Overzicht aorta

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Overzicht aorta

  1. 1. Marc de Graauw<br />marc@marcdegraauw.com<br />AORTAthe Dutch Healthcare Infrastructure<br />
  2. 2. Marc de Graauw<br />marc@marcdegraauw.com<br />Healthcare <br />Information <br />System<br />HIB<br />BSN (“Burger<br />Service<br />Nummer”)<br />Registry<br />Messa-<br />ging<br />Services<br />Healthcare <br />Information <br />System<br />Patient<br />Registry<br />Healthcare <br />Information <br />System<br />Provider <br />Registry<br />UZI (PKI)<br />Registry<br />Healthcare <br />Information <br />System<br />Act<br />Registry<br />
  3. 3. Marc de Graauw<br />marc@marcdegraauw.com<br />The Netherlands<br />“AORTA” is the national backbone<br />Healthcare Information Systems at institutions and GP’s will be online 24x7<br />No clinical data at backbone, only an index of where clinical information resides<br />Clinical data stays at the source<br />Only possible with dense infrastructure <br />Patient, provider registries et cetera<br />
  4. 4. Marc de Graauw<br />marc@marcdegraauw.com<br />NICTIZ<br />(Dutch EHR Standards Organization)<br />Timeline <br />Medication File<br />Primary Care Summary<br />2003: start<br />2006: Healthcare Information Broker delivered <br />2006/7: First HIS qualifications<br />2009: General availability<br />
  5. 5. Marc de Graauw<br />marc@marcdegraauw.com<br />NICTIZ & Dutch Healthcare<br />Communication between: <br />Healthcare Provider (GP, hospital etc.)<br />Healthcare Information Broker (HIB)<br />HIB provides:<br />index of which parties have patient data<br />no patient data itself<br />messaging services<br />aggregation services<br />Health Level Seven version 3 (HL7v3)<br />
  6. 6. Marc de Graauw<br />marc@marcdegraauw.com<br />Ministry of Healthcare<br />NICTIZ<br />National <br />Institute for ICT<br /> in Care<br />CIBG<br />Healthcare <br />Professionals<br />Authority<br />UZI-Register<br />Healthcare <br />Provider Registry<br />SBV-Z<br />Unique Person Id <br />Registry Provider<br />Healthcare <br />Information<br />Broker<br />Gov<br />Hospitals<br />Others<br />Pharmacists<br />GP’s<br />Market<br />Healthcare <br />System<br />Suppliers<br />Healthcare<br />Access <br />Providers<br />Regional <br />Facilities<br />
  7. 7. Marc de Graauw<br />marc@marcdegraauw.com<br />Healthcare <br />Information <br />System<br />HIB<br />BSN (“Burger<br />Service<br />Nummer”)<br />Registry<br />Messa-<br />ging<br />Services<br />Healthcare <br />Information <br />System<br />Patient<br />Registry<br />Healthcare <br />Information <br />System<br />Provider <br />Registry<br />UZI (PKI)<br />Registry<br />Healthcare <br />Information <br />System<br />Act<br />Registry<br />
  8. 8. Marc de Graauw<br />marc@marcdegraauw.com<br />Healthcare <br />Information <br />System<br />HIB<br />BSN (“Burger<br />Service<br />Nummer”)<br />Registry<br />Messa-<br />ging<br />Services<br />Healthcare <br />Information <br />System<br />Patient<br />Registry<br />Healthcare <br />Information <br />System<br />Provider <br />Registry<br />UZI (PKI)<br />Registry<br />Healthcare <br />Information <br />System<br />Act<br />Registry<br />
  9. 9. Marc de Graauw<br />marc@marcdegraauw.com<br />AORTA<br />all messages go through healthcare information broker<br />three basic patterns:<br />HIS sends message to other HIS, HIB just routes<br />HIS sends message to HIB (mainly for registry updates and queries)<br />HIS queries several other HISses, HIB does registry lookups, accumulates data<br />
  10. 10. Marc de Graauw<br />marc@marcdegraauw.com<br />HIB<br />Healthcare <br />Information <br />System<br />Message <br />to HIS<br />Message<br />to HIB<br />Act<br />Registry<br />Healthcare <br />Information <br />System<br />Query<br />(to multiple HIS)<br />Act<br />Registry<br />Healthcare <br />Information <br />System<br />
  11. 11. Marc de Graauw<br />marc@marcdegraauw.com<br />Healthcare <br />Information <br />System<br />HIB<br />BSN (“Burger<br />Service<br />Nummer”)<br />Registry<br />Messa-<br />ging<br />Services<br />Healthcare <br />Information <br />System<br />Patient<br />Registry<br />Healthcare <br />Information <br />System<br />Provider <br />Registry<br />UZI (PKI)<br />Registry<br />Healthcare <br />Information <br />System<br />Act<br />Registry<br />
  12. 12. Marc de Graauw<br />marc@marcdegraauw.com<br />UZI Registry<br />provide Dutch healthcare PKI standards<br />provide and distribute smartcards with private keys<br />to all authorized healthcare institutions<br />to all authorized healthcare personnel<br />provide smartcard readers, and necessary software<br />publish and maintain certificate revocation lists <br />also provides authentication forwarding software<br />
  13. 13. Marc de Graauw<br />marc@marcdegraauw.com<br />Healthcare <br />Information <br />System<br />HIB<br />BSN (“Burger<br />Service<br />Nummer”)<br />Registry<br />Messa-<br />ging<br />Services<br />Healthcare <br />Information <br />System<br />Patient<br />Registry<br />Healthcare <br />Information <br />System<br />Provider <br />Registry<br />UZI (PKI)<br />Registry<br />Healthcare <br />Information <br />System<br />Act<br />Registry<br />
  14. 14. Marc de Graauw<br />marc@marcdegraauw.com<br />“Burger Service Nummer”<br />Unique Id for every Dutch person<br />Based on social security number<br />Law is amended to permit use in care<br />Maintain BSN Registry<br />Provide access to registry <br />query for BSN based on name, address, birthdate<br />query for name, address, birthdate based on BSN<br />Web Service<br />direct and through HIB / HL7v3<br />
  15. 15. Marc de Graauw<br />marc@marcdegraauw.com<br />Healthcare <br />Information <br />System<br />HIB<br />BSN (“Burger<br />Service<br />Nummer”)<br />Registry<br />Messa-<br />ging<br />Services<br />Healthcare <br />Information <br />System<br />Patient<br />Registry<br />Healthcare <br />Information <br />System<br />Provider <br />Registry<br />UZI (PKI)<br />Registry<br />Healthcare <br />Information <br />System<br />Act<br />Registry<br />
  16. 16. Marc de Graauw<br />marc@marcdegraauw.com<br />HIB (Healthcare Information Broker)<br />Routing of messages between HIS’s<br />Act Registry: which HIS has information on which patient for which kind of data<br />add/change/delete Act Information<br />Patient Registry (partly gateway to BSN)<br />Provider Registry (partly gateway to UZI)<br />Collection of query data<br />Logging, access control<br />VPN based, TCP/IP, HTTP network<br />
  17. 17. Marc de Graauw<br />marc@marcdegraauw.com<br />Healthcare <br />Information <br />System<br />HIB<br />BSN (“Burger<br />Service<br />Nummer”)<br />Registry<br />Messa-<br />ging<br />Services<br />Healthcare <br />Information <br />System<br />Patient<br />Registry<br />Healthcare <br />Information <br />System<br />Provider <br />Registry<br />UZI (PKI)<br />Registry<br />Healthcare <br />Information <br />System<br />Act<br />Registry<br />
  18. 18. Marc de Graauw<br />marc@marcdegraauw.com<br />Infrastructure example<br />
  19. 19. Marc de Graauw<br />marc@marcdegraauw.com<br />Actually, it’s not that simple...<br />
  20. 20. Marc de Graauw<br />marc@marcdegraauw.com<br />Healthcare Information Systems<br />Must qualify “Well Maintained HIS”<br />performance, security, maintenance, uptime etc.<br />Implement National Guidelines<br />Do logging<br />Do local authorizations<br />

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