EHR systems use and quality in

Report
EHR Systems Use and
Quality in Austria
FH-Prof. DI Dr. Stefan Sauermann
UAS Technikum Wien
Program Director, Biomedical Engineering Sciences
ProRec Austria
EHR Systems Quality Labelling and Certification
21 - 22 November 2011, Belgrade
Myself:

Communications engineer,
◦ 15 years MedUni 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

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

eGovernment 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 (eCard)
◦ 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
SWSW
SW
CISCISGP GP
CIS SW,
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

eMedication 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
◦ HL7 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
SWSW
SW
CISCISGP GP
CIS SW,
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 „eHealth 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
◦ [email protected]

The Austrian national EHR:
◦ www.elga.gv.at
EHR Systems Quality Labelling and Certification
21 - 22 November 2011, Belgrade

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