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SeHF 2014 | Datenaustausch zwischen Spitälern

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SeHF 2014 | Datenaustausch zwischen Spitälern

  1. 1. Datenaustausch zwischen Leistungserbringern Info Society Days Swiss eHealth Forum Donnerstag, 6. März 2014, Matthias Heubi  Alexander Mestre
  2. 2. Vernetzung: Gestern Infrastruktur pro Leistungserbringer (Erzeugung) Zuweiser, Labor, Spital (Abfrage) Nicht IHE XDS-fähiges System (PACS) Nicht IHE XDS-fähiges System (Fachapplikation) IHE XDS-fähiges System 3
  3. 3. Vernetzung: Gestern Vorteile • Etabliert • Bei telefonischer Anfrage können Diskrepanzen sofort ausgeräumt werden Nachteile • Langwieriger Prozess • Anfragen nur zu Büroarbeitszeiten • Es werden Unmengen an CDs oder Fotokopien produziert • Grossformate sind schwierig zu versenden 4
  4. 4. Vernetzung: Heute Infrastruktur pro Leistungserbringer (Erzeugung) Zuweiser, Labor, Spital (Abfrage) Nicht IHE XDS-fähiges System (PACS) Nicht IHE XDS-fähiges System (Fachapplikation) IHE XDS-fähiges System 5 Universalarchiv
  5. 5. Vernetzung: Heute Vorteile • Direkte Einsichtnahme ohne vorherige Anfrage (bei automatisch erteilter Berechtigung) • Zugriff auf alles an einem zentralen Ort (vs. mehrere Anfragen an verschiedene Abteilungen) • Technische Umsetzung ohne Einbezug Dritter Nachteile • Proprietäre Lösung (Native, Web) • GUI sieht bei jedem Spital anders aus • GUI sieht teilweise je nach Datentyp anders aus (DICOM, PDF, JPEG) 6
  6. 6. Vernetzung: In naher Zukunft Infrastruktur pro Leistungserbringer (Erzeugung) Basis-Infrastruktur der Affinity Domain Zuweiser, Labor, Spital (Abfrage, Abklärung) Patient Identity Source (MPI) Document Registry Nicht IHE XDS-fähiges System (PACS) Document ConsumerNicht IHE XDS-fähiges System (Fachapplikation) IHE XDS-fähiges System 7 IHE –fähiges Universalarchiv
  7. 7. Vernetzung: In naher Zukunft Vorteile • Direkte Einsichtnahme ohne vorherige Anfrage (bei automatisch erteilter Berechtigung) • GUI immer gleich, unabhängig von Datenlieferant • Direkte Übernahme der Daten in lokale Software Nachteile • Zugriff erfordert IHE Document Consumer • Komplexe Materie – verwirrend für Einsteiger • Tendenziell teure Basisinfrastruktur (Affinity Domain mit Master Patient Index , Registry) 8
  8. 8. Da geht die Reise hin • Die Zukunft gehört unbestrittenermassen den IHE- fähigen Lösungen • IHE gemäss eHealth Schweiz wird Gesetz (EPDG) • Die Teilnahme für Spitäler ist nicht freiwillig (Sanktionen durch Krankenkasse) • Komplexe Lösungsansätze und teure Basisinfrastruktur verzögern jedoch die Umsetzung 9
  9. 9. ARTS Webclient • Pragmatische Lösung Schnell und unproblematisch einsetzbar • Seit 2001 als Produkt verfügbar (z.B. Spital Limmattal) • Für schnell realisierbare Zuweiser-Anbindung (z.B. Spital Bethesda) • Als Mobile Client und als Web-Portal auch für Umsetzung von eHealth Schweiz 10
  10. 10. ARTS Webclient 11
  11. 11. IHE XDS im Überblick 12 Basis-Infrastruktur der Affinity Domain Zuweiser, Labor, Spital (Abfrage) Infrastruktur pro Leistungserbringer (Erzeugung) Patient Identity Source (MPI) Document Registry Document Consumer Document Repository DocumentSource
  12. 12. ARTS Brückenfunktion für IHE 19
  13. 13. IHE XDS mit ARTS 20 Basis-Infrastruktur der Affinity Domain Zuweiser, Labor, Spital (Abfrage) Infrastruktur pro Leistungserbringer (Erzeugung) Patient Identity Source (MPI) Document Registry Document Consumer Document Repository DocumentSource
  14. 14. Brückenfunktion: Erstellung Infrastruktur pro Leistungserbringer (Erzeugung) Basis-Infrastruktur der Affinity Domain Beliebige Quellsysteme Document Registry Patient Identity Source (MPI) HIS 22 Zuweiser, Labor, Spital (Abfrage) Document Consumer
  15. 15. Brückenfunktion: Erstellung Transparente IHE-Anbindung • Publiziert den Inhalt des Archivs automatisch in die IHE-Domäne • Gesteuert durch ein parametrisierbares Regelwerk • Unterstützt alle primären ARTS Operationen • Unterstützt implizite Datenformat-Konversionen (z.B. CDA von/nach PDF, DICOM nach JPEG) 23
  16. 16. Infrastruktur pro Leistungserbringer (Abfrage) KIS Basis-Infrastruktur der Affinity Domain Fremder Leistungserbringer (Erzeugung) Brückenfunktion: Abfrage Document Registry Patient Identity Source (MPI) Document Repository Document Repository ARTSClient Web/Native 24
  17. 17. Brückenfunktion: Abfrage Integrierter Document Consumer • Erlaubt den Zugriff auf andere IHE Document Repositories der Affinity Domain • Direkt in ARTS Server integriert • Ermöglicht eine gesamtschweizerische Sicht auf die komplette Krankengeschichte des Patienten 25
  18. 18. ARTS Certified Integration Integrationsstufen 1. Abfrage / Aufruf ARTS Viewer 2. Ablage / Archivieren von Berichten 3. Vollintegration (Archiv unsichtbar)  Beinhaltet IHE Live Abfrage  Darstellung in der Regel direkt im KIS 26
  19. 19. Zusammenfassung • Vernetzung bringt wesentlichen Mehrnutzen für alle Teilnehmer • Für verschiedene Szenarien existieren technisch verschiedene Lösungsansätze • Für IHE und eHealth Schweiz bietet ARTS spezielle Brückenfunktionen • Für Fachapplikationen mit Unterstützung von ARTS Certified Integration entsteht signifikanter Mehrwert 28
  20. 20. Weiterführende Informationen • Empfehlungen Standards und Architektur von eHealth Schweiz  www.e-health-suisse.ch/umsetzung/00146/00148/index.html • IHE Technical Frameworks  www.ihe.net/Technical_Frameworks • ARTS Universalarchiv  www.arts-universalarchiv.ch • Solution Präsentationen  Mobile elektronische Krankengeschichten, 14:30 & 16:00  Zuweiser(an)bindung, Freitag 13:30 Uhr 29

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