The Euro Rec Institute Its Structure Activities and

The Euro. Rec Institute: Its Structure, Activities and New Services François MENNERAT, MD Ph. D Euro. Rec Pro. Rec-France 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org

Introduction to Euro. Rec www. eurorec. org 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org

The Euro. Rec Institute • • European Institute for Health Records Non-profit organisation – – founded in December 2002 as their Federation by the four Pro. Rec centres that were established at that time (Belgium, Spain, France, and Bulgaria) registered on 12 May 2003 • according to the French law • Active at the European level with respect to the "subsidiarity principle" • Bound to become self-sustainable 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 3

A succession of EU projects • MEDIREC - Medical Record – (EC, FP 3, A-2103, 1994 -1995) • PROREC - Promotion Strategy for the European HC Record – (EC, FP 4, HC-1110, 1996 -1998) • WIDENET - Offering World-Wide Services through an International Network of Health Record centres – (EC, FP 5, IST-14203, 2000 -2003) • Q-REC - Quality Labelling and Certification of Electronic Health Record systems in Europe – (EC, FP 6, IST-27360, 2005 -2008) 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 4

A succession of EU projects • MEDIREC – The Lisbon Declaration • PROREC – First Pro. Rec centres established and co-operation between all stakeholders • WIDENET – Extension of the PROREC network (additional Pro. Rec centres created) – Establishment of Euro. Rec (June 14, 2003) • Q-REC – Harmonisation of EHRS Certification – Delivery of new Services 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 5

Euro. Rec's overall objectives • Foster Quality of EHR Systems (EHRS) – To the benefit of patients • Support Interoperability of EHRS in Europe – To the benefit of citizens • Facilitate the emergence and consolidation of a European market of medical software 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 6

Euro. Rec's goals • Support Pro. Rec centres • Inform users of current trends in EHRs and express their needs • Help public authorities to define and implement strategies • Support the EHRs industry (ROI) • Promote research, education and development in EHRs • Foster international co-operation – with US, Canada, Japan, Australia… 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 7

The Network of Pro. Rec centres Members: – – – – – Belgium Bulgaria Denmark France Germany Italy Ireland Romania Slovenia Spain Applicants: – – – – – Norway Greece Hungary Portugal Poland Sweden The Netherlands Slovakia United Kingdom? “ Differences in legal and organisational framework, languages, etc. 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 8

Euro. Rec: Organisation Euro. Rec … Pro. Rec Centres (Economy of scale / Synergy) … (Complementarity / National pecularities / Law / Languages) … Users (Clinicians, Citizens) 2006 -10 -10 EHRS Purchasers, Healthcare Vendors Authorities Payers Euro. Rec 2006, Genève www. eurorec. org

Euro. Rec: Organisation The current Board: • • • 2006 -10 -10 President Georges DE MOOR (BE) Vice President (1) Kieran HICKEY (IE) Vice President (2) Rolf ENGELBRECHT (DE) Treasurer Louis SCHILDERS (BE) Deputy Treasurer Knut BERNSTEIN (DK) Secretary General François MENNERAT (FR) Euro. Rec 2006, Genève www. eurorec. org 10

Euro. Rec: Funding • • 2006 -10 -10 Membership fees Annual conferences Services (cf. new Business Plan) E. C. funded projects : CERTFE, QREC, RIDE. . . Euro. Rec 2006, Genève www. eurorec. org 11

European Conferences on Electronic Health Records (EUROREC conferences) • • 2006 -10 -10 1997, Paris 1998, Rotterdam 1999, Sevilla 2001, Aix-en-Provence 2002, Berlin 2003, Dublin 2004, Bruxelles/Brussel 2006, Genève Euro. Rec 2006, Genève • PROREC • WIDENET • Q-REC www. eurorec. org 12

EHRs and EHRs From data storage to data interchange and to data processing From communication to interoperability 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org

Electronic Health Record EHR - Basic generic form – repository of information regarding the health of a subject of care, in computer processable form ISO TR 20514: 2005 "Definition, Scope and Context of Electronic Health Records" 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 14

Electronic Health Record System (EHRS) – system for recording, retrieving and manipulating information in electronic health records • CEN pr. EN 13606 -1 "Electronic Health Record Communication Part 1: Reference Architecture" – set of components that form the mechanism by which electronic health records are created, used, stored, and retrieved • It includes people, data, rules and procedures, processing and storage devices, and communication and support facilities • ISO TR 20514: 2005 "Definition, Scope and Context of Electronic Health Records" 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 15

Clinical process • relies on data and information management (and processing): – – – acquisition reception/sending out (emission) storage classification interpretation/confrontation against knowledge building up and validating hypotheses, making decisions – production of new data and information 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 16

Flows and stocks of health data • do reflect this activity • EHR systems are (should be) at the core of any health information systems • The idea of a single centralised health record is nothing but a pipe dream – Even if repositories of sharable data are increasingly needed – several health records held by different parties will inevitably always exist – between which messages will convey data – Some of them will contain sharable data • Interoperability between these records is an unavoidable requirement 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 17

Definition of Interoperability CEN / TC 251 • a state which exists between two application entities when, • with regard to a specific task, • one application entity can accept data from the other and perform that task • in an appropriate and satisfactory manner • without the need for extra operator intervention 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 18

Key role of interoperability • Single most important characteristic of EHRs = ability to share EHR information between different authorised users • In technical terms requires: – interoperability of information in the EHR – interoperability of EHR systems which exchange and share this information ISO TR 20514: 2005 "EHR Definition, Scope, & Context" 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 19

Trends in EHR Systems • EHR Systems become – transmural / virtual – multidisciplinary and interactive – intelligent Integration with other health care software applications into bigger systems. . . Administrative Records Medical Records Nursing Records Patient Personal Health Records 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 20

Trends in EHR Systems • Medical and Bio-Medical data – “The PHENOMES will meet the GENOMES in the EHRs of the Future” • Security: Privacy Enhancing Techniques • Semantic Interoperability: Ontology based approaches • Added value of EHRs: eg. Decision Support Systems • Grid Technology: Health. Grid 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 21

Current and future activities: The Q-REC project European Quality Labelling and Certification of Electronic Health Records (EHR) Systems IST – 27370 - SSA 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org

Objectives of the project • Design an effective, credible and sustainable mechanism for the Quality Labelling / certification of EHR Systems in Europe • Define a model for Quality Labelling / Certification including – Good Practices and Guidelines – Harmonised procedures 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 23

The scope of Q-REC • does not include – either national projects – or general issues regarding interoperability • is restricted to interoperability between EHR Systems • With an emphasis on conformity testing and certification 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 24

Operationally • State of the art and existing procedures for the Quality Labelling / Certification of EHR Systems • Terminology regarding Quality Labelling / Certification • Functional profiles for the classification of EHR Systems to certified • Good practices and models of certification procedures – including a list of quality criteria • Manual of benchmarking processes by formal testing for the quality labelling / certification of EHR Systems • Business Model for Certification / Quality Labelling 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 25

Resources to support interoperability of EHR Systems • • • 2006 -10 -10 Permanent publicly accessible Registers of Quality conformance criteria EHR Archetypes Coding Systems used in Health Care Relevant standards for EHR Systems Available XML schemas and Open. Source components for EHR Systems Euro. Rec 2006, Genève www. eurorec. org 26

Partners in the consortium Participants: 1 European Institute for Health Records (Co-ordinator) Euro. Rec 2 Pro. Rec‑Ireland Pro. Rec-IE 3 Pro. Rec‑France Pro. Rec-FR 4 Pro. Rec‑Belgium Pro. Rec-BE 5 MEDIQ A/S (Pro. Rec-Danmark) MEDIQ 6 Pro. Rec‑Deutschland Pro. Rec-DE 7 Research In Advanced Medical Informatics and Telematics RAMIT 8 University College London UCL 9 Pro. Rec‑Slovenija Pro. Rec-SI 10 Pro. Rec‑Bulgariya Pro. Rec-BG 11 Pro. Rec‑România Pro. Rec-RO 12 Dutch Organisation for Applied Scientific Research TNO Sub-contractors: 13 European Centre for Ontological Research ECOR 14 Empirica 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 27

Other projects • Euro. Rec is part of the RIDE project – "A Roadmap for Interoperability of e. Health Systems in Support of COM 356 with Special Emphasis on Semantic Interoperability" • Euro. Rec is part of the EHR-Implement project – Meant to examine political, social and organisational factors influencing large scale EHR implementations, and to identify best practices 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 28

Conclusion • Euro. Rec is playing its part in the development of e. Health in Europe, as anticipated by the European Commission • By facilitating and supporting the extensive development, implementation and use of interoperable high quality EHR systems throughout Europe • By providing an increasing number of effective services to suppliers, users, and public authorities 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 29

ur yo r fo ou y nk ha T n… tio ten at as well as for your questions ! www. eurorec. org 2006 -10 -10 Euro. Rec 2006, Genève www. eurorec. org 30