Madrid Maarten Landuyt amp Johan Van Bussel Standardisation of amp data reuse for Belgian health registries Sponsored by Unknown effectiveness 50 Likely to be ineffective or harmful 3 ID: 758515
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Slide1
Healthdata.be
2017.05.10, HL7 Conference,
Madrid
Maarten Landuyt & Johan Van
Bussel
Standardisation
of & data reuse for Belgian health registries
Sponsored bySlide2
Unknown effectiveness (50%)
Likely to be ineffective or harmful (3%)
Unlikely to be beneficial (6%)
Trade-off between
benefits and harms (7%)
Likely to be
beneficial (24%)
Beneficial (11%)
BMJ Clinical Evidence (2014)
Clinical registries are necessary!
n = 3000Slide3
3
Epidemiological surveillances are necessary!
Sabbe et al., (2012
) Measles resurgence in
Belgium,
EurosurveillanceSlide4
4
BUT
?
?
?
?
?
?
?
!
?
?
Slide5
The main cause of burn-out in physicians?
#1: increase administrative burden (70.4%)Slide6
6
“René, listen very carefully,
I shall say this
only once
”“Only once”
= key principle of Action plan eHealth 2013-2018Slide7
technical
implementation: free & open
information
architecture: technically neutral
technical
service desk
set of
business processes
Maximal reuse
of
existing data
and
linking of previously collected data
(“only once” registration)
Each data provider receives
timely feedback
reports
within 1 reporting environment
1
Healthdata’s
ambition for healthcare registries
Less administrative
burden & higher efficiency
= more
time for
patient
►
higher quality of care= more time for research ► higher quality of research= lower costsSlide8
Secure Data
Transfer & encoding of IDs
Data Validation
Annotation & Correction Request
Data Storage
BI-Reporting
Registration
in Primary System
HEALTHSTAT
HD4DP
Analysis
Data
Capture
Data Monitoring
HD4RES
DATAWAREHOUSE (SAS)
Use of National Registry Number
as ID
Trusted Third Party for encryption and pseudonymization
healthdata.be
Healthdata.be at a
glance
Technical description of each data collection
Generic healthdata.be architecture
approved by
:
WG
Architecture
: Positive advise (12/12/2014 & 06/03/2015)
Sectorial
Committee health (Privacy commission)
: Authorization (21/04/2015
)
eHealth-platform
: Authorization (22/04/2015
)Slide9Slide10Slide11Slide12
In production
N = 20
“To do”
N > 100Slide13
Interoperability
Information
architectureSlide14
Variables needed for
scientific
research
question
Information mostly
not available
in primary systems (EHR, HIMS, LIMS, …)
Information
needed
in the
context of
continuity of care
or internal
administration.
Information
should be available in primary systems
(EHR, LIMS, …) in a structured and coded way
Registry
A
Registry
B
Registry
C
Registry
D
Identification
,
typically available in
authentic sources
Typology based on inventory of 8,000 variables collected by ca. 50% of current registriesSlide15
The collection of health care data:
need for interoperability
Redefined eHealth European Interoperability
Framework (IHE)
Legal and regulatory
Policy
Care process
Information
Applications
IT Infrastructure
Legal and regulatory
Policy
Care process
Information
Applications
IT Infrastructure
Compatible legislation and regulations
Collaboration agreements
Alignment of care processes and workflows
Data model, terminologies, formatting
Integration in healthcare applications
Communication and network protocols
Organization A
Organization B
Information
Information
Data model, terminologies, formattingSlide16
Standardisation
of
registry content
International standard: ISO/TS 13972:2015(en): Health informatics —
Detailed Clinical Modeling
, characteristics and processes.
Implementation by
NFU:
“Clinical Building Blocks
”
The following organizers and participants contributed to the Technical Specification: Health Level 7 International (HL7) (USA), — National ICT Institute in Health Care (NICTIZ, Netherlands), National Health Service (NHS) (England), Canada
Infoway
(Canada), National E-Health Transition Authority (NEHTA),(Australia),
OpenEHR
(International), EN 13606 association (Europe), Intermountain Healthcare (USA), …
Method
Assets
(
products)
N=42Slide17
Example
of a Clinical Building Block “Breathing”
Values: SNOMED-CTSlide18
Standardisation
of
healthdata
registriesSlide19
i
tems match
w/a CBB
100%
i
tems do not
match w/a CBB
42 CBB’s
46 Projects
mapped
3142 itemsSlide20
covers
63%
of
3142
variablesSlide21
Registry standardisation in 3 phases
Phase 1
Map existing registries to CBBs
Phase 2
Adjust questions to CBB structure
Phase 3
CBB-based registriesSlide22
REUSE of data through
a
cbb
-based API on hd4dpSlide23
Interfacing without CBBs
EMR
Input formats (m)
Registries (n)
LIMS
EHR
…
HL7v3 CDAr2
HL7 FHIR
…
Basic dataset
KMEHR
Registry 1
Registry 2
Registry 3
…
m * n connections (max)Slide24
Interfacing with CBBs
EMR
Input formats (m)
Registries (n)
LIMS
EHR
…
HL7v3 CDAr2
HL7 FHIR
…
Basic dataset
KMEHR
Registry 1
Registry 2
Registry 3
…
m + n connections (max)
v
ersus m*n connections from previous slide
CBBsSlide25
Q
&
A
healthdata@wiv-isp.be
www.healthdata.be
healthdata be
@
healthdatabe
Sponsored by