eHealth Standards and Profiles in Action
for Europe and Beyond
Vincent van Pelt
Senior Advisor, Nictiz (NL)
eHealth Forum
October 26, 2016
eHealth Stakeholders Group
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eStandards
www.estandards-project.eu
• The ambition of eStandards is to strengthen Europe’s global voice and
local impact
– Reinforcing the bridges across the Atlantic, and between member states
– Addressing the challenges around interoperability in a practical way.
• Expected results - more alignment and convergence
– Experiences from different countries
– New use cases (after Antilope)
– Guideline addressing how to work with:
• Competing or overlapping standards
• Clinical content in profiles for large-scale eHealth deployments
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Interoperability – agreements on different levels
Security, Privacy, Governance
Standards and Profiles, Certification
www.estandards-project.eu
Legal and regulatory
Compatible legislation and regulations
Policy
Agreements between organisations
Care Process
Alignment of care processes
Information
Datasets, coding, terminologies
Applications
Integration, formatting of information, UI
IT Infrastructure
Communication protocols, network, databases
Antilope
3
Interoperability – cooperation of different stakeholders
www.estandards-project.eu
Security, Privacy, Governance
Standards and Profiles, Certification
Strategic
Tactical
Operational
Legal and regulatory
Legislators,
advisors
CEOs
Lawyers
Policy
Policy
makers
Care
Managers
Healthcare
professionals
Informationanalysts,
terminologists
Patients
Care Process
Business- and
information
architects
Information
Systemarchitects
Applications
Software
developers
System
engineers
System
maintanance
IT Infrastructure
Antilope
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Use Cases and Realization Scenarios
www.estandards-project.eu
• Use case - describes a process and its requirements
a functional description of what needs to be done
• Realization scenario – provides a possible solution for the use case
a technical solution for the use case (one use case can have multiple realization scenarios)
• Examples: medication, discharge letters, referrals, radiological studies, patient summary,
involvement of the patient, telemonitoring, …
Combining standards and profiles
www.estandards-project.eu
Care Processes
Can be described as use cases that consist of process steps
In these process steps, information has to be exchanged
Information
Information elements have to be defined..
..and linked to terminologies
Applications
Information must be ‘packaged’ into communication standards
Preferably using reusable information building blocks
Profiles use MIBBs and only have to define cardinality and conformance
IT Infrastructure
And sent between ICT systems, networks and databases
eStandards
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eStandards – some key messages
www.estandards-project.eu
• Look at all the interoperability levels, and work together in implementation projects.
Care Process
• Start small, from clearly defined use cases.
• Use standardized templates for describing use cases and realization scenarios
• Do not reinvent the wheel, look for use cases that already have been worked out
(Antilope, eStandards).
• Selection of standards and profiles depends on the use case (and on the domain)
• From one use case you can create different realization scenarios (using different
standards and profiles) – then find out which scenario works best (using a template
for comparing realization scenarios).
eStandards – some key messages
www.estandards-project.eu
Information
• Use tools for the data definition, such as ART-DECOR. Once again, the wheel has already
been invented – reuse work from others, literally or as inspiration.
Applications
• Make sure vendors can implement the standards by defining implementation guidelines
• Use what has already been done in the field
IT Infrastructure
• Look for standards for push and pull traffic
• As international as possible
eStandards – some key messages
www.estandards-project.eu
• Identify use cases from an end-user perspective, including glossary, scenario, actors, privacy
requirements and variations.
• Select profiles and standards (e.g. IHE and Continua profiles) that support the use case.
• Refine data content, including document templates, metadata, master files, terminology.
• Write interoperability specifications (implementation guides) that describe the standards/profiles
selected, the refined data content, and other project specific local needs. This specification enables
implementation of the use case across the various IT systems and devices.
• Organise testing by preparing test cases and a test environment for implementers to demonstrate
component interoperability and by organising cross-implementer connectivity testing.
• Educate end-users on interoperability: Develop communications materials to familiarise end-users on
the benefits and impact of Interoperability.
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Templates for Use Case and Realization Scenario
www.estandards-project.eu
Use Case
Realization Scenario
Title
Title
Purpose
Related Use Case
Relevance
Scenario context
Domain
Scale
Context
Information
Participants
Functional process
steps
Actors
Transactions
Technical process
steps
Associated Profiles
Possible issues
Implementation
examples
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ART-DECOR
Dutch ‘clinical building blocks’
www.estandards-project.eu
International
projects
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Use Case Repository
www.estandards-project.eu
Realization Scenario
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Useful links
www.estandards-project.eu
• eStandards
• Antilope
• ART-DECOR
– International
– Dutch
• eHealth Network (eHN)
– Assets
•
•
•
•
ART-DECOR
SNOMED-CT
LOINC
HL7
– FHIR
• IHE
• Guide to interoperability between
XDS Affinity Domains
• Use Case Repository
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