Hannu Virkanen, Juha Mykkänen, Jiechen Jiang University of Kuopio, HIS R&D Unit. Dr. Juha Mykkänen, FinnWell China seminar Tekes, 16 December 2008

Transcription

1 Principles of integrating added-value applications to health information management and sharing e-health Partnership Research Project Report 3 Hannu Virkanen, Juha Mykkänen, Jiechen Jiang University of Kuopio, HIS R&D Unit Dr. Juha Mykkänen, FinnWell China seminar Tekes, 16 December 2008 Finnish Agency for Technology and Innovation Tekes grant no /07 Agenda: Overview of results from integration guidelines development in China/Finland ehealth Partnership Background Materials and Methods Models used as a basis Case examples Recommendations Experience and conclusions 2 1

2 Background Many of the concrete and methodology needs in the China/Finland ehealth partnership project have been related to integration and interoperability regional information sharing inner-hospital integration digital community health centre public health information sharing Integration guidelines identified as one of the shared areas in the project Report 3: Principles of integrating added-value applications to health information management and sharing Including examples of how Finnish products can be integrated in the case of maternity pathway Report trilogy, Part III: The Future : suggestions and illustrations based on the needs analysis (report 1), literature, joint work 3 Materials and methods Literature and previous research Validation and application of models from similar R&D work in Finland and Internationally: PlugIT, SerAPI, SOLEA, Healthcare Services Specification Project Knowledge from previous joint R&D activities in China: Export HIS, ehealth Partners Finland Research group s and other publications on application integration, Enterprise Architecture, SOA, Chinese situation Results of report 1 Workshops and meetings Joint meetings with companies (both Chinese and Finnish) Dedicated meetings in Shanghai, 11/2007, 01/2008, 11/2008, Net.Health Asia conference 11/2008 Workshops in Finland 01/08, 03/08, 06/08 Number of discussions by project staff with Chinese partners 4 2

3 Overview of Report 3 basis 1. Defining integration and interoperability needs and cases current state description most urgent needs of users and administration classification of integration needs and solution principles Information, Process, Service, User integration 2. Specifying integration solutions inputs needed for the solution process for integration specification main requirements analysis participating applications information and functional standards and specifications list of questions for solutions and examples support for specifying: scope, information / semantics, functionality / interactions, application infrastructure / architecture, technical aspects 5 Overview of Report 3 guidelines and examples (continued) 3. Generic recommendations for integration recommendations for integration types of chapter 1 tailored and practical recommendations for information integration, functional specification, user integration, process integration, migration / maturity 4. Examples of integration specification using the list of questions / integration guideline as the outline maternity information sharing (based on current state description) regional information sharing (based on regional model by Shanghai project) added value application (based on ehit product integration) 5. Conclusions and recommendations based on the experience and studied solutions related to the use of holistic EA and needs analysis, migration in integration solutions, project planning, interfacing requirements 6 3

4 Models and needs used as a basis Needs and requirements in China current state description / maternity pathway other specific needs lack of specific guidelines and standard for health information exchange low degree of integration many requirements related to provider, management and patient information needs, development of referrals and care pathways more details in presentation by Jiechen Jiang Models and standards by Finnish companies and experts Reference and literature models Enterprise Architecture (generic model, TOGAF) Integration specification methods and procedures Interoperability models (classification of needs, standards evaluation and selection framework) SOA models (generic process model, reference models) 7 Case example 1: maternity pathway information needs Example: inter-organizational information sharing describing solutions to recognized development point in information sharing, using delivery information of maternity pathway as an example (from report 1) lots of resources consumed after expected delivery by health center staff lack of specific delivery information, but ALSO very analogous generic information sharing needs 4 different integration models related to the identified need a more accurate specification of integration solution using the integration specification guideline: the utilization of regional data center could utilize common shared registry / repository models such as IHE XDS not used at the moment 8 4

5 Case example 2: regional information sharing / Shanghai partners + Kingstar Description, not specification Based on the material and discussions with Chinese partners, especially Weifang community health center and Kingstar Focusing on the regional information sharing solution basic demographic and EPR information, including visits and registrations, lab, outpatient prescriptions, referrals launching of regional web application from local application (from health centre where the local doctor workstation is made by the same vendor) National data sets used as basis, but separate project-specific specifications No maternity information A very vendor-centric and project-centric model, no real knowledge of integration details by user organizations, no true utilization of open specifications / standards 9 Case example 3: ehit added value measurement applications for maternity - 1 main integration and interoperability needs: home measurements performed by the patient, data used by the professionals in Weifang (/ East hospital) pregnancy diabetes requires frequent monitoring: self measurement workflow and practical arrangements: own device or provided by service provider organizations identification by phone or measurement device or person id configuration for the mobile application use of information by the care givers on hospital / CHC visits or periodical checks by professionals or alerts related to threshold values directly from device or remotely on home visits definition which measurements are needed 10 5

6 Case example 3: ehit - 2 application architecture: central database based solution home measurements transferred to the central database information can be used regionally, not many point-to-point connections if no direct data integration (shared data definitions and id s), mediation server is needed to make necessary transformations and id mappings could also make transformations to regional standard data formats optimally professionals have easy access to regional data through doctor and nurse work stations information modelling: shared model (data set) for measurement data (semantics) -> interface interaction modelling: measurement is collected from device, stored in mobile application and sent (push model) to central database -> interface technical infrastructure: mobile internet / other mobile connections, http servers technical interfaces: web services (SOAP/XML) lightweight messages for mobile communications 11 Experience and conclusions Conclusions of the report simple data integration has worked so far for Chinese partners number of applications and components, and functional coverage of systems increasing more standardized and systematic approach needed also on local level move from vendor-centric model to open standards needed necessary: rigorous needs analysis and solid architectural approach higher initial costs, but architectural and data quality improvements and medium / long term savings necessary for building the basis for healthcare services transformation Experience from the collaboration time-consuming communication and validation of understanding - cultural and language barriers learning curve and development culture: fast skyscrapers vs. gradual evolution differences in timescales, multiplicity of needs and goals on both sides research, government, companies, users 12 6

7 Kiitos 13 7