M403 ehealth Interoperability Overview

Transcription

1 CEN/CENELEC/ETSI M403 ehealth Interoperability Overview 27 May 2009, Bratislava Presented by Charles Parisot

2 Mandate M/403 M/403 aims to provide a consistent set of standards to address the needs of the rapidly-evolving field of ehealth for the benefit of future healthcare provision The three European Standards Organisations (ESOs), CEN, CENELEC and ETSI, accepted this mandate from the European Commission. Mandate requires active collaboration with COCIR, EHTEL, ISO/TC 215, IHE, HL7, Eurorec, IHTSDO, GS1, IEEE, DICOM. 2

3 Mandate M/403 Scope: ehealth and in particular the electronic health record with three priority issues: patient and health practitioner identification; the patient summary; an emergency data set. 2 phases First year (2008) setting up a work programme Three years to execute the programme and get results. Open for extensions beyond first three years. 3

4 Wide Coordination needed! Base Standards Development Profile Development ehealth Projects Interoperability Specifications CEN IHTSDO IEC/ISO JTC1 IHE Continua Based on original by: Charles Parisot 4

5 The symptoms.. Across Europe ehealth projects: Selects the standards they need independently The same requirement is addressed with a different mix of standards Cost of projects custom interoperability specifications end-up being very high (several man years) Cost of custom interoperability conformance test tools are realized to be massive, including the testing efforts. Cost of project specific implementations is very high initially and to maintain, with no reuse by other ehealth projects. Achieving interoperability, even for basic use cases, is not practical without considering re-use of: Standards-based specifications (e.g. profiles) Test tools and test plans Product implementations 5

6 Key points of ehealth INTEROP ehealth-interop is requirements driven and collaborative: Primary goal is not to develop new standards. Populate use cases with existing international standards when possible; Collaborate with standards fora, consortia and SDOs. Reuse and encourage reuse. ehealth-interop has a tight schedule: Phase 1 was succesfully completed in December 2008 following european-wide consensus building Phase 1 report was approved by the European Commission in March Phase 2 is planned to be launched mid

7 Mandate M/403 Phase 1 A team of appointed experts reporting to the ESOs have: examined the portfolios of existing standards from the many different organizations in the sector, including international formal bodies and industry standards consortia performed an analysis of sector needs and provided recommendations for specific standards developments 7

8 ehealth-interop Report: Mandate M/403 Phase 1 outcome A work programme needs agreement both on a: What How Focus of this presentation 8

9 The different classes of standards related specifications (1) Consistent across Europe 9

10 The different classes of standards related specifications (2) Interoperability Specifications: specific to a project, based on Profiles addresses the business-level use case Profiles: intermediate level of interoperability building blocks Interop Specs Profiles Base Standards: Either (1) very specific or (2) quite generic Base Stds 10

11 ehealth-interop Report: Proposals 5 Major Processes (1) use case definition and prioritization (2) standards development (3) profile development and maintenance (4) profile quality assurance test plans and tools (5) sharing of best practices in deploying ehealth projects Organise activities in support of these processes 11

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13 13 ehealth-interop Report: Proposals processes (1) Establish processes Business use case definition and prioritisation For Phase 2 of the ehealth Standards Mandate, it is proposed to establish a small project team under joint oversight of Member States and Stakeholder Group (users and industry), in the context of and in cooperation with other similar initiatives, to analyse, consolidate and prioritise use cases for Profile Specifications in Phase 2 and thereafter.

14 14 ehealth-interop Report: Proposals processes (2) Base standards development For Phase 2 of the ehealth Standards Mandate, rely on the existing harmonisation entities: CEN, CENELEC, ETSI ICT Standards Board (ICTSB) and Joint Initiative Council on SDO Global Health Informatics Standardization (JIC); and improve their efficiency by means of four identified actions.

15 15 ehealth-interop Report: Proposals processes (3) Profile development and maintenance For Phase 2 of the ehealth Standards Mandate, charter an entity to ensure that the prioritised and documented Business use cases are broken down into Technical use cases, and specific Base Standards are selected and profiled. Profiles should cover all layers of interoperability, from transport, through messaging services, to data structures and terminologies; these last two are two of the major elements necessary to provide semantic interoperability in health. It is recommended to use the processes defined by ISO TR28380 (IHE Global standards Adoption Process) to develop internationally agreed, or Europe specific, Profiles.

16 16 ehealth-interop Report: Proposals processes (4) Profile quality assurance, test plans and tools This activity is to ensure, for Profiles, a coordinated process among the various contributors and users. For Phase 2 of the ehealth Standards Mandate, it is proposed to charter IHE-Europe in partnership with ETSI, Continua and possibly others. It is important to link this activity with the existing national testing efforts in some of the European countries, and with international arrangements.

17 17 ehealth-interop Report: Proposals processes (5) Sharing of best practices in deploying ehealth project This activity is to give every national, regional or local project a European-wide forum to share experiences and publish bestpractice guides that offer guidance in conducting the deployment activities of ehealth projects. For Phase 2 of the ehealth Standards Mandate, It is proposed to rely on CALLIOPE project to conduct these activities for 2009 and Beyond 2010, a permanent chartered European entity needs to be designated to conduct these activities.

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19 European Use Case results from clustered project specific use cases 19

20 Semantics Semantic interoperability, especially at the clinical information level, is critical to achieving full exchange, understanding and appropriate consequent action among linguistically and culturally disparate clinicians and other parties. 20

21 For clinical semantics the following are required: Support for multilingual representations: global registries of standardised information models and related metadata; Common standards to allow data exchange on predefined key variables & compilation of content; Mechanism for ensuring the clinical consensus; Support for collaborative tools to develop, maintain and disseminate consensus approved content; Support for multilingual clinical constructs for context; Sustainable organisational and legal regulations. 21

22 Proposed Workplan Describes how to establish mutually agreed workplans: to meet the policy goal of cross-border care; to enable interoperability at a regional/national level. Aligns with the broader scope of: use case definition and prioritisation; standards development; profile development and maintenance; profile quality assurance test plans and tools; and sharing of best practices in deploying ehealth projects. 22

23 ehealth-interop Report: Proposals - deliverables Workplan Use-case based Profile priorities First, use epsos Project driven cross-border cases to provide complementary intraregional/national use cases: 1. regional/national patient summary, and 2. prescription. Second, two additional use cases: 1. radiology enterprise workflow, and 2. radiology information cross-enterprise sharing. Thirdly follow-on use cases: 1. laboratory enterprise workflow, 2. laboratory information cross-enterprise sharing, and 3. for care outside conventional care facilities, involving the interoperability necessary from home/mobile devices. 23

24 Proposed Workplan Phase 2, Year 1 Phase 2,Year 2 Phase 2... Regional/national Patient Summary and Prescription Use Cases Use Case Definition and Prioritisation Intra and Cross-Enterprise Imaging Results Sharing Use Cases Intra and Cross-Enterprise Laboratory Results Sharing Use Cases, Home Remote Monitoring Use Case Four New Use Cases Profile Development and Maintenance Profile Recognised for Regional/national Patient Summary and Prescription Use Cases Profiles Recognised for Intra and Cross-Enterprise Imaging Results Sharing Use Cases Profiles Recognised for Intra and Cross-Enterprise Laboratory Results Sharing Use Cases, and Home Remote Monitoring Use Case European Test Plans and Tools for first set of Recognised Profiles European Testing Event Profile Implementation Quality Assurance Test Plans and Tools for four sets of European-recognised Profiles European Testing Event { Best Practice Forum Harmonisation: CEN13606-HL7 RIM Misc. e.g. quality of care measure reports Base Standards Development and Maintenance Pan-European Terminologies Safety / Security and Privacy Structure / content binding Personal / Body Area Networks 24

25 Need more information? Ms. Shirin Golyardi, NEN, 25