The document summarizes a FHIR x Nuts hackathon that took place from April 21-25, 2023. The hackathon involved 9 organizations, 6 EHR vendors, and 2 standards organizations. They demonstrated and tested the scalable secure FHIR stack for use cases like medical referrals and multidisciplinary team consultations. The stack provides security, scalability, and is infrastructure independent. Next steps include further implementing the stack for other standards and use cases.
The need for interoperability in blockchain-based initiatives to facilitate c...Massimiliano Masi
Slides for the IEEE Blockchain Symposium in Glasgow, https://blockchain.ieee.org/standards/clinicaltrialseurope18, https://blockchain.ieee.org/standards/clinicaltrialseurope18/speakers
This webinar will focus on practical applications of the FAIR data principles, particularly in the context of clinical bioinformatics. We will highlight several example projects that have put the FAIR principles in practice, and discuss the advantages and some of the challenges involved. ELIXIR Galaxy community (elixir-europe.org/communities/galaxy) promotes the use of Galaxy projects that enhance the FAIRness in data analysis. We will demonstrate the Galaxy services that deliver practical FAIR data analysis with “Single Sign-On” capability provided by ELIXIR-AAI. The aim is to provide (medical) researchers with the practicalities of implementing and using FAIR principles in the context of the CINECA project as applied to translational research at Erasmus University Medical Center.
The “How FAIR are you” webinar series and hackathon aim at increasing and facilitating the uptake of FAIR approaches into software, training materials and cohort data, to facilitate responsible and ethical data and resource sharing and implementation of federated applications for data analysis.
The CINECA webinar series aims to discuss ways to address common challenges and share best practices in the field of cohort data analysis, as well as distribute CINECA project results. All CINECA webinars include an audience Q&A session during which attendees can ask questions and make suggestions. Please note that all webinars are recorded and available for posterior viewing.
This webinar took place on 4th March 2021 and is part of the CINECA webinar series.
For previous and upcoming CINECA webinars see:
https://www.cineca-project.eu/webinars
The need for interoperability in blockchain-based initiatives to facilitate c...Massimiliano Masi
Slides for the IEEE Blockchain Symposium in Glasgow, https://blockchain.ieee.org/standards/clinicaltrialseurope18, https://blockchain.ieee.org/standards/clinicaltrialseurope18/speakers
This webinar will focus on practical applications of the FAIR data principles, particularly in the context of clinical bioinformatics. We will highlight several example projects that have put the FAIR principles in practice, and discuss the advantages and some of the challenges involved. ELIXIR Galaxy community (elixir-europe.org/communities/galaxy) promotes the use of Galaxy projects that enhance the FAIRness in data analysis. We will demonstrate the Galaxy services that deliver practical FAIR data analysis with “Single Sign-On” capability provided by ELIXIR-AAI. The aim is to provide (medical) researchers with the practicalities of implementing and using FAIR principles in the context of the CINECA project as applied to translational research at Erasmus University Medical Center.
The “How FAIR are you” webinar series and hackathon aim at increasing and facilitating the uptake of FAIR approaches into software, training materials and cohort data, to facilitate responsible and ethical data and resource sharing and implementation of federated applications for data analysis.
The CINECA webinar series aims to discuss ways to address common challenges and share best practices in the field of cohort data analysis, as well as distribute CINECA project results. All CINECA webinars include an audience Q&A session during which attendees can ask questions and make suggestions. Please note that all webinars are recorded and available for posterior viewing.
This webinar took place on 4th March 2021 and is part of the CINECA webinar series.
For previous and upcoming CINECA webinars see:
https://www.cineca-project.eu/webinars
Building an Integrated Healthcare Platform with FHIR®WSO2
Healthcare records are increasingly becoming digitized. As patients move around the healthcare ecosystem, their electronic health records must be available, discoverable, and understandable. Further, to support automated clinical decisions and other machine-based processing, the data must also be structured and standardized. This is becoming a matter of interest for institutes such as government agencies and regional bodies, and we are already seeing rules and regulations come into action. For example, the Centers for Medicare and Medicaid Services (CMS), which is a part of the Department of Health and Human Services (HHS) of the United States, has published the “Interoperability and Patient Access final rule (CMS-9115-F)”. This aims to put patients first by giving them access to their health information when they need it most and in a way they can best use it.
Fast Healthcare Interoperability Resources (FHIR®) is a next-generation standard framework created by HL7 combining the best features of previous HL7 standards. FHIR® leverages the latest web standards and focuses on ease of implementability.
The slides showcase the primary components of FHIR, discover the architectural principles behind its design, and understand implementation considerations.
Advice for Healthcare IT Startups NYC Executive Informational and Networking ...Todd Winey
Breaking into healthcare as an IT startup can be challenging. Learn some tips and tricks for success in the healthcare IT market from people who have been there and done that.
Présentation à l'occasion de la Conférence HIMSS Amsterdam 2013 du DMP, "French PHR/EHR" on its creation, usage and lessons learnt with a national e-health record by François MACARY (ASIP Santé)
Industrial Data Space Association - New Members, New Insights, New Future Dir...Thorsten Huelsmann
Digitalisation is both an enabler and a driving force behind innovative business models. A key ability for innovative business models is to be able to combine data in one “ecosystem”: Services are decoupled from physical platforms/products, The architecture levels are decoupled, Products become platforms and vice versa, “Ecosystems“ develop around platforms, Innovation takes place cooperatively.
Data as strategic resource enables smart services, products and our desired lifestyle of the future.
This presentation was held at the FI-PPP phase 3 workshop, 6-7 March in Brussels. Especially explaining how and on what conditions phase 3 projects can use the FIspace platform.
The project “empoWering prIvacy and securiTy in non-trusteD envirOnMents” (WITDOM for short) is a three-year multi-disciplinary, Research and Innovation Action co-funded by the European Commission in the context of Horizon 2020, the EU Framework Programme for Research and Innovation.
WITDOM aims at protecting the privacy and security of data outsourced to untrusted ICT providers, such as clouds. By protecting sensitive data cryptographically and by applying the privacy-by-design paradigms, WITDOM will provide a holistic framework that addresses end-to-end security for sensitive data. WITDOM's data protection methods will be tailored to the risks associated with different classes of data, so that users remain immune to the threats, vulnerabilities, and risks that may affect remote data processing.
CINECA webinar slides: Data Gravity in the Life Sciences: Lessons learned fro...CINECAProject
We live in an era of cloud computing. Many of the services in the life sciences are keenly planning cloud transformations, seeking to create globally distributed ecosystems of harmonised data based on standards from organisations like GA4GH. CINECA faces similar challenges, gathering cohort datasets from all over the globe, many of which are pinned in place, due to their size, legal restrictions, or other considerations. But is “bringing compute to the data” always the right choice? In this webinar, based on experiences from the Human Cell Atlas Data Coordination Platform and other projects from EMBL-EBI, we will explore the concept of “data gravity”: The idea that whilst there are forces that may hold data in one place, there are others that require it to be mobile. We’ll consider how effectively planning a cloud strategy requires consideration of the gravity of datasets, and the impact it may have on team skills required, incentives for good practice, and storage and compute costs.
The CINECA webinar series aims to discuss ways to address common challenges and share best practices in the field of cohort data analysis, as well as distribute CINECA project results. All CINECA webinars include an audience Q&A session during which attendees can ask questions and make suggestions. Please note that all webinars are recorded and available for posterior viewing. CINECA webinars include an audience Q&A session during which attendees can ask questions and make suggestions.
This webinar took place on 12th November 2020 and is part of the CINECA webinar series.
For previous and upcoming CINECA webinars see:
https://www.cineca-project.eu/webinars
For companies, data is only worthwhile if it can be processed. At the same time, a new, comprehensive and generally accepted handling practice has to be anchored in the way data is utilized.
Industrial Data Space is a virtual data space which supports the secure exchange and simple linking of data in business ecosystems on the basis of standards and by using collaborative governance models.
Data is only exchanged if it is requested from trustworthy certified partners. The data owner – i.e. the company – determines who is allowed to use the data in what way. As a result, the partners of one supply chain have joint access to certain data by mutual consent so that they can start something new, develop new business models, design their own processes more efficiently or initiate additional added value processes elsewhere, either alone or together.
This presentation was shown at Digital Transport Days, November 9, 2017.
Scenario:
Midwest Regional Health is one of Wisconsin's largest and most sophisticated hospitals, is Implementing a new EHR system that will better their services to their internal and external customers. They are asking ITMC (I-Tech Medical Consortium) to help them navigate through this long term project, thereby improving their commitment to their surrounding community.
Building an Integrated Healthcare Platform with FHIR®WSO2
Healthcare records are increasingly becoming digitized. As patients move around the healthcare ecosystem, their electronic health records must be available, discoverable, and understandable. Further, to support automated clinical decisions and other machine-based processing, the data must also be structured and standardized. This is becoming a matter of interest for institutes such as government agencies and regional bodies, and we are already seeing rules and regulations come into action. For example, the Centers for Medicare and Medicaid Services (CMS), which is a part of the Department of Health and Human Services (HHS) of the United States, has published the “Interoperability and Patient Access final rule (CMS-9115-F)”. This aims to put patients first by giving them access to their health information when they need it most and in a way they can best use it.
Fast Healthcare Interoperability Resources (FHIR®) is a next-generation standard framework created by HL7 combining the best features of previous HL7 standards. FHIR® leverages the latest web standards and focuses on ease of implementability.
The slides showcase the primary components of FHIR, discover the architectural principles behind its design, and understand implementation considerations.
Advice for Healthcare IT Startups NYC Executive Informational and Networking ...Todd Winey
Breaking into healthcare as an IT startup can be challenging. Learn some tips and tricks for success in the healthcare IT market from people who have been there and done that.
Présentation à l'occasion de la Conférence HIMSS Amsterdam 2013 du DMP, "French PHR/EHR" on its creation, usage and lessons learnt with a national e-health record by François MACARY (ASIP Santé)
Industrial Data Space Association - New Members, New Insights, New Future Dir...Thorsten Huelsmann
Digitalisation is both an enabler and a driving force behind innovative business models. A key ability for innovative business models is to be able to combine data in one “ecosystem”: Services are decoupled from physical platforms/products, The architecture levels are decoupled, Products become platforms and vice versa, “Ecosystems“ develop around platforms, Innovation takes place cooperatively.
Data as strategic resource enables smart services, products and our desired lifestyle of the future.
This presentation was held at the FI-PPP phase 3 workshop, 6-7 March in Brussels. Especially explaining how and on what conditions phase 3 projects can use the FIspace platform.
The project “empoWering prIvacy and securiTy in non-trusteD envirOnMents” (WITDOM for short) is a three-year multi-disciplinary, Research and Innovation Action co-funded by the European Commission in the context of Horizon 2020, the EU Framework Programme for Research and Innovation.
WITDOM aims at protecting the privacy and security of data outsourced to untrusted ICT providers, such as clouds. By protecting sensitive data cryptographically and by applying the privacy-by-design paradigms, WITDOM will provide a holistic framework that addresses end-to-end security for sensitive data. WITDOM's data protection methods will be tailored to the risks associated with different classes of data, so that users remain immune to the threats, vulnerabilities, and risks that may affect remote data processing.
CINECA webinar slides: Data Gravity in the Life Sciences: Lessons learned fro...CINECAProject
We live in an era of cloud computing. Many of the services in the life sciences are keenly planning cloud transformations, seeking to create globally distributed ecosystems of harmonised data based on standards from organisations like GA4GH. CINECA faces similar challenges, gathering cohort datasets from all over the globe, many of which are pinned in place, due to their size, legal restrictions, or other considerations. But is “bringing compute to the data” always the right choice? In this webinar, based on experiences from the Human Cell Atlas Data Coordination Platform and other projects from EMBL-EBI, we will explore the concept of “data gravity”: The idea that whilst there are forces that may hold data in one place, there are others that require it to be mobile. We’ll consider how effectively planning a cloud strategy requires consideration of the gravity of datasets, and the impact it may have on team skills required, incentives for good practice, and storage and compute costs.
The CINECA webinar series aims to discuss ways to address common challenges and share best practices in the field of cohort data analysis, as well as distribute CINECA project results. All CINECA webinars include an audience Q&A session during which attendees can ask questions and make suggestions. Please note that all webinars are recorded and available for posterior viewing. CINECA webinars include an audience Q&A session during which attendees can ask questions and make suggestions.
This webinar took place on 12th November 2020 and is part of the CINECA webinar series.
For previous and upcoming CINECA webinars see:
https://www.cineca-project.eu/webinars
For companies, data is only worthwhile if it can be processed. At the same time, a new, comprehensive and generally accepted handling practice has to be anchored in the way data is utilized.
Industrial Data Space is a virtual data space which supports the secure exchange and simple linking of data in business ecosystems on the basis of standards and by using collaborative governance models.
Data is only exchanged if it is requested from trustworthy certified partners. The data owner – i.e. the company – determines who is allowed to use the data in what way. As a result, the partners of one supply chain have joint access to certain data by mutual consent so that they can start something new, develop new business models, design their own processes more efficiently or initiate additional added value processes elsewhere, either alone or together.
This presentation was shown at Digital Transport Days, November 9, 2017.
Scenario:
Midwest Regional Health is one of Wisconsin's largest and most sophisticated hospitals, is Implementing a new EHR system that will better their services to their internal and external customers. They are asking ITMC (I-Tech Medical Consortium) to help them navigate through this long term project, thereby improving their commitment to their surrounding community.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
Welcome to Secret Tantric, London’s finest VIP Massage agency. Since we first opened our doors, we have provided the ultimate erotic massage experience to innumerable clients, each one searching for the very best sensual massage in London. We come by this reputation honestly with a dynamic team of the city’s most beautiful masseuses.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...
FHIR x NUTS hackathon, End presentation, April 2023.pptx
1. FHIR x Nuts hackathon
End presentation
HL7 Netherlands WGM
21st of April 2023
2. Today
● Welcome and introduction
● Healthcare professional perspective
● General info hackathon
● BgZ x Nuts testing environment demo
● BgZ x Nuts use case & demo
● Conclusions
Second half: in depth
● Scalable Secure FHIR stack
● Technical details & Technical AMA
● Detailed next steps
3. Welcome by HL7-NL: Rob Mulders
FHIR in a nutshell
● Fast Healthcare Interoperable Resources
● HL7 international
● Free and open healthcare data API
● With modern (web) standards
● JSON/XML, HTTP, REST
● Familiar to new generation of developers
● Easy to implement the basics
● Dutch API strategy
● “FHIR-Besluit” of Dutch Ministry of Health
4. Welcome by : Marlene Gigase
The Nuts community consists of an increasing number of parties that believe it is
important to achieve fast, scalable, cheap, safe and privacy-friendly data
exchange in healthcare.
The parties in the Nuts community facilitate each other and work together pre-
competitively to realize data exchange based on (inter)national open standards.
5. Community
Nuts Community develops a layer of trust
on top of the Internet,
deployable for many applications
not limited to the healthcare domain
11. Transforming from curing disease to fostering
health as the starting point of the system
Essential to focus on:
(1) prevention and healthpromotion,
(2) collaboration, coördination and direction
(3) innovation and pleasure in work for
healthprofessionals
Supported by open standards
12.
13. Perspective from the healthcare professional:
David Smitz (dentist)
Communication is 70 % of the care we deliver. Shortage of healthcare providers and staff.
Today (referral flow)
- 50 procent of time lost in security and bad
communication
- Referral via Secure mail
- Manual document transfer
- Phone communication for confirmation
Tomorrow (after the Hackathon)
- Secured, frictionless and seamless
communication with trusted partners
- Futureproof adaptable system
- Hacking proof
14. General info hackathon
- 5 days
- 9 organizations
- 6 ehr vendor/healthcare organizations
- 1 test environment vendor organization
- 2 supporting standards organizations
- an actual international event
- Hvala vam! 🇸🇮
- Hotel de Witte Bergen in Hilversum & Live broadcast April 21, 3:30 p.m. via
Nuts Community channel
23. 🏥
ZBC
1
1. Patient is in treatment in a private clinic (ZBC)
with EHR Medicore by Tenzinger
24. 🏥
ZBC
1
2. Patient is referred from ZBC
to dentist
- Dentist uses PMS add-on by Kiesz
- Referall from Tenzinger EHR to Kiesz EHR
- Workflow Task according to TA NP
- Notification mechanism according to TA NP
- Dentist views/imports referral data (BgZ) as registered
by ZBC
🏥
Dentist
referral
25. 🏥
ZBC
1
3. Patient collects referral
data (BgZ) from dentist
- Patient uses his PHR by Drimpy (PGO)
- Flow according to MedMij agreement set
🏥
Dentist
👨
📱
collect
referral data
3
26. 🏥
ZBC
1
4. Intake of patient at dentist
- Patient informs dentists that there are more
useful data holders (like GP).
- Patient registers consent for GP to share
health data with dentist, in his PHR (PGO)
from Drimpy.
- This step can be used at any given moment if
wanted/needed
🏥
Dentist
👨
📱
3
register consent
extra data
holders
4
27. 🏥
ZBC
1
5. Patient is referred to
general hospital
- General hospital uses EHR by Nexus
- Physician of general hospital views/imports
health data as registered by dentist
🏥
Dentist
👨
📱
3
4
🏥
General
hospital
referral
5
28. 5. Patient is referred to general hospital
Video: incoming referral 0m00s - 01m00s
https://drive.google.com/file/d/1Q8XRJXpaaT7HFISJoLmASIAQ4LX0fY0V/view?u
sp=share_link
29. 🧑⚕️
🏥
ZBC
1
6. Physician of general hospital places patient
on MDT-consultation
- MDT-platform Vitaly by Parsek
- MDT consisting of physicians of 3
hospitals and 1 dentists views
- health data as registered by
general hospital
- pdf/a as registered by
general hospital
- dicom imaging data as
registered by dentist
🏥
Dentist
👨
📱
3
4
🏥
General
hospital
5
🧑
🏽⚕️
👨
🏿⚕️
👩
🏼
Transmural MDT
place on
MDT
6
30. 6. Physician of general hospital places patient on MDT-
consultation
Video: 1m00s - 02m52s
https://drive.google.com/file/d/1Q8XRJXpaaT7HFISJoLmASIAQ4LX0fY0V/view?u
sp=share_link
31. 🧑⚕️
🏥
ZBC
1
7. Referral to university hospital (UMC)
- Physician from general hospital
uses Parsek MDT-app to refer
patient to university hospital
(UMC)
- University hospital (UMC) uses
Firely-server
- Physician of UMC views/imports
health data (BgZ) as concluded by
MDT and registered by general
hospital
🏥
Dentist
👨
📱
3
4
🏥
General
hospital
5
🧑
🏽⚕️
👨
🏿⚕️
👩
🏼
Transmural MDT
6
🏥
UMC
referral
7
7
32. 7. Physician of general hospital places patient on MDT-
consultation
● Video 2m52s - 06m51s:
https://drive.google.com/file/d/1Q8XRJXpaaT7HFISJoLmASIAQ4LX0fY0V/vie
w?usp=share_link
33. 🧑⚕️
🏥
ZBC
1
8. Patient undergoes surgical procedure and is discharged,
Physician of UMC gives feedback to MDT after surgery
- Physician from UMC put patient
on MDT
- University hospital (UMC) uses
Firely-server
- MDT uses Parsek
🏥
Dentist
👨
📱
3
4
🏥
General
hospital
5
🧑
🏽⚕️
👨
🏿⚕️
👩
🏼
Transmural MDT
6
🏥
UMC
7
7
8
8
34. 8. Patient undergoes surgical procedure and is discharged, Physician of
UMC gives feedback to MDT after surgery
● Video 06m51s-07m27s:
https://drive.google.com/file/d/1Q8XRJXpaaT7HFISJoLmASIAQ4LX0fY0V/vie
w?usp=share_link
36. Deliverables of this hackathon (1)
1. the Healthcare professional & patient :
a. real-time availability of data in structured way
b. no need for overtyping
c. safe & easy to scale & highly flexible : future-oriented
2. the Payer :
a. can expect much less costs for infrastructure because Nuts-node is Open Source and under the
auspices of the vendor, and the Internet is used as the infrastructure & highly scalable
3. the Ministry :
a. important step in implementing the national Action plan Healthcare-ICT -market
b. example how it successful can work using open standards and community based development
37. Deliverables of this hackathon (2)
1. Illustrated the power of the Scalable Secure FHIR stack* for use cases:
a. Medical care referral (BgZ-referral)
b. MDT consultation (MDO)
2. Tested and created specifications for the scalable implementation of the
Twiin Technical Agreement Notified Pull (TA NP)
3. Enthused new national and international vendors for the Scalable Secure
FHIR stack
4. Prepared for the LSP x Nuts hackathon in May 2023
5. We had a lot of fun!
* Learn more about the Scalable Secure FHIR stack in the next slides!
38. Conclusions
This week we used the Scalable Secure FHIR stack
to build a scalable implementation of the secure exchange of FHIR-data:
The Scalable Secure FHIR stack:
- is already being implemented for birthcare, long term care and
medication data exchange
- works for viewing home care data by GP’s
- works for two extra use cases after this hackathon
- medical care referral (BgZ-referral)
- MDT consultation (MDO)
- is infrastructure independent
* Except MedMij use cases
DID
VC
TLS
openid4vc
FHIR data
FHIR API
Sum of national and European
regulations and visions
Let’s make the Scalable Secure FHIR stack the de
facto standard for all FHIR-data exchanges*
39. Scalable Secure DICOM stack
The parts of the stack that provide scalability and
security are data-agnostic!
DID
VC
TLS
openid4vc
DICOM
Let’s make the Scalable Secure DICOM stack the de
facto standard for all DICOM-data exchanges!
40. Scalable Secure OpenEHR stack
The parts of the stack that provide scalability and
security are data-agnostic!
DID
VC
TLS
openid4vc
OpenEHR
Let’s make the Scalable Secure OpenEHR stack the
de facto standard for all OpenEHR-data exchanges!
41. Scalable Secure RDF stack
The parts of the stack that provide scalability and
security are data-agnostic!
DID
VC
TLS
openid4vc
RDF
Let’s make the Scalable Secure RDF stack the de
facto standard for all RDF exchanges!
42. Scalable Secure OMOP stack
The parts of the stack that provide scalability and
security are data-agnostic!
DID
VC
TLS
openid4vc
OMOP
Let’s make the Scalable Secure OMOP stack the de
facto standard for all OMOP exchanges!
43. Scalable Secure <<your favorite data standard>> stack
The parts of the stack that provide scalability and
security are data-agnostic!
DID
VC
TLS
openid4vc
<<your favorite
data standard>>
Let’s make the Scalable Secure <<your favorite data
standard>> stack the de facto standard for all
<<your favorite data standard>> exchanges!
47. National and European regulations and visions converge
towards 1 technical interoperability stack of standards:
data
- FHIR as mandatory data standard for all health
data exchanges in the Netherlands (“FHIR besluit”,
MinVWS dd. 28th March 2023)
FHIR data
FHIR API
48. National and European regulations and visions converge
towards 1 technical interoperability stack of standards:
trust
- eIDAS2’s ARF as mandatory architecture
framework for identification & authentication in
Europe
- “Twiin x Nuts” as a basis for linking health data
infrastructures (“Landelijk dekkend netwerk van infrastructuren”,
MinVWS dd. 13th of April 2023)
DID
openid4vc
VC
DID
VC
TLS
49. The Scalable Secure FHIR Stack (SSF)
DID
VC
TLS
openid4vc
DID
VC
TLS
OAuth
This week’s menu!
FHIR data
FHIR API
FHIR data
FHIR API
Sum of national and European
regulations and visions
50. The Scalable Secure FHIR Stack (SSF)
DID
VC
TLS
openid4vc
DID
VC
TLS
OAuth
This week’s menu!
v5.1
v5.x
(expected
end 2023)
FHIR data
FHIR API
FHIR data
FHIR API
Sum of national and European
regulations and visions
51. The Scalable Secure FHIR Stack (SSF) is already being
implemented at large scale
- Birthcare: implementation running for
80% of hospitals, birthcare ultrasound centers, midwives
- Long term care: implementation running for
~100 of elderly care, disabled care organizations and hospitals
- Medication: implementation running in two regions including
EHR market leaders for GP’s and pharmacists
- Hospital/ clinic: implementation running in one region including
FHIR market leader for academic hospitals
52. The Scalable Secure FHIR Stack (SSF) is already being
implemented at large scale
- Birthcare: implementation running for
80% of hospitals, birthcare ultrasound centers, midwives
- Long term care: implementation running for
~100 of elderly care, disabled care organizations and hospitals
- Medication: implementation running in two regions including
EHR market leaders for GP’s and pharmacists
- Hospital/ clinic: implementation running in one region including
FHIR market leader for academic hospitals
network care
network care
patient transfer
patient referral
53. The Scalable Secure
FHIR stack (SSF stack)
is infrastructure-
independent In the LSP x Nuts hackathon the
SSF stack is being implemented
in the LSP-infrastructure
55. Next steps
1. Keep on building
2. Keep on promoting the use of international open standards for both data and trust
3. Stop thinking about how to create scalable secure FHIR healthcare exchanges: align with national and European regulations
and visions and use the Scalable Secure FHIR stack
4. Collaborate with partners to further enhance the specifications of BgZ x Nuts
5. Collaborate with partners to build/enhance more use cases
using the Scalabe Secure FHIR stack:
a. Secondary use (Health-RI)
b. Regional Viewer (Cumuluz)
c. CareTeam (share information about the composition of individual health networks, IKNL & CareCodex)
d. Questionnaires (share questionnaires between organizations and between organizations and citizens, IKNL & CareCodex)
e. Medication (view an integrated actual medication overview and update when necessary, MO-programme)
f. Imaging (DICOM+FHIR, NVVR)
g. Home care (GP can read home care records, Actiz)
h. Dental Care (health data exchange for dentists, KNMT)
i. Paramedic Care (health data exchange for physiotherapists and other paramedics, PPN)
j. Mental Care (De Nederlande GGZ)
k. General Practitioner (NHG, LHV)
l. or come up with your own use case!
56. Are you ready to create interoperability?
If you represent one of the highlighted organizations
or your name is Ernst Kuipers
or you just want to actively contribute to interoperability
please contact: info@nuts.nl
60. 1. Patient is in treatment in a private clinic (ZBC) with EHR Medicore by Tenzinger
2. Patient is referred from ZBC to dentist. Dentist uses PMS add-on by Kiesz
a. Dentist views/imports referral data (BgZ) as registered by ZBC
3. Patient collects referral data (BgZ) from dentist using his PHR by Drimpy (PGO)
4. Intake of patient at dentist: Patient informs dentists that there are more useful data holders (like GP). Patient
registers consent for GP to share health data with dentist in his PHR (PGO) from Drimpy.*
a. Option : Dentist views health data at GP
5. Patient is referred to general hospital with EHR by Nexus
a. Physician of general hospital views/imports health data as registered by dentist
6. Physician of general hospital places patient on MDT-consultation (transmuraal MDO) : MDT-platform Vitaly by
Parsek
a. MDT consisting of physicians of 3 hospitals and 1 dentists views
i. health data as registered by general hospital
ii. pdf/a as registered by general hospital
iii. dicom imaging data as registered by dentist
7. Physician from general hospital uses Parsek MDT-app to refer patient to university hospital (UMC) that uses Firely-
server
a. Physician of UMC views/imports health data (BgZ) as concluded by MDT and registered by general hospital
8. Patient undergoes surgical procedure and is discharged
* This step can be used at any given moment if wanted/needed
62. 1. Patiënt is onder behandeling in een Zelfstandig Behandelcentrum (ZBC) met XIS: het EPD Medicore van
Tenzinger
2. Patiënt wordt doorverwezen van ZBC naar tandarts met XIS : open source XIS OpenDental van Kiesz
a. Tandarts raadpleegt BgZ-gegevens zoals vastgelegd door ZBC
3. Patiënt haalt bij de tandarts de verwijsgegevens (Bgz) op vanuit zijn PGO van Drimpy
4. Intake van patiënt bij tandarts: Patiënt laat weten dat er meerdere relevante bronhouders (huisarts) zijn, en geeft in
PGO toestemming aan deze bronhouders (huisarts) om hun data te delen met tandarts
a. Optie : Tandarts raadpleegt gegevens bij n bronhouders/huisarts
5. Patiënt wordt doorverwezen naar algemeen ziekenhuis met XIS van Nexus
a. Arts algemeen ziekenhuis raadpleegt gegevens bij tandarts
6. Arts algemeen ziekenhuis plaatst patiënt op transmuraal MDO : MDO-platform Vitaly van Parsek
a. MDO team met artsen van 3 ziekenhuizen en tandarts raadplegen
i. BgZ-gegevens
ii. bijbehorend beeld
iii. pdf/a
7. Patiënt wordt doorverwezen naar academisch ziekenhuis met FHIR-applicatie van Firely
a. Arts academisch ziekenhuis raadpleegt BgZ-gegevens
8. Patiënt wordt geopereerd en ontslagen.