EHR Systems Use and Quality in Austria FH-Prof

EHR Systems Use and Quality in Austria FH-Prof. DI Dr. Stefan Sauermann UAS Technikum Wien Program Director, Biomedical Engineering Sciences Pro. Rec Austria EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

Myself: Communications engineer, ◦ 15 years Med. Uni Vienna, BME Head of national CEN ISO mirror „Medical Informatics“ Founding member of IHE Austria Consulting ELGA ◦ CDA harmonisation of the Lab Report Research project in personal healthcare ◦ www. healthy-interoperability. at EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

Health Care in Austria Insurance based system ◦ ~25 public insurances 15000 GPs ◦ many with social security contracts Hospitals: mostly provincial holdings ◦ Additional private hospital groups Many legacy IT systems ◦ Big and small EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

EHR systems: market (estimates) Software use ◦ 80 -90% of GPs use software ◦ Nearly all hospitals use EHRs Number of products ◦ Many GP systems! (> 100 vendors) ◦ >10 hospital products (>10 vendors) Market shares ◦ 4 GP software vendors cover 60% of market ◦ 4 Hospital products cover 75% of market stable over last five years EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

Existing law: enables treatment Laws for the medical professions e. Government law Data protection law Enables point-to-point data exchange Not suited for single access all data for one patient EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

National EHR law: expected within months Enables sharing of patient related data Data protection is primary concern ◦ Access only in context of treatment ◦ Patients have control on who may access what Storage ◦ What, how long . . . EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

EHR systems: quality assessment Existing GP software certification (in discussion) ◦ Approval of reimbursement for treatment (e. Card) ◦ Reimbursement (Social insurance) ◦ Standardised data export (Chamber of doctors) No incentive for using quality assessed / certified EHR systems EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

National EHR ELGA: growing! Central components (Built by ELGA) Master Patient Index „Affinity domain“ (Build by HCP or vendor) Healthcare Provider Index Local Document Registries with Repositories Domain B GPGP SW SW SW CIS GP GP SW, CIS CIS Follows IHE IT Infrastructure (XDS, ATNA, BPC, . . . ) EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade Domain …

ELGA Timeline (roughly) Master patient, HCP index available Harmonised CDA available e. Medication in pilot Security system in procurement Conformant affinity domains existing ◦ Reference domain in procurement Reference domain go live expected 2012/13 All hospitals integrated 2014 GPs integration in full swing 2015 EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

Highlight: Clinical Documents (Real beauties!!) http: //www. elga. gv. at/index. php? id=28 Discharge information Radiology and Lab reports ◦ HL 7 CDA Content harmonized ◦ >120 medical experts ◦ Implementations already available Usability guided design EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

Possible steps to certification Central components (Built by ELGA) Master Patient Index „Affinity domain“ (Build by HCP or vendor) Healthcare Provider Index Local Document Registries with Repositories Domain B Domain … GPGP SW SW SW CIS GP GP SW, CIS CIS Security first? Then affinity domain connection? Then GP/CIS connection? EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

Certification priorities Without access rights /security there is no data exchange This is a task in Europe May this be a first „e. Health Certificate“ on European level? EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

Looking forward to hear from you! Stefan Sauermann ◦ University of Applied Sciences Technikum Wien ◦ stefan. sauermann@technikum-wien. at The Austrian national EHR: ◦ www. elga. gv. at EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade