A Nordic reference architecture for Personal Connected Health and Care
Apr 12, 2017
A Nordic reference architecture for Personal Connected Health
and Care
Agenda
∙ Why a Nordic collaboration? ∙ Nordic reference model for Personal connected health
architectures ∙ Applied architectures of the Nordic countries
– Norway– Sweden– Denmark
∙ Q&A
At the home of the Citizen
Health Care
Home Care
Home care tele health solution
Diabetes tele health solution
Geriatric tele health solution
The reality without standards – citizen perspective
At the home of the Citizen
Health Care
Home Care
Home care tele health solution
Diabetes tele health solution
Geriatric tele health solution
A shared set of standards simplifies consolidation in the home setting
Health or home Care
Electronic health record
KOL tele care solution
At the home of the Citizen
The reality without standards - healthcare professional perspective
Health or home Care
Electronic health record
KOL tele care solution
At Home of the Citizen
A shared set of standards reduces the amount of double registration
At the home of the Citizen
Health or home Care
Electronic health record system vendor
Diabetes tele care solution
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A vendor has to invest in integrations specific to each customer - 4 customers means 4 times the cost. And we all know who pays the bill!
The reality without standards - market/vendor perspective
At the home of the Citizen
Health or home Care
Electronic health record system vendor
Diabetes tele care cloud solution
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Using standards, One integration fits all customers - 4 customers shares the cost of 1 integration.
Shared standards reduce cost for actors on the Nordic e-health market
At the home of the Citizen
With a Nordic collaboration, a vendor is more likely to invest in a standard and customers/buyers will spend less on integrations
Coordinated standards selections
Vendor 1Vendor 2Vendor 3
Vendor 4
The collaboration
Jonan Eltes
Thor Schliemann
Lars Kristian Roland
Jari Porrasmaa
?
Towards a Common Nordic Language for Telemedicine Architecture
Norwegian architecture principles:● Standards based (Continua, FHIR and SCAIP) + nordic cooperation● Separate storage and display applications (allow for multi-vendor solutions)● Data that is important to be shared, is planned stored in national repository (FHIR-based), but
in mean-time municipalities will implement local FHIR-based systems according to national specifications
● Not all data is relevant to share… some is kept locally. ● Citizen must be able to see all data about themselves. ● Currently draft recommendations
Norwegian reference architecture for personal connected health
Swedish architecture principles:- The architecture is vendor- and topology agnostic (open market)- Is actually an application of the generic reference architecture. All principles of the general national HIE reference
architecture apply, to secure that all information can be accessed for any legally supported purpose- Standards-based information exchange - today Continua and HL7 Green CDA WS. HL7 FHIR PoC in the planning (future
Nordic alignment).
Swedish reference architecture for personal connected health
Sweden - applied reference architectureCase 1 - “Integrated telemedicine solution”
Sweden - applied reference architecture Case 2 - “Personal Monitoring as a Service”
Danish architecture principles:● Separate storage and display applications (multi-vendor solutions)● Data collected within the principles of Continuas framework● HL7 CDA PHMR (Personal Health Monitoring Record)
Danish reference architecture for collecting health data from the citizens
Danish reference architecture for sharing documents and images
Danish Cross Sharing Architecture:● Clinical Data available as documents HL7 CDA● Using IHE XDS infrastructure services
Danish architecture principles
Clear accountability∙ The collection of health data is done in cooperation between the parties
– accurate agreements about who is responsible for equipment, support, etc.
The collected Health Data made available to all relevant health professionals∙ Data are at the level as other data produced at hospitals etc.
The use of International standards - ensures broad market support∙ Using standards to reduce uncertainty by investing in solutions and ensure∙ enables re-use, reduced cost and comlexity
Common metadata for forward search of relevant clinical information about patients∙ to find relevant information across domains and IT solutions∙ increasing semantic interoperability
Telecare North (TCN)
In Region of North Jutland, Denmark a large scale project for COPD patients, Telecare North (TCN), have shown that there are benefits to be gained for both patients and society.
The research has given a nuanced view of telemedicine. It shows that there is an economic benefit to the society, but only if telemedicine offered for the right groups, for example people with severe COPD.
∙ They had a strong focus on empowering citizens in telemedicine offers.∙ The project hit the target for usability with 88 percent of participants in Telecare
North finding their telemedicine equipment user-friendly.∙ The positive impact that telemedicine has the citizen's quality of life.
– 61 percent of participants feel that they are better able to control their disease, and
– 71 percent feel safer in everyday life with telemedicine.
Tele health information system
EHR information access
Health care information system
Welfare data capture application
Exchange of EHR documents
Form-based patient questionnaires
Welfare technology device
Observation uploadDevice connectivity
A B C
Welfare technology device data
subscription
Norway: PCD-01 (hData) + FHIR (REST)
Norway: Continua Norway: FHIR???(still undefined)
Norway: Not defined Norway: FHIR/REST Norway: XDS m/FHIR-innhold
SE now: IHE PCD-01, next: FHIR
SE now: Continuanext: Continua
SE NOW: SE-specific, next FHIR
SE NOW: vendor-specific, next: ?
SE NOW: Green CDA WS, next: FHIR
SE NOW: Green CDA WS, next: FHIR
DK: Now Propr. JSONRecommended: to be done
DK: Continua recommended
DK: HL7-CDA QFD/QRD (Continua)
DK:Not defined DK: To be done DK: IHE-XDS w/PHMR and QFD/QRD
FI;: FHIR for wellbeing apps to connect to national PHR
FI;: Evaluating continuaVendor specific solutionsBluetooth, USB, etc.
FI;: FHIR questioinaire and FHIR questioinaire response, some CDA as well
FI;: Not defined (looking into FHIR subsc. mechanism)Mainly vendor specific for telecare
FI;: FHIR / REST + Web GUI professionalsPatientData: CDA R2+ DICOM + PDF
FI;: HL7 V3, XDS-I + XCA, DICOM
SE
NO
DK
FI
Questions?
Meet us at the Inera booth!