Trillium Bridge ehealth Forum 2014 Athens
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Presentation of the Trillium Bridge Project in EU/US MoU Roadmap EHR Interoperability session
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Trillium Bridge ehealth Forum 2014 Athens
- 1. Update on the Trillium Bridge Project Catherine Chronaki euoffice@HL7.org www.trilliumbridge.eu Funded under FP7-610756
- 2. 2 eHealth market is demanding! HL7 CDA is a powerful tool for incremental interoperability Endorsed and adopted by several governments Constrained with Templates and Implementation Guides Developed independently… a cost to interoperability eHealth market calls for agile processes and tools Interoperability to lower costs plug-n-play interoperability assets Intelligent user interfaces Can SDO’s do better? What can you do to help?
- 3. 3 EU/US MoU Roadmap: expected outcomes Development of use cases/user stories Perform Vocabulary Analysis Perform Infrastructure Alignment Perform Healthcare provider Mediated Exchange analysis Semantic and syntactic mapping of scenario related health data Pilots A global standard or IG for patient summaries?
- 4. 4 Why Trillium Bridge? A builder perspective… What can we do to lower the cost of transatlantic business engagement in eHealth? Reduce barriers for transatlantic coordination, health care, trade Decrease standards development and implementation costs Accelerate convergence towards global standards Support right of citizens to their health data and safety Well, perhaps we could try building.. …a Transantlantic Bridge for EHR summaries!
- 5. 5 Trillium Bridge Project What: Pragmatic Feasibility study on the exchange of Patient Summaries across the Atlantic How: Comparing, analyzing, and mapping patient summaries starting with Meaningful Use 2 C-CDA/CCD and EU patient summaries (epSOS) When: From: July 2013 to February 2015 Who: A stellar consortium comprising EU member state ministries, provider networks, industry, associations, SDOs
- 6. 6 Innovative Entrepreneurs US Health Care Providers European Standardization epSOS National Bodies with Patient Access pilot Trillium Bridge: transatlantic community of Knowledge and Action
- 7. 7 Objectives of Trillium Bridge Building the Transatlantic bridge for patient summaries Use cases gap analysis identify barriers /easy winsdeployment Interoperability assets Implementations Validation Policy alignment, future standardization, and sustainability Feasibility study to set the tone and pace for interoperability in the global eHealth ecosystem. Attain the vision of EU-US eHealth MoU and roadmap!
- 8. 8 Milestones to success Selecting Grounds: • Pilot Use Cases • Business Architecture • Gap Analysis Building the Bridge: • Aligning Structure & Terminology • Trust Agreements • Interoperability assets Testing the Bridge: • Testing Tools • Data Sets • Validation Reports Policy Alignment: •Organizational, Legal, Regulatory Interoperability • Feasibility Analysis • Cross-vendor integration • Incentives • Standardization • Innovative Business models • eIdentification, • Security and privacy • Education • Clinical Research We are here
- 9. 9 Trillium Bridge Use Cases One Value proposition: When patient needs unplanned care overseas, a EHR summary fit for the purpose of safe and efficient health care is available. After the health care encounter, patient receives encounter report in a format and language that can be understood back home. Two use cases: Provider mediated (citizen controlled, provider initiated) Patient mediated (citizen initiated, citizen controlled) Blazing the transatlantic path – constraints and assumptions Translation of narrative unstructured content (not in scope) Incorporate patient summary elements in EHR or PHR (not in scope) Preconditions: citizen empowerment EU Citizens have access to their EU Patient Summary (e.g. epSOS PAC, HECR) US Citizens have access to their Clinical Summary in C-CDA/ CCD
- 10. 10 10 Imagine the Barriers to International Care International visitors to US each year 66,600,000 US people travel abroad each year 58,496,587 Average stay (days) when travelling 4 Total Person-Days in Foreign Country 500,386,348 Total Person-Years in Foreign Country 1,370,922 US ED Visits/year 129,800,000 US Population 309,300,000 ED Visits/1000 US Citizens 420 Expected ED visits by travelers to/from US 575,317 Why Trillium Bridge? Source: Larry Garber, Atrius Health
- 11. 11 Provider Mediated Case: Technical Architecture Overview National Contact Point (Italy) National Contact Point (Spain) National Contact Point (Portugal) Trillium Bridge Gateway (based on the epSOS Open NCP) IHE XCA IHE XCPD IHE ATNA (epSOS) Local Connector & eHealth Exchange Gateway Transformer CTS-2 IHE XCA IHE XCPD IHE ATNA (eHealth Exchange) National Contact Points other interested MS Lux, Finland, Greece, Slovenia.. MU2 C-CDA/ CCDEU Patient Summary epSOS pivot document (EN) Terminology Services • EU epSOS master values (MVC/MTC) • US core value sets (NLM)
- 12. 12 Patient Mediated Use Case: Technical Architecture Overview Portuguese Portal (epSOS Patient Access) TrilliumBridge Transformer Tethered Personal Health Record or Health App or BlueButton+ CTS-2 Terminology Services • EU epSOS master values (MVC/MTC) • US core value sets (NLM) Italian (Lombardy) Portal (epSOS Patient Access) Doctor Displays PS In local language prepares encounter report Get EU patient summary Request transform.. Martha gets her CCD Via BlueButton Get clinical summary Paolo has encounter report in CCDA/CCD Request transform.. Spanish Portal (epSOS Patient Access Service) EU MS National Portal (epSOS Patient Access) OpenNCP Portal 1 2 3 4 56 7 Paolo has his EU Patient Summary epSOS pivot (EN) 1 2 Request transform.. 3 4
- 13. 13 Trillium Bridge: achievements/work ahead Completed Gap analysis In collaboration with S&I WG EHR Interoperability work stream Released Deliverable D2.2: Comparing Patient Summaries in the EU and US: Gap Analysis and Pilot Use Case Definition Identified interoperability Assets Established the basis for a terminology service to offer interoperability assets Plan to provide prototype CTS-2 service Inform and support standardization efforts Refine assets, complete the puzzle
- 15. 15 EU/US MoU Roadmap: expected outcomes & Trillum Bridge Development of use cases/user stories Perform Vocabulary Analysis Perform Infrastructure Alignment Perform Healthcare provider Mediated Exchange analysis Semantic and syntactic mapping of scenario related health data Pilots A global standard or IG for patient summaries?
- 16. 16 Check out the Trillium Demo.. I hope you had the opportunity to see the demo of Martha and Paolo crossing the Trillium Bridge with their patient summary. If not, you still have time to stop at the interoperability pavilion during the break. Otherwise, stay tuned… for Boston. www.ehealth2014.eu ROMANI A TURKE Y CROATI A CZECH REPUBL IC BOSNIA & HERZEGOVI NA European HL7 affiliate membership 957 orgs (2011) email: Euoffice@HL7.org List: Europe@HL7.org Web site: www.HL7.eu
- 17. 17 Parting Thoughts… eHealth standards are the safety net that strengthens the fabric of the global eHealth infrastructure. Interoperability at affordable cost Built once used anytime and anywhere Working across cultures and borders Health IT is enabling safe informed health care Key to new market opportunities Milestone in the path to a healthier world Culture of collaboration, creativity, and understanding for the eHealth ecosystem. Deploy or Die! Joi Ito, Head MIT Media Lab
Editor's Notes
- Good afternoon, Mr chairman, distinguished guests, It is a unique privilege and honor to be here, in the eHealth Forum, in Megaron, in Athens, in my homeland, a week before the European elections to give you an update on the exchanging patient summaries across the Atlantic. The Trillium Bridge project. It was last year, at the 3rd EU/US Marketplace and EU/US MoU Assembly in Dublin that I was invited to present the Trillium Bridge as a proposed initiative. The truth is that our transatlantic team in close collaboration with the ONC S&I WS EHR Interoperability has been busy. We have accomplished a lot as you will see, but Trillium Bridge is an ambitious project, and we are not really happy, We feel that we could or we should have accomplished more. Anyway, you will be the judge of that. What, I would like to share with you today three things: (a) we have pieced together parts of the puzzle of the transatlantic exchange of patient summaries; (b) In doing so we have helped advanced awareness of interoperability issues in Europe.
- Before, I go into Trillium Bridge specifics, I would lie to share with you my thoughts on the HL7 CDA standards, interoperbailtiy and the eHealth market We have done well, but you can do better. Recently, I attended a course on Behaviour economics where the keynote shared with us, that the information society can help us invest our energy into meaningful work.
- Why? Reduce barriers for transatlantic coordination, health care, trade Decrease standards development and implementation costs Accelerate convergence towards global standards Support fundamental right of citizens to their health data, ensuring their safety when receiving health care overseas. That is the vision of the EU-US eHealth cooperation MoU and roadmap! Build a bridge for EU/US patient summaries to be exchnaged across the Atlantic Identify use cases of transatlantic exchange of patient summaries Compile gap analysis to identify barriers and easy wins Assemble Interoperability assets to support implementation effort Validate exchange of patient summaries and bestow an award Develop feasibility study to guide future developments Facilitate policy alignment, future standardization, and sustainability Why? Lower costs/barriers for transatlantic business engagement Reduce implementation/configuration costs Decrease standards development costs Accelerate convergence towards global standards Support the fundamental right of citizens to their health information First steps towards realizing the vision of the MoU Consider This: What does it take for a provider of a health information system that has been certified under MU-2 to configure it for the EU market? Have you any thoughts on the amount of this effort today? What should Trillium Bridge do to reduce it?
- So how are we going to build this transatlantic bridge for EHRs? Well, first we will Select the grounds, identify the most promising areas/the low hanging fruits, by comparing patient summary specifications for gap analysis and by selecting key use cases. Then, we will Build the bridge: assemble interoperability assets, mappings of terminology data sets, translations, etc. Next we will Test the bridge: configure testing tools and validate patient summary exchange But for our efforts to persist and be result oriented, we will also contribute to policy alignment, standardization, sustainability of resources. We will address seven key areas: education, cross-vendor integration, incentives, standardization, innovation, research, security & privacy, Policy briefs will be developed by thought leaders at the two ends of the Atlantic and our findings and lessons learned and recommendations will be reported In our feasibility study to guide future calls for proposals to inspire and drive investment in new initiatives and products. Our feasibility study will be based on validation reports by leading providers in the EU and US. These include in the US Kaiser Permanente and Atrius Health (a gp network in Ma) and member states (Prt, Spain, It) that have committed to implementing the epSOS patient access service.
- the Master Value Sets Catalogue (MVC), which applies across all Member States, and the Master Translation/Transcoding Catalogue (MTC).