The document discusses the eHealth Connector, a convenience API for software vendors in Switzerland. It aims to simplify integration with eHealth standards by encapsulating functionality for content management, communication, and future standards. The API is open source and supports common CDA document types. Developers can contribute source code or fund new features. Widespread adoption would lower barriers to the Swiss eHealth system.

1. eHealth Connector
A "Convenience-API" for Softwarevendors
Swiss eHealth Forum 2014 - IHE Thementrack - 7. März 2013

2. Agenda
1. Context - eHealth in Switzerland
2. The eHealth Connector – a Convenience API
3. Supporting organizations
4. Unless one does it – ways for contribution
5. Conclusion
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3. eHealth architecture Switzerland summary
Source: eHealth Suisse
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4. The standards cloud
Standards and Implementation guides
Communication
Standards
Electronic Business Standards
ebXML, SOAP …
Internet Standards
HTML, HTTP, PDF, JPEG …
Content Standards
Healthcare Content Standards
HL7 CDA, CEN EHRcom,
ASTM CCR, DICOM …
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5. Current available HL7 CDA content profiles
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6. Current available HL7 CDA content profiles
Emergency Department
Summary
Notfallaustrittsbericht
Rapport de sortie d'urgence
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7. Current available HL7 CDA content profiles
Medical summary for emergency treatment
Medizinische Notfalldaten
Données médicale pour le traitement
d'urgence
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8. Current available HL7 CDA content profiles
Laboratory Reports for Public Health
Meldepflichtige Laborbefunde
Rapports de laboratoire soumis à
déclaration
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9. Current available HL7 CDA content profiles
Laboratory Reports in the Transplantation Process
Laborbefunde im Transplantationsprozess
Rapports de laboratoire dans le processus de
transplantation
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10. Current available HL7 CDA content profiles
eVACDOC
Immunization Content
Elektronischer Impfausweis
Carnet de vaccination numérique
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11. Current available HL7 CDA content profiles
coming soon:
Social medical care plan
Sozialmedizinischer Pflegeverlegungsbericht
Document médico-social de transmission
(DMST)
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12. Observed market demand
• Required know-how for software vendors is extremely high
• In-depth knowledge of known standards are often missing
• Thus, the entry barrier is too high right now
Objective:
An eHealth
Connector should
encapsulate as
much functionality
as possible
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13. Sample use case 1 - Vaccination
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14. Sample use case 2 – Laboratory
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15. Sample use case 3 – Emergency department
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16. Functionality for content
• Export, import and validation
– Serializing and Deserialisierung of CDA-Documents following one of the
CDA-CH-XXXX implementation guides. Payload provided by an easy to
use object interface (IntelliSense)
– Validation of CDA-Documents following one of the CDA-CH-XXXX
implementation guides. Schematrons must exist.
This functionality is planned and specified but it is not currently implemented. Therefore we are looking for contributors right now.
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17. Functionality for communication
• Communication of any document (send and receive)
– Support of IHE transactions
• Transformation (mapping) of CDA-CH-XXXX payload into the
required metadata for transport using the IHE Provide and Register
Document Set-b [ITI-41] or IHE Distribute Document Set on Media
[ITI-32] transactions.
• Registry Stored Query [ITI-18]
• Retrieve Document Set [ITI-43]
• Encrypted transmission of CDA-CH-XXXX documents over the
internet using the mentioned IHE transactions with transport layer
security (TLS)
• Storage on IHE XDM-compatible media including metadata
• Special functions depending on the implementation guide / use case
• IHE Request Clinical Guidance [PCC-12] transaction
This functionality is planned and specified but it is not currently implemented. Therefore we are looking for contributors right now.
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18. Ready for future functionality requests
Possible upcoming feature requests
• Management of X.509 certificates for the access to the configured
communication endpoints
• Support of policy enforcement rules according to the eHealth Suisse
recommendations
• Support of IHE XUA Profile
• etc.
 please contact us with your feature requests
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19. Technology
• Base
– Open Health Tools framework (OHT)
– Model-Driven Health Tools (MDHT)
• eHealth Connector API distribution
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Open source is public available
Platform independent
integration into all java development environments
integration into .Net development environments using IKVM.NET
IKVM.NET is an implementation of Java for Mono and the Microsoft
.NET Framework that includes the following components:
• A Java Virtual Machine implemented in .NET
• A .NET implementation of the Java class libraries
• Tools that enable Java and .NET interoperability
– Runtimes (JAR and DLL) will be available for IHE Suisse members
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20. Architecture
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21. Current results
1. Documentation (in German)
• Concept for the integration of HL7 CDA into general practitioner
software
• Concept for implementation and API specification (including Javadoc
online Help)
See: http://medshare.net/publikationen
2. Code
• Proof of Concept including demo applications for Java and .Net
See: http://sourceforge.net/projects/ehealthconnector/
• Updated Javadoc online help
See: http://www.medshare.net/fileadmin/eHealthConnectorAPI/doc/
(Notice: This is currently a mix in German, French, English; will get
improved ;-)
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22. Intentions without any contracts, yet
• IHE Suisse
Intention to provide long term support
• medshare Ltd.
Intention to provide maintenance and support
• eHealth Suisse
Intention to contribute to the maintenance, if
IHE Suisse decides to take its role
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23. Ways for contribution
The eHC aims to be a trusted component, providing quality,
stability and conformity!
• Source code contribution
– Usage (boosts supply-demand ratio):
Open source allows public usage to everyone for free
– Implementation:
You may submit patches and eventually get nominated as a committer,
later
A maintenance fee will be charged
• Financial contribution
– Ordering Functionality
Your needs will be implemented based on a contractual relationship
– Sponsoring
Sponsors will get the right for their logo publication on eHC publications
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24. Interested stakeholders
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Bern University of Applied Sciences, Medical Informatics Biel
Source-Code contribution for CDA-CH-LRTP (Bachelor Project)
Viavac
Source-Code contribution for CDA-CH-VACD
Arpage
Financial contribution for CDA-CH-VACD
Inselspital
Financial contribution for CDA-CH-EDES
Geneva University Hospitals
Financial contribution for a new CDA-CH specification: Shared Medication Treatment Plan and its
integration in the eHealth Connector
Infomed
Source-Code contribution for IHE XUA Integration
HCI Solutions (Triamed)
Prototype-Integration of CDA-CH-VACD, CDA-CH-EDES and Shared Medication Treatment Plan
Elexis
Prototype-Integration of CDA-CH-VACD, CDA-CH-EDES and Shared Medication Treatment Plan
(In order of commitment)
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25. Further interviews
• Users
– Government departments (Federal Office of Public Health FOPH,
several Cantons)
– Hospitals (University hospitals, cantonal hospitals)
• Vendors
– Product vendors
– Infrastructure vendors
– Software Development companies
These meetings are planned in February/March 2014
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26. Take Home Message
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Documentation and source code are public available for free
Sponsored open source project
Based on the Open Health Tools (OHT) Framework
Convenience methods for the management of CDA-CH content
Convenience methods for the transmission of documents
Allows interoperability, harmonization
Easy access to the Swiss eHealth trust space
Supported by eHealth Suisse and IHE Suisse
Support and third level support will be setup right now
Functionality will be implemented as soon as commitments are there
 Unless one does it ;-)
 Just do it :-)
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27. Question and Anwers
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28. Upon questions
Tony Schaller, Technical Project Manager IHE Suisse
tony.schaller@medshare.net