The document discusses the virtual hospital information system (HIS) of the future. It describes how the classical HIS operates at strategic, tactical, and operational levels, while the virtual HIS of the future will be 1) virtual, 2) multidimensional, 3) shared, 4) customer-centered, 5) secure, and 6) available to support quality care. Key aspects of the virtual HIS include operating in the cloud, sharing records between providers and patients, and ensuring data security and system performance as usage increases.

1. The virtual Hospital Information System of the future
Prof. dr. B. Sijnave
CIO UZ Gent
September 20, 2012
© 2012 Universitair Ziekenhuis Gent

2. The classical HIS today
Strategic level
Tactical level
Operational level
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3. The HIS of the future
V irtual
I ‐dimensional
mult
sha R ed
cus T omer centered
sec U re
A vailable
supporting qua L ity of care
© 2012 Universitair Ziekenhuis Gent 3

4. The virtual HIS or the HIS in the cloud
V
I
R
T
U
A
L
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5. HIS
The virtual HIS or the HIS in the cloud – MIS part
Main driver for MIS in the cloud is cost
V reduction (small set‐up cost, small
maintenance cost, …)
I
Type of data that is concurrential would only embrace private cloud
R solutions
T Example: different TCOs for different ERP
U deployment options
A
L
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6. HIS
The virtual HIS or the HIS in the cloud – EHR part
V EHR
EPR
I
R
T Main driver for EPR in the cloud would most probably be…
cost reduction (small set‐up cost, small maintenance cost, …)
U Type of data that is confidential would force strictly secured
A and highly available private cloud solutions
but this most definitely has a cost, reducing the
L effect of the main driver…
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7. The multi‐dimensional HIS (1)
Internal multi‐dimensionality
V
I
R
T
U
A
doctors nurses
L pharmacists
© 2012 Universitair Ziekenhuis Gent paramedics … 7

8. The multi‐dimensional HIS (2)
External multi-dimensionality
V
I
R
T
U
A
L
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9. The shared HIS: a bare necessity
V
I
R
T
U
A
L
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10. The shared HIS: possible approaches
The discussion between
V
I
&
R
T
U doesn’t have a single truth, but should have a complementarity, or
A instead of
L
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11. Shared Patient record in practice: Netherlands
V Opt Out
I Costly
No ther. relation check
No cxclusions
R
T
U
A
L Smaller, Opt‐IN
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12. Shared Patient record in practice: NHS
V 2009
I
R feb 2010
T
U apr 2010
A
L Dec 2011
(est: 2014)12
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13. The shared HIS in Belgium
What it is today…
V
I
R …
governmental initiatives
T
U
…
A
hubs of hospitals and GPs
L networks of hospitals
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14. The shared HIS in Belgium
What it could become tomorrow…
V
I
R …
governmental initiatives
T
U
…
A
hubs of hospitals and GPs
L networks of hospitals
© 2012 Universitair Ziekenhuis Gent 14

15. The customer centered HIS
250.000 EPR
V patiënt empowerment
200.000
I
R 150.000
T 100.000
U 50.000
A 0
L
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Pubmed citations
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16. Patient empowerment: finally accessible?
V
I Shared
EPR - PHR
R
Shared EPR
T
U EPR
A EMR
L
© 2012 Universitair Ziekenhuis Gent 16

17. The secure HIS
V • Compiled medical data is very attractive…
Insurance companies
I Pharmaceutical industry
R Employer related (sickness)
….
T
U • Data safety concerns (outside hacking)
A
L
© 2012 Universitair Ziekenhuis Gent 17

18. The available and performing HIS
The more simultaneous users, the more the availability
V and the performance of the systems gets challenged
I
R
T
U
A
L
© 2012 Universitair Ziekenhuis Gent 18

19. The quality HIS: data quality = care quality
V
I medical longitudinal record in a mobile world
R increased complexity, treatment options and regulations
T increasing number of participating health actors
transmural care, data sharing, cooperation
U prevention and home monitoring
A cost reduction (if implemented right)
Data = The ‘Evidence’ for Evidence based medicine
L ….
© 2012 Universitair Ziekenhuis Gent 19

20. The virtual HIS of the future can only be
virtual…
Thank you for your attention!
© 2012 Universitair Ziekenhuis Gent 20