IST 027065 RIDE http:www'srdc'metu'edu'trwebpageprojectsride

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IST 027065 RIDE http//www.srdc.metu.edu.tr/webpa
ge/projects/ride/

• A Roadmap for Interoperability of eHealth Systems
  in Support of COM 356 with Special Emphasis on
  Semantic Interoperability

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Project Objectives

• A roadmap project for interoperability of eHealth
  systems leading
• To recommendations for actions and
• To preparatory actions at the European level
• Will prepare the ground for future actions as
  envisioned in
• The action plan of the eHealth Communication COM
  356

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RIDE Partners

• METU SRDC
• OFFIS
• IFOMIS
• EuroRec
• CNR
• NTUA ICCS
• NUIG DERI
• IHE D
• OLE

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RIDE Roadmap Phases
D2.2.1 Standardization Efforts
D2.1.1 Current European eHealth Practices
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RIDE Roadmap Phases

• Management and Exchange of Clinical Data
• -Longitudinal Electronic Health Record
• -Electronic Prescribing
• -Electronic Booking.
• Telemedicine Applications
• -Tele-Expertise
• -Tele-Diagnosis .
• Applications for the Patient
• -Personal Consumer Health Record
• -Health Service Yellow Pages
• Public Health Applications
• -Epidemiological Registries
• -Public Health Surveillance

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RIDE Roadmap Phases

• Standards for metadata and terminologies
• How to match patient identifiers
• Standards for Audit Records
• Interoperability of Medical Summary content
• Achieving chain of trust
• Standards for identifying the clinicians and the
  roles of Clinicians
• Authenticating the Healthcare Providers
• Standards for patient consent forms
• Digital signatures for patient consent

• Establishing a Europe-wide secure network to
  exchange medical summaries (EHR) across member
  states
• Define the models, methods and systems of
  workflow management for achieving business
  process interoperability, internally and across
  healthcare domains in the European Member States

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RIDE Roadmap Phases

• Emergency Dataset
• Patient Summaries
• Electronic Health Record
• Clinical Guidelines, Evidence Based Medicine
• Decision Support Systems
• Semantic Interoperability, Classification
  Standards, and Coding Schemes
• Providing mechanisms to uniquely identify
  patients, healthcare professionals and
  institutions even across Member State borders

• Establishing a Europe-wide secure network to
  exchange medical summaries (EHR) across member
  states
• Define the models, methods and systems of
  workflow management for achieving business
  process interoperability, internally and across
  healthcare domains in the European Member States

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RIDE Roadmap Phases

• IT infrastructure, interfaces and eHealth
  messaging systems
• Documentation EHR, Patient Summaries, Emergency
  Datasets
• Clinical Guidelines and Decision Support Systems
• Semantic Interoperability, Classification
  Standards and Coding Schemes
• Patient, Health Professional and Institution
  Identifiers
• Security, privacy and legal issues
• Business processes

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MEMBER STATE A
Local Physician
Local System
Authenticate
Mary Brown
Local Data Repository A
Member State A Locator Service
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Local Data Repository A
MEMBER STATE B
Health Professional Registry
Healthcare Provider Registry
Mary Brown
Choose Record
Authenticate
Request Medical Summary
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RIDE Roadmap Phases
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RIDE Roadmap Phases
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RIDE Roadmap Phases
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Work Package 2

• RIDE D.2.2.1 Standardization Efforts (due Month
  4) for providing semantic interoperability in the
  Health domain A short Survey on IHE Patient
  Care Coordination Framework
• RIDE D.2.2.1 Standardization Efforts (due Month
  4) for providing semantic interoperability in the
  Health domain A Survey and Analysis of
  Electronic Healthcare Record Standards This
  deliverable is published in ACM Computing Surveys

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Work Package 2

• RIDE D.2.2.1 Standardization efforts (due Month
  4) for providing semantic interoperability in the
  eHealth domain Semantic Interoperability The
  deliverable covers
• The current challenges about the standards for
  semantic interoperability,
• Surveys the most relevant organizations in charge
  of the development of standards,
• Focuses on the structured content of Patient
  Summary ontology languages terminologies and
  coding schemes

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Work Package 2

• RIDE D.2.1.1 Current European Practices in
  eHealth domain Survey of NHS Connecting for
  Health (England)
• RIDE D.2.1.1 Current European Practices in
  eHealth domain Survey of Canada Health Infoway
• RIDE D.2.1.1 Current European Practices in
  eHealth domain A brief survey of the Initiative
  by the Dutch National ICT Institute for
  Healthcare (NICTIZ)
• RIDE D.2.1.1 Current European Practices in
  eHealth domain Survey of CARELINK (Sweden)
• RIDE D.2.1.1 European Current practices in
  providing semantic interoperability in eHealth
  domain Survey of eHealth Practices (Czech
  Republic)
• RIDE D. 2.1.1 Current European practices in
  providing interoperability in eHealth domain
  Survey of Cyprus Health Care System
• RIDE D.2.1.1 Current European practices in
  providing interoperability in eHealth domain
  Danish Healthcare System

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Work Package 2

• RIDE D.2.1.1 Current European eHealth
  practices A Brief Survey of the Digital Health
  Record Project conducted by the Ministry of
  Social Affairs of Estonia
• RIDE D.2.1.1 Current European practices in
  eHealth A Brief Survey of the Initiative by the
  German Federal Ministry of Health
• RIDE D.2.1.1 Current European practices in
  providing interoperability in eHealth domain
  HEALTHCONNECT and NEHTA (Australia)
• RIDE D.2.1.1 Current European practices in
  eHealth A Brief Survey of the eHealth
  Initiatives of Austria
• RIDE D.2.1.1 Current European practices in
  providing interoperability in eHealth domain
  KMEHR-BIS and BE-HEALTH (Belgium)
• RIDE D.2.1.1 European Current practices in
  providing semantic interoperability in eHealth
  domain Survey of eHealth Practices in Greece
• RIDE D.2.1.1 Current European practices in
  providing interoperability in eHealth domain
  HUNGARY

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Work Package 2

• RIDE D.2.1.1 Current European practices in
  providing interoperability in eHealth domain
  Survey of eHealth initiatives in IRELAND
• RIDE D.2.1.1 Current European practices in
  providing interoperability in eHealth domain
  LATVIA
• RIDE D.2.1.1 Current European practices in
  providing interoperability in eHealth domain
  Survey of HealthNet (Luxembourg)
• RIDE D.2.1.1 Current European practices in
  providing interoperability in eHealth domain
  Survey of Malta Health Care System
• RIDE D.2.1.1 European Best practices in
  providing semantic interoperability in eHealth
  domain Survey of Norway Healthcare Services
• RIDE D.2.1.1 Current European practices A
  Brief Survey of the use of ICT in the health
  sector in Poland
• RIDE D.2.1.1 Current European practices in
  providing interoperability in eHealth domain
  Portugal

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Work Package 2

• RIDE D.2.1.1 Current European practices in
  providing interoperability in eHealth domain
  SLOVENIA
• RIDE D.2.1.1 Current European practices in
  providing interoperability in eHealth domain
  SPAIN
• RIDE D.2.1.1 Current International Practices in
  providing interoperability in eHealth domain A
  Survey of US eHealth Initiatives
• RIDE D.2.1.1 European Current practices in
  providing semantic interoperability in eHealth
  domain Survey of eHealth Practices (France)
• RIDE D.2.1.1 European Best practices in
  providing semantic interoperability in eHealth
  domain
• This deliverable complements the Member States
  studies by surveying the related IST and eTen
  Projects and presents the Radar Diagrams to
  investigate their relevance to the RIDE Project.
• In the second part, the discrete areas of
  interest that will be covered by RIDE Roadmap are
  investigated

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Work Package 2

• RIDE D.2.3.1 Requirement Analysis for the RIDE
  Roadmap (due Month 6) This document provides an
  overview of e-health application scenarios from a
  users perspective and derives interoperability
  requirements of the various application
  scenarios, with special emphasis on the topics
  addressed by the RIDE project
• The main purpose of this deliverable together
  with the survey of state-of-the-art and standards
  is to determine goals and challenges and to
  provide input to the definition of a vision
  statement and the gap analysis

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Work Package 3

• RIDE D.3.1.1 Goals and Challenges I (due Month
  8)
• As a preliminary version, the first two goals and
  the related challenges detailed in this
  deliverable are
• Establishing a Europe-wide secure network to
  exchange medical summaries (EHR) across member
  states and
• Define the models, methods and systems of
  workflow management for achieving business
  process interoperability, internally and across
  healthcare domains in the European Member
  States.
• RIDE D.3.1.1 Goals and Challenges II (due Month
  12)
• The goal identification process
• The State-of-the0Art is taken into account
• All the scenarios given in the Requirement
  Analysis deliverable and RIDE Vision Statement
  are considered
• The input collected additional from key persons
  in the healthcare environment in the first RIDE
  workshop are taken into account
• The input was enriched by a specific questionnaire

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Work Package 3

• RIDE D.3.1.1 Goals and Challenges II (due Month
  12)
• Establishing a Europe-wide secure network to
  exchange emergency datasets, patient summaries,
  and electronic health records or excerpts thereof
  within and across Member States,
• Emergency Dataset
• Patient Summaries
• Electronic Health Record
• Clinical Guidelines, Evidence Based Medicine,
  Decision Support Systems
• Semantic Interoperability, Classification
  Standards, and Coding Schemes
• Providing mechanisms to uniquely identify
  patients, healthcare professionals and
  institutions even across Member State borders,
  and
• Define the models, methods, and systems of
  workflow management for achieving business
  process interoperability, internally and across
  healthcare domains in the European Member States

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Work Package 3

• RIDE D.3.2.1 Vision for a Europe-wide
  Semantically Interoperable eHealth Infrastructure
  I (due Month 8) The current and envisioned
  situation for the following subjects which are in
  the scope of the RIDE Project
• IT infrastructure, interfaces and eHealth
  messaging systems
• Documentation EHR, Patient Summaries, Emergency
  Datasets
• Clinical Guidelines and Decision Support Systems
• Semantic Interoperability, Classification
  Standards and Coding Schemes
• Patient, Health Professional and Institution
  Identifiers
• Security, privacy and legal issues
• Business processes
• RIDE D.3.2.2 Vision for a Europe-wide
  Semantically Interoperable eHealth Infrastructure
  II (due Month 14) In order to visualize the
  goals and to see how the current requirements can
  be addressed in the future, we have developed
  visionary scenarios

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Work Package 4

• RIDE D.4.1.1 Gap Analysis I (due Month 10)
• The gaps that exist between the state of the
  art research ongoing in the eHealth domain
  (as-is situation) and the desired future
  description identified in the RIDE vision
  statement for achieving semantic interoperability
  in eHealth (to-be situation), are identified
• RIDE D.4.1.1 Gap Analysis II (due Month 16)
  Since the as-is-situation differ from one Member
  State to another, this deliverable concentrates
  on the gaps observed in the Member States. This
  deliverable is not due yet but we provide the on
  going work as an interim version

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Work Package 4

• RIDE D.4.2.1 Trends and Opportunities I (due
  Month 10)
• This deliverable first investigates the most
  recent trends in five selected countries UK,
  Germany, Belgium, USA, and Canada
• The second part of this deliverable addresses
  more general trends and opportunities
• Web Services which gained momentum in the
  healthcare domain two major players, HL7 and IHE
  adopt the Web services
• Trends and opportunities in terminologies and
  ontologies are discussed
• Another version of this deliverable, namely, RIDE
  D.4.2.2 Trends and Opportunities II is due
  Month 18.

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Work Package 4

• RIDE D.4.4.1 RIDE Roadmap I (due Month 12)
• This deliverable provides a top-down framework
• An approach to come up with enactment factors
  from
• Policy objectives,
• Metrics to characterize the roadmapping
  activities, and
• A taxonomy which systematically expresses the
  content of a national or regional Roadmap towards
  eHealth in Europe
• The taxonomy defines the following four main
  streams
• Enabling activities on the infrastructure and to
  achieve basic interoperability (building the
  technical infrastructure, setting up proper
  regulatory framework, security and privacy,
  produce or adopt standards and reference
  materials to achieve semantic interoperability,
  setting up certification process on quality and
  safety of eHealth solutions)
• Vertical services to increase the efficiency of
  current care-related workflows
• Problem-oriented perspective, to enhance the
  quality and the appropriateness of care provision
• The meta-level issues arising from the 3 main
  streams and supporting activities

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Work Package 4

• RIDE D.4.4.2 RIDE Roadmap II (due Month 20)
• An interim version of the second version of the
  RIDE Roadmap which concentrates on
• The enabling activities on the infrastructure
  and to achieve basic interoperability which is
  identified as the first stream in the taxonomy
  given in the first version of RIDE Roadmap
• The goal is to enumerate possible ways of
• Rapid, accurate, and secure exchange of
  electronic healthcare records among authorized
  users which includes the patient himself
• With this Deliverable, we attempt to provide a
  starting technical framework necessary for
  creating a European Interoperability framework
• A more detailed version of the RIDE Roadmap will
  be provided at Month 24

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A Scenario

• Mary Brown suffering from cardiovascular problems
  consults a healthcare institute in her home state
  A
• After her treatment, her physician in Member
  State (MS) A, first authenticates himself to the
  local system and creates patients Medical
  Summary
• Her local physician digitally signs the Medical
  Summary and the local system transfers these
  documents (Medical Summary and the Digital
  Signature) to the Data Repository and an audit
  record is sent to the local data repository
• The Local Data repository informs the Member
  State Locator service so that the Locator service
  indexes the document with the demographics of the
  patient and the meta data if available
• All of these interactions are audited and the
  participating entities are authenticated
• The patient provides her consent on the use of
  her medical summaries and digitally signs the
  consent form and the consent form is sent to the
  local data repository

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A Scenario

• Mary Brown goes to Member State B for further
  medical treatment and contacts Dr. Can Deniz
• Dr. Can Deniz in Member State B wishing to access
  Mary Browns Medical Summaries authenticates
  himself to his local medical system and sends the
  request to Member State B Locator Service
• Dr. Can Denizs and the hospitals authentication
  information is obtained from MS Bs Health
  Professional Registry and Provider Registry and
  are sent to the Locator Service of MS B which
  passes it to Locator Service MS A for auditing
  purposes
• Member State B Locator service tries to locate
  Mary Browns Medical Summaries both in Member
  State B and also in all the other Member States
  if no specific Member State is stated in the
  request
• When the Locator Service of the Member State A
  receives the request from MS B, it checks its
  indices and provides the location of the record
  (if found) together with its metadata to the
  Locator Service of Member State B
• Locator of Member State B passes this data to the
  requesting Healthcare Institute

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A Scenario

• All these interactions are audited by the
  Auditing services of both of the Member State A
  and B
• Dr. Can Deniz chooses the records he wishes to
  retrieve and send this request to the Locator
  Service of MS B
• LS of MS A sends this information to the MS A
  Data Repository
• Mary Browns consent form is retrieved and if
  satisfied, the record is sent to the LS MS A and
  eventually to LS MS B and the requesting
  physician Dr. Can Deniz
• All of these interactions are audited
• All the traffic within and between Member States
  are encrypted.
• The Locator services of all the Member States
  must have a certificate and any two Locator
  Services planning to exchange data must have each
  others certificate
• In each Member State, all the Healthcare
  Institute and all the healthcare professionals
  have unique identifiers and certificates which
  are stored in the Healthcare Provider Registry
  and Healthcare Professional Registry respectively
  as already discussed

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Project Timeline
M0
M4
M8
M15
M6
M12
M10
M2
State-of-the-Art
User Requirements
Goals and Challenges I
Vision I
RIDE Roadmap I
Goals and Challenges II
Vision II
Gap Analysis
Trends and Opportunities
RIDE Roadmap II
Project Management
Dissemination
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Dissemination

• Three RIDE Workshops up to now
• Our project has a high visibility if you Google
  with ehealth interoperability roadmap, it ranks
  the top among 121.000 resources on the Web

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http//www.srdc.metu.edu.tr/webpage/projects/ride/
modules.php?nameDeliverables
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Thank you