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This proposal aims to create a secure and efficient infrastructure for patients to access and audit their medical information online. The focus is on collecting and structuring audit messages related to clinical data, allowing patients to retrieve and track their documents easily.
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ATNA Repository Query Detailed Profile Proposal for 2014/15 presented to the IT Infrastructure Planning Committee Mauro Zanardini (consorzio Arsenàl.IT) October 2nd 2014, Webinar
The requirements… • European Digital Agenda dedicates its Action 75 to increase patients empowerment giving them online access to their medical information. In this sense great attention is played on allowing the patient to consult the audit of data access… • Decreto FSE, Articolo 14 comma 3 (Ministerial Order): “Each access to clinical information stored in the regional PHR must be tracked in a specific section of patient’s web portal. The patient SHALL have electronic access to those information anytime…” • Many others are coming…
Which are the Problems…? Audit Infrastructure: Each enterprise manages and collects audit messages created by systems that belong to it: • THEY DO NOT WANT TO EXPORT THOSE DATA FROM THEIR ENTERPRISE. • In a HIE scenario a unique and centralized Audit Record Repository is technically/organizationally unfeasible. • Users that can ask for these audit messages belong to different enterprises and often they use different systems (Web Access, mobile device, EHR...)
Use-case • How it should/could work: All the audit messages related to Mr. Brown documents are collected and structured in accordance to ATNA profile in many ATNA ARR. The app can discover all these messages and can consume them. The app can show relationship between documents and events logged tracking users that retrieved documents. • How it works: All the audit messages related to Mr. Brown documents are collected and structured in accordance to ATNA profile in many ATNA ARR, but it is not defined a standard way to retrieve these messages. The patient should ask each enterprise to withdraw audit messages that are many times unreadable by a human, so useless.
The need… Query for Clinical Data SharingInfrastructure PHR AUDIT Infrastructure Query for Audit Data WHO/WHY/WHEN retrieve my documents
Value Proposition • IHE should take in consideration the increasing number of projects focused in PHR functionalities. • There are many vendor interested in this work-item. • This is a natural step in the federation of enterprises… • IHE specific: IHE manages the FHIR SecuriyEvent resource in collaboration with DICOM and HL7. This work-item could be the first step to sponsor/enforce this partnership.
Proposed Standards & Systems Basic Standard (IHE ATNA, RFC3881, DICOM Supp 95) RESTful: • HL7 FHIR (Resource SecurityEvent) SOAP: ???
Effort Estimation • The Effort for this work item is evaluated: • Small/Medium work effort. • Is there someone who is willing to act as profile editor? • Mauro Zanardini (Arsenàl.IT)