Cases • Use Case: Search Patients in other Affinity Domains (PIX1) • HCP sends request to LPI and then to the MPI. Response: • PIX Query delivers the affinity domains where the patients occurs as well. • The response DOES NOT include health records. • Advantage: PIX serves as preparation to generate EHR. ZPV-ID, Name, VSNR, … OÖ-LPI-ID, Name, VSNR, … T-LPI-ID, Name, VSNR, … Region A Region B 1st visit 2nd visit 1 Patient Identifier Cross-Reference

  13. Requirements • Information required for Patient Identities in MPI • Austrian Social Security Number ( high data quality) • EHIC (Challenges: Doublet Management) • Children w/o SS and EHIC (Challenges: multiple births) • Link/Merge of patient identities • Delivery of demographic data (PDQ) • Provide information about other affinity domains for a specific patient(PIX) • Logs of all access • Interfaces according to IHE and participation at IHE Connectathon

  14. Architecture & Technical Details ELGA Domains / Affinity DomainsLPI 1 … LPI n ELGA Portal Local ELGA Domains MPI – Master Patient Index MPI – Master Patient Index HTTPS/WSDL (HL7v3) Service PIF Service PIX Service PUN Service PDQ Transparencyon data access Service Admin Frontend Admin ZPV Adaptor SYSLOG/TCP JDBC HTTPS/WSDL Service ARR (Audit Record Repository) ZPV Notification Service ZPI Database ZPV Log ELGA ARR PIF … Patient Identity Feed PIX … Patient Identity Cross-Reference PUN … PIX Update Notification PDQ … Patient Demographics Query ZPV – Zentrale Partnerverwaltung(Master Data Management) ZPV

  15. Architecture & Technical Details

  16. Architecture & Technical Details • Data Security(1) • Firewall Configuration • The firewall of the MPI is configured to allow only the IP Addresses of the LPIs to get access (restriction to individual IPs or IP ranges). • Security Certificates • The MPI and each LPI issue a security certificate. The Public Keys are exchanged. • OIDs (Object Identifier) • The application MPI processes only requests if known OIDs are included (each LPI has a unique OID). L-PI Z-PI IP Adresse L-PI Z-PI L-PI L-PI (1) The applications MPI and the LPIs already run in secure networks (eHI-Net, Healix, CNSV, PP).

  17. Architecture & Technical Details • Performance Tests (ZPV Notification Service) • ZPV Notification Services from one week are processed within 10 hours. • Therefore the server capacity and the application performance is sufficient to process the data within a reasonable time frame (<2 hours / day for notification service). 10h / week

  18. Architecture & Technical Details • Performance/Stress Tests (PIF/PIX/PDQ) • Stress tests of the services PIF/PIX/PDQ including Clearing • Expected Results • Identify errors due to high load on services and servers • Identify potential performance bottlenecks • Extrapolate for a productive server configuration • Results expected Mid May. 

  19. Architecture & Technical Details • Clearing GUI

  20. Project Information • Project Goals • Implementation of the MPI based on the approved specification • Preparation for production readiness • Provision of the necessary infrastructure (Development, Test, Production) • Connection of 2 LPIs (Local Patient Index) to the MPI – if possible from 2 different “Connectathon approved” SW providers • Pilot • Timeframe • Start: 23.11.2009 • Finish: 15.6.2011

  21. Summary and Outlook • Status • Scope, progress and Budget according to plan • Validated Design (by ELGA) • MPI Services developed and verified by internal tests (PIF, PIXv3, PDQv3, ATNA, CT) • Successful participation at the Connectathon in Pisa, 2011 (secure node, PIXv3, PDQv3, ATNA, CT) • First successful tests with LPIs (OÖ, VG/BHB) • Realistic test scenarios with various LPIs and MPI • Performance and Stress tests in May • Outlook: • Stabilize, increase maturity and get acceptances from the project steering committee

  22. Connectathon 2011 Resultats Entscheiden Steuern Berichten (*) http://connectathon-results.ihe-europe.net/

  23. Connectathon 2011 Resultats Entscheiden Steuern Berichten IHE Integration Statement http://www.itsv.at/ihe

  24. The Team of the Austrian MPI • The Team of the Austrian MPI at ITSV GmbH(*) • Roman Dietrich, Bakk. • Ing. Norbert Fritz • Dr. Sylvia Geyer • Dr. Thomas Hladschik • Mag. Michael Holakovsky • Gerd Kainz • Dr. Robert Schanzer • Georg Stockinger • Dipl.-Ing. Andreas Zugaj • and Ressources from CSC, Siemens, ITH icoserve, Consigma (*) in alphabetical order by last name

  25. Thank you for your attention !

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