unblocking semantic interoperability for ehr
DESCRIPTION
Unblocking semantic interoperability for Electronic Health RecordsTRANSCRIPT
UNBLOCKING SEMANTIC
INTEROPERABILITY FOR EHR
Sam Forouzi
March 2014
Summary
• Overview of Semantic Interoperability
• Understanding Health Information
• Historic Problems & Solutions
• Current Challenges and a need for innovative solutions
Semantic Interoperability
Semantic Interoperability for EHR
• Information Exchange among Actors on-time– Information: must be meaningful, complete, up-
to-date, and use-full
– Exchange: information recipient must be able to interpret incoming information according to the source
– Actors: Systems, Devices, and Humans
– On-time: Notification in real-time and on-demand
Interoperability: Care Organization
Workflow: Care Organization
Patient is Registered / AdmittedProprietary Interfaces are used to notify hospitals departmental
LIS
DIS
Pharmacy
Bed Management
HIS
System Integration: Care Organization
HIS
Integration Engine
LIS Pharmacy
DIS
Bed Management
Filter
Translate
Transform
ADT Notification
Interoperability: Universally
• Source of Truth
• Actor Identification & matching
• Entity Identification & matching
• Rules & Procedures
• Interpretations
• Normalization
• Ownership
• Technologies & Standards
Health Information
Personal Health Information
Healthy Living
• Behaviours
• Personal Actions
• Education
• Coaching
• Planning
• Executions
• Consultation
• Progress and Results Tracking
Health Care
• Preventing Care vs. Care for Conditions
– Primary Care
– Acute Care
– Home Care
– Long-Term Care
– Ambulatory Care
– Allied Care
Information Systems
Healthy Living
• Personal Portals
• Mobile Apps
• Devices
• Paper based
• Not available
Health Care
• EMRs
• Paper Based
• HIS
• LIS
• RIS
• DIS
• CIS
• EHR
• Patient Portals
History: Past Problems & Solutions
History
•Hospital Info. Systems
•Clinical Systems
•Proprietary Interfaces
•HL7 v2.x
1980s
•IEs
•EMR Vendors
•CDA
1990s •HL7 V3
•Canadian EHRs, Acute Care Integrations
•US EMR adaption, HIEs & ACOs
2000s
•US CCD, BB+, FHIR, Portals, NwHIN, State Wide HIE
•Can: EMR, Local Integration Areas Models, CDS
2010-14
CurrentChallenges
Vital Signs
Costs
Quality
Access to Care
Safety
Errors
Care Recipients
Chronic Cases
Population
Knowledge
Aging Population
Wait-time
Facts
• 2011 Canadian healthcare spending was11.6% of GDP (38% of Nat. budget)National Health Expenditure Trends, 1975 to 2011. CIHI
• 75% of healthcare spending is consumed by chronic disease managementCenters for Disease Control, 2012, http://www.cdc.gov/chronicdisease/
• In 2008/2009, more than 2.3 million Canadians were living with diabetes.
Public Health Agency of Canada
Innovative Solutions
• Let people manage their health information• Develop and promote universal identifiers• Improve operation by refining workflows and
procedures • Standardize – refine existing standards but not reinvent
or-localize• Educate: track or use information for all actors• Identify and target source of truth for building a
normalized and complete EHR• Use proven technologies• Reduce dependencies and technical requirements
QUESTIONS?