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eHealth around the world 
Challenges of EHR 
Implementation in Slovenia 
Tomaž Vidonja, CMO, ICT Technology Network Institute 
5th Sep 2014, Kolkata, India 
1 
2014 All Rights Reserved! 
ICT Technology Network Institute.
Same Simple Population Questions 
How many patients have been 
diagnosed with Sickle Cell 
disease last year? 
How many diabetes patients 
are controlling their sugar? 
What is the percentage of 
patients with high BMI? 
2 
2014 All Rights Reserved! 
ICT Technology Network Institute.
Real value of health IT … 
… is in: 
• well-structured, 
• reliable health data 
based on 
• open clinical data models! 
3 
2014 All Rights Reserved! 
ICT Technology Network Institute.
Key Requirements 
Meaning preservation 
Vertical semantic framework from DB to GUI 
Sharing – moving the data 
Ability to merge data from multiple sources - Solid data 
standards & protocols 
Aggregation – putting the data together 
Semantic merging using shared content models 
Portable querying 
Evolution – of systems 
Separate the semantics from the software 
4 
2014 All Rights Reserved! 
ICT Technology Network Institute.
5 
Vendor-Neutral Data 
Images -> PACS 
Documents –> CDA/IHE 
Structured Data - ??? 
Options 
-> HL7v3 RIM 
-> openEHR 
2014 All Rights Reserved! 
ICT Technology Network Institute.
openEHR 
An open, domain-driven 
platform for developing 
flexible e-health systems 
• Separation of content and 
technology 
• Computable data 
• Two-level modeling 
– Archetypes – maximal data 
set 
– Templates - data set for use 
case 
• Multi-lingual 
6 
2014 All Rights Reserved! 
ICT Technology Network Institute.
What is OpenEHR? 
A community - based on years of international 
collaboration in research, focused 
engineering 
7 
http://openehr.org/ 
2014 All Rights Reserved! 
ICT Technology Network Institute.
Why OpenEHR? 
design and real-world implementation 
experience 
8 
2014 All Rights Reserved! 
ICT Technology Network Institute.
Widely adopting the OpenEHR 
Healthcare Providers and 
Authorities (21) 
Funded Research Projects 
(1 - EU) 
Non-profit and Open 
Source Organisation (2) 
Governments (10) 
Academic Research (19) 
9 
2014 All Rights Reserved! 
ICT Technology Network Institute.
What we did in Slovenia? 
Smart Healthcare & Wellbeing Cluster 
… to deliver the VALUE. 
10 
2014 All Rights Reserved! 
ICT Technology Network Institute.
Cluster & the Open Data Platform 
Community 
Cluster 
Platform 
• Open Community 
• Business & Tech 
• Users & Apps 
• Platform – The Tool 
• Development 
• Innovation 
• OpenEHR 
• Global & Research 
• Foundation 
11 
2014 All Rights Reserved! 
ICT Technology Network Institute.
Where it is used today? 
Children's Hospital, Ljubljana, Slovenia 
• Think!EHR Platform as vendor-neutral clinical data 
repository based on openEHR specification is used in 
Think!Med Clinical (clinical information system) for 
longitudinal EHR at the 220 bed. 
A national open health data repository 
• In operational environment as part of the Slovenian 
interoperability backbone providing solution to eHealth 
applications such as eReferral, ePrescription, eVaccinaton 
and national clinical registries. 
12 
2014 All Rights Reserved! 
ICT Technology Network Institute.
Who else outside Slovenia … ? 
13 
2014 All Rights Reserved! 
ICT Technology Network Institute.
City of Moscow eHealth 
Moscow city - 780 medical facilities, including: 
• 149 hospitals, 76 health centers, 428 policlinic institutions 
Volume: 
• Patients- 12 million, Beds in hospitals – 83,000 
• Physicians – 45,000, all users – 130,000 
• Patient visits/year - 161 million 
• Documents/year - 1 Billion, 25TB 
Based on IHE and Think!EHRTM Platform 
Pilot live at 6 clinics as of Aug 2013! 
14 
2014 All Rights Reserved! 
ICT Technology Network Institute.
Lifetime Health Records 
How will we read EHR data 50 years from now? 
Separate the semantics from the software 
2014 All Rights Reserved! 
ICT Technology Network Institute. 
15
Why? 
• Reduce Time to Market 
• Lower development cost 
• Enable higher quality, 
more functionality 
• Build a solid foundation 
for next-generation 
applications 
16 
2014 All Rights Reserved! 
ICT Technology Network Institute.
Think!EHRTM Platform 
Think!EHRTM Platform is a vendor-independent, big-data, 
high-performance Clinical Data Repository designed to 
store, manage, query, retrieve and exchange 
structured electronic health record data based on open 
standards 
Think!EHRTM Platform includes: 
Think!EHR Server, Think!EHR Explorer, Think!EHR Integration, 
Think!EHR EventTracker, Think!EHR Development Toolkit 
17 
2014 All Rights Reserved! 
ICT Technology Network Institute.
The Clinical Process 
2014 All Rights Reserved! 
ICT Technology Network Institute. 
18
Building Global Community 
Governments and eHealth Programmes 
• require to capture data from disparate sources in 
various formats and store it in a common, context-sensitive 
form 
Vendor/developers 
• require a seamless solution that will enable them to 
develop and deliver next generation health care 
applications, fast and efficent. 
Health systems and care providers 
• require centralized vendor-neutral, lifelong open data 
health platform for EHRs, other disparate applications 
and health apps with the ability to enhance research 
capabilities 
19 
2014 All Rights Reserved! 
ICT Technology Network Institute.
Beyond the Clinical Data Repository 
(1) a comprehensive web-based EHR Explorer 
empowering developers to build forms, views, queries 
and rules using simple drag-and-drop features; 
(2) storage of designed and generated artifacts within 
the platform; 
(3) rich set of interfaces including REST, Harvard-MIT 
SMART API (smartplatforms.org), HL7 FHIR and IHE.XDS; 
(4) CTS2 interface for standardized integration with 
external terminology server needed to properly include 
terminologies like ICD, LOINC and SNOMED-CT; 
(5) all data is versioned, each data entry can be accessed 
using a stable URI. 
20 
2014 All Rights Reserved! 
ICT Technology Network Institute.
Instead of conclusion … 
WHY NOT? 
Start creating and 
growing The OpenEHR 
Community in India … 
Let‘s move now! 
21 
2014 All Rights Reserved! 
ICT Technology Network Institute.
Share your ideas & thoughts … 
ICT Technology Network Institute 
Smart Healthcare & WellBeing Cluster 
tomaz.vidonja@ict-slovenia.net 
www.ict-slovenia.net 
+386 40 272118 
22 
2014 All Rights Reserved! 
ICT Technology Network Institute.

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tomaz vindonja

  • 1. eHealth around the world Challenges of EHR Implementation in Slovenia Tomaž Vidonja, CMO, ICT Technology Network Institute 5th Sep 2014, Kolkata, India 1 2014 All Rights Reserved! ICT Technology Network Institute.
  • 2. Same Simple Population Questions How many patients have been diagnosed with Sickle Cell disease last year? How many diabetes patients are controlling their sugar? What is the percentage of patients with high BMI? 2 2014 All Rights Reserved! ICT Technology Network Institute.
  • 3. Real value of health IT … … is in: • well-structured, • reliable health data based on • open clinical data models! 3 2014 All Rights Reserved! ICT Technology Network Institute.
  • 4. Key Requirements Meaning preservation Vertical semantic framework from DB to GUI Sharing – moving the data Ability to merge data from multiple sources - Solid data standards & protocols Aggregation – putting the data together Semantic merging using shared content models Portable querying Evolution – of systems Separate the semantics from the software 4 2014 All Rights Reserved! ICT Technology Network Institute.
  • 5. 5 Vendor-Neutral Data Images -> PACS Documents –> CDA/IHE Structured Data - ??? Options -> HL7v3 RIM -> openEHR 2014 All Rights Reserved! ICT Technology Network Institute.
  • 6. openEHR An open, domain-driven platform for developing flexible e-health systems • Separation of content and technology • Computable data • Two-level modeling – Archetypes – maximal data set – Templates - data set for use case • Multi-lingual 6 2014 All Rights Reserved! ICT Technology Network Institute.
  • 7. What is OpenEHR? A community - based on years of international collaboration in research, focused engineering 7 http://openehr.org/ 2014 All Rights Reserved! ICT Technology Network Institute.
  • 8. Why OpenEHR? design and real-world implementation experience 8 2014 All Rights Reserved! ICT Technology Network Institute.
  • 9. Widely adopting the OpenEHR Healthcare Providers and Authorities (21) Funded Research Projects (1 - EU) Non-profit and Open Source Organisation (2) Governments (10) Academic Research (19) 9 2014 All Rights Reserved! ICT Technology Network Institute.
  • 10. What we did in Slovenia? Smart Healthcare & Wellbeing Cluster … to deliver the VALUE. 10 2014 All Rights Reserved! ICT Technology Network Institute.
  • 11. Cluster & the Open Data Platform Community Cluster Platform • Open Community • Business & Tech • Users & Apps • Platform – The Tool • Development • Innovation • OpenEHR • Global & Research • Foundation 11 2014 All Rights Reserved! ICT Technology Network Institute.
  • 12. Where it is used today? Children's Hospital, Ljubljana, Slovenia • Think!EHR Platform as vendor-neutral clinical data repository based on openEHR specification is used in Think!Med Clinical (clinical information system) for longitudinal EHR at the 220 bed. A national open health data repository • In operational environment as part of the Slovenian interoperability backbone providing solution to eHealth applications such as eReferral, ePrescription, eVaccinaton and national clinical registries. 12 2014 All Rights Reserved! ICT Technology Network Institute.
  • 13. Who else outside Slovenia … ? 13 2014 All Rights Reserved! ICT Technology Network Institute.
  • 14. City of Moscow eHealth Moscow city - 780 medical facilities, including: • 149 hospitals, 76 health centers, 428 policlinic institutions Volume: • Patients- 12 million, Beds in hospitals – 83,000 • Physicians – 45,000, all users – 130,000 • Patient visits/year - 161 million • Documents/year - 1 Billion, 25TB Based on IHE and Think!EHRTM Platform Pilot live at 6 clinics as of Aug 2013! 14 2014 All Rights Reserved! ICT Technology Network Institute.
  • 15. Lifetime Health Records How will we read EHR data 50 years from now? Separate the semantics from the software 2014 All Rights Reserved! ICT Technology Network Institute. 15
  • 16. Why? • Reduce Time to Market • Lower development cost • Enable higher quality, more functionality • Build a solid foundation for next-generation applications 16 2014 All Rights Reserved! ICT Technology Network Institute.
  • 17. Think!EHRTM Platform Think!EHRTM Platform is a vendor-independent, big-data, high-performance Clinical Data Repository designed to store, manage, query, retrieve and exchange structured electronic health record data based on open standards Think!EHRTM Platform includes: Think!EHR Server, Think!EHR Explorer, Think!EHR Integration, Think!EHR EventTracker, Think!EHR Development Toolkit 17 2014 All Rights Reserved! ICT Technology Network Institute.
  • 18. The Clinical Process 2014 All Rights Reserved! ICT Technology Network Institute. 18
  • 19. Building Global Community Governments and eHealth Programmes • require to capture data from disparate sources in various formats and store it in a common, context-sensitive form Vendor/developers • require a seamless solution that will enable them to develop and deliver next generation health care applications, fast and efficent. Health systems and care providers • require centralized vendor-neutral, lifelong open data health platform for EHRs, other disparate applications and health apps with the ability to enhance research capabilities 19 2014 All Rights Reserved! ICT Technology Network Institute.
  • 20. Beyond the Clinical Data Repository (1) a comprehensive web-based EHR Explorer empowering developers to build forms, views, queries and rules using simple drag-and-drop features; (2) storage of designed and generated artifacts within the platform; (3) rich set of interfaces including REST, Harvard-MIT SMART API (smartplatforms.org), HL7 FHIR and IHE.XDS; (4) CTS2 interface for standardized integration with external terminology server needed to properly include terminologies like ICD, LOINC and SNOMED-CT; (5) all data is versioned, each data entry can be accessed using a stable URI. 20 2014 All Rights Reserved! ICT Technology Network Institute.
  • 21. Instead of conclusion … WHY NOT? Start creating and growing The OpenEHR Community in India … Let‘s move now! 21 2014 All Rights Reserved! ICT Technology Network Institute.
  • 22. Share your ideas & thoughts … ICT Technology Network Institute Smart Healthcare & WellBeing Cluster tomaz.vidonja@ict-slovenia.net www.ict-slovenia.net +386 40 272118 22 2014 All Rights Reserved! ICT Technology Network Institute.

Editor's Notes

  1. Constant change in Information Care Process Technology Patient needs Legislation Separation of content and technology Archetypes - Detailed Clinical Models Existing archetypes for many clinical terms Templates customize data set for each use case
  2. Multilingual
  3. Constant change in Information Care Process Technology Patient needs Legislation Separation of content and technology Archetypes - Detailed Clinical Models Existing archetypes for many clinical terms Templates customize data set for each use case