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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

Real value of health IT …
… is in:
• well-structured,
• reliable health data
based on
• open clinical data models!
3

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

5
Vendor-Neutral Data
Images -> PACS
Documents –> CDA/IHE
Structured Data - ???
Options
-> HL7v3 RIM
-> openEHR

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

What is OpenEHR?
A community - based on years of international
collaboration in research, focused
engineering
7
http://openehr.org/

Why OpenEHR?
design and real-world implementation
experience
8

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

What we did in Slovenia?
Smart Healthcare & Wellbeing Cluster
… to deliver the VALUE.
10

Cluster & the Open Data Platform
Community
Cluster
Platform
• Open Community
• Business & Tech
• Users & Apps
• Platform – The Tool
• Development
• Innovation
• OpenEHR
• Global & Research
• Foundation
11

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

Who else outside Slovenia … ?
13

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

Lifetime Health Records
How will we read EHR data 50 years from now?
Separate the semantics from the software
15

Why?
• Reduce Time to Market
• Lower development cost
• Enable higher quality,
more functionality
• Build a solid foundation
for next-generation
applications
16

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

The Clinical Process
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

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

Instead of conclusion …
WHY NOT?
Start creating and
growing The OpenEHR
Community in India …
Let‘s move now!
21

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

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