logging in or signing up ePrescript Symposium MB Goldye Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 161 Category: Product Traini.. License: All Rights Reserved Like it (0) Dislike it (0) Added: June 16, 2007 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... Premium member Presentation Transcript Slide1: ePrescript: ePrescript Workshop on e-Prescription Telematics@health.be symposium 7 December 2006 Agenda: Agenda Presentation of the ePrescript project ePrescript scenarios and implementation options Demo of ePrescript services Challenges and Roll Out issues Is there an added value? Debate Conclusions andamp; Invitation to participate The ePrescript Project: eTen project for the validation of e-prescription prototypes (ePrescribe / eTranscript) ePrescribe: the 'assisted' prescription (with or without EHR) eTranscript: the 'transfer' services via a prescription pool server International consortium: Belgium, Ireland and Poland Belgian partners: MediBRIDGE NV, coordinating partner OmegaSoft (Medical as well as Pharma) Ministry of Health Dates: from June 1st 2006 to November 30th 2007 The ePrescript Project ePrescript specific services: ePrescript specific services Web-based 'full' electronic prescription Secure prescription transfer services International equivalence search services Cross border transcription services A prescription issued in another country (border pharmacy) (syntax translation) Dispensing message services Initially a copy of the prescription with a status 'dispensed' Later on including relevant products dispensed without any prescription ePrescript is NOT…: ePrescript is NOT… a permanent drug prescription repository a drug delivery database for for pharmaco-epidemiology or pharmaco-economics for prescription research for billing purposes nor for prescription profiles! there is even no ID of the prescribing physician in the PPS prescription message !! ePrescription validation status: ePrescription validation status Yet available within ePrescript: Standard prescription INN prescription Foreseen: Magisterial prescription From a formulary A reference to the pharmacy register Based on the composition Only ingredients Ingredients and pre-packed medicinal products Completed with a minimal set of clinical data, e.g. allergies Agenda: Agenda Presentation of the ePrescript project ePrescript scenarios and implementation options Demo of ePrescript services Challenges and Roll Out issues Is there an added value? Debate Conclusions andamp; Invitation to participate ePrescript scenarios: ePrescript scenarios Two main options: Non addressed prescriptions (default) Addressed prescriptions (on explicit individual request of the patient or in special settings) Two files/messages: A header with ID of sender, patient and prescription message + encryption key addressed to a TTP – Trusted Third Party The prescription message as such with solely the prescribed medicinal products, addressed to the PPS – Prescription Pool Server Slide10: TTP PPS Non-addressed Message Slide11: TTP PPS Addressed Message Slide12: TTP PPS Feedback (Addressed Message) ePrescript security issues: ePrescript security issues The prescription remains permanently encrypted: Decryption is done by the addressee/receiver based on a key obtained through the header message Content of the prescription never accessible by the PPS provider The prescription as such does not contain identification data Identification data (patient as well as the physician) are only available on the TTP server. The TTP doesn’t have the prescription as such (no recombination of information possible) Content of the electronic prescription: Content of the electronic prescription Should contain at least everything legally required in a paper based prescription … but the message definition needs to allow the inclusion of all possible elements of a prescription Content will obviously depend on the kind of prescribed products, e.g.: A national code (CNK) can be sufficient sometimes More data required for a magisterial prescription The ePrescript prescription contains some clinical data, e.g. allergens, some risk factors, co-treatment aspects… Structure of the electronic prescription: Structure of the electronic prescription Kmehr based with 'officially approved' additions / changes Introducing the concept of 'specialised transactions' as foreseen in Kmehr2. Kmehr2 enables transactions with a different content in the same message: prescription (s), essential/important clinical data Full validation through x-schema approach One transaction of the type 'prescription' per message Completed with a transaction of the type 'Sumehr', restricted, with some clinical data. Per prescription: one to n items (prescribed medicinal products). Content of a dispensing message: Content of a dispensing message In principle a copy of the original prescription message: Without any clinical data transaction With a status flag added to each item: Dispensed Refused Cancelled if not dispensed within a reasonable timeframe Or still 'Prescribed' if not yet processed In case of an INN prescription: replacing the INN name with the name of the dispensed product What is CardSpace?: What is CardSpace? CardSpace is a Indentity Selector Mechanism for users Available on Windows XP, Windows Vista andamp; 2K3 Available on other platform in the future Goal Simplify and improve the safety of accessing resources and sharing personal information on the Internet Based on the experience of Microsoft Passport Why CardSpace?: Why CardSpace? The Internet is a dangerous place! Identity theft, spoofing, phishing, fraud, misuse Username + password is weak and overwhelmed Poor choice Poor management Poor (re-)use How do we safely, reliably identify a site to a user… …and a user to a site? 'Good phishing sites fooled 90% of participants' – Harvard The weak link is often the user himself The « laws » of identity: The « laws » of identity User control and consent Minimal disclosure for a defined use Justifiable parties Directional identity Pluralism of operators and technologies Human integration Consistent experience across contexts CardSpace fulfills all these requirements Windows CardSpace: Windows CardSpace Reduces reliance on usernames andamp; passwords Consistent experience for login and registration Helps end users avoid some phishing attacks InfoCards: InfoCards Simple abstraction for digital identity Metaphor of physical cards Virtual cards for managing claims Self-issued cards Authority Issued cards Link to smartcard like Belgian EID Secure subsystem Protected UI, anti-spoofing, encrypted storage Vista, XP, Server 2003, IE7 Slide22: Relying Party Identity Provider Relying Party CardSPACE eTClient Identity Provider Relying Party Demo: Demo In the EHR Configuration of the ePrescription function Production of a prescription Export of the prescription Collection of the prescription from PPS Display of the content of the prescription within the pharma application Delivery of the medicinal product In ePrescribe: production of a prescription Slide24: Slide25: Slide26: Slide27: Slide28: Slide29: Slide30: Slide31: Slide32: Slide33: Agenda: Agenda Presentation of the ePrescript project ePrescript scenarios and implementation options Demo of ePrescript services Challenges and Roll Out issues Debate Conclusions andamp; Invitation to participate Challenges: Challenges Legal issues Content related issues IT Framework andamp; Context Structure related issues Operational issues Legal issues: Legal issues Royal Decree nr 78 of 10th November 1967 on the exercise of medical profession Art. 21 mentions that any prescription has to be signed and dated by a doctor or dentist Modifications by the Law of 22nd December 2003: Modifications by the Law of 22nd December 2003 Article 21 opens the possibility to use e-signature A Royal Decree can determine the modalities Slide38: Legal Conclusion The possibility to use an e-prescription is inserted in the legal framework The e-signature must be: advanced (based on asymmetric encryption) realised by a qualified certificate And through a secure way A Royal Decree can modalize the use of an e-prescription but is not necessary and not yet adopted Management of the “Informed consent” & the Dispensing Message: Management of the 'Informed consent' andamp; the Dispensing Message There is no unanimity regarding the need of 'informed consent' for the electronic prescription the delivery feedback Initial implementation: informed consent foreseen Is there a difference between the holder of the GMD/DMG and the other prescribers? Informed consent is 'shared' between the involved parties… but how do we handle 'conflicting' consents? Recording an informed consent does not harm… Challenges: Challenges Legal issues Content related issues IT Framework andamp; Context Structure related issues Operational issues Content related challenges: Content related challenges Definition of 'relevant OTC' products delivered Standardisation of / consensus on a large number terminologies. The terms used in CBIP/BCFI, in APB, in Kmehr and in some proprietary databases are different! =andgt;Consensus required on Pharmaceutical (product) forms Dispensing forms and dispensing units Ingredients / substances Physical forms and 'generic' pharmaceutical product forms (for the INN prescription) Route of administration =andgt;Can be handled within a closed environment =andgt;Work to do at national level before national roll out!! Challenges: Challenges Legal issues Content related issues Structure related issues IT Framework andamp; Context Operational issues Importance of structuring: Importance of structuring Purpose of the electronic prescription: improved processing of the prescription The model is very (ideally) structured. Not all the providers are able to produce this now. Processing of free text still immature (at least within low end applications…) Better to limit export than to use free text Challenges: Challenges Legal issues Content related issues Structure related issues IT Framework andamp; Context Operational issues Challenges: IT framework & context: Challenges: IT framework andamp; context Availability of authentication services Legal validity of the electronic prescription and/or acceptance by the social security authorities A solution for the regulated medicinal products Validation and acceptance of Kmehr2 Granularity of the prescribing applications… are they able to produce structured prescriptions? Challenges: Challenges Legal issues Content related issues Structure related issues IT Framework andamp; Context Operational issues Challenges: operational issues: Challenges: operational issues Weekend andamp; Urgency Partial delivery Simultaneous prescriptions / renewals Validity and expiration date Need for autoregulation Roll out strategy ePrescript roll-out strategy: ePrescript roll-out strategy First operational pilot sites: Q1 2007 Hove/Lint Leuven / Kortenberg Heist-op-den-Berg Domino based roll-out Important rate of 'users' of applications Sufficient level of local goodwill between physicians and pharmacists Open documentation involving other 'providers' of EHR systems and/or PhIS e-Ten ePrescript pilot goal: e-Ten ePrescript pilot goal ePrescript added value?: ePrescript added value? The realisation of an 'added value' in a 'win/win' approach is a prerequisite for e-prescribe services to succeed A win/win is not possible without goodwill of the main stakeholders: the prescriber, the pharmacist and the patient Added value for the pharmacist: Reduction paper (archive) Exchange / availability of some reliable clinical information Less fraud Impact on stock management Simplify dispensing process, especially when linked to a robot Improvement of service level to the patient ePrescript added value?: ePrescript added value? The realisation of an 'added value' in a 'win/win' approach is a prerequisite for e-prescribe services to succeed A win/win is not possible without goodwill of the main stakeholders: the prescriber, the pharmacist and the patient Added value for the pharmacist: Reduction paper (archive) Exchange / availability of some reliable clinical information Less fraud Impact on stock management Simplify dispensing process, especially when linked to a robot Improvement of service level to the patient ePrescript added value: ePrescript added value Added value for the physician: No more paper… mobile prescription Dispensing message as a starting point for improved compliance management.. Increasingly important, more especially also for INN prescriptions Less fraud Some information on the dispensed OTC products Added value for the patient: Pre-preparation of prescribed medicinal products, e.g. the extra-temporaneous prescriptions, leading to an enhanced comfort (only for the addressed prescription) Completeness of the patient file resulting a more secure care providing Is it possible to get even more added value?: Is it possible to get even more added value? ePrescript message already enables the transfer of social security information (e.g. an 'approval for reimbursement'): Potential for an important added value for physician and pharmacist Concept transmitted to RIZIV/INAMI and Ministry Sick funds seems to have 'technical problems'… The mobile prescription… Cooperation: Cooperation All documentation available for free Domain experts requested for the coding tables EHR providers andamp; PhIS providers should produce / integrate the electronic prescription 28th February: technical meeting for developers Info can be obtained anytime at the partners offices or at eprescription@eurorec.org Questions?: Questions? 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ePrescript Symposium MB Goldye Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 161 Category: Product Traini.. License: All Rights Reserved Like it (0) Dislike it (0) Added: June 16, 2007 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... Premium member Presentation Transcript Slide1: ePrescript: ePrescript Workshop on e-Prescription Telematics@health.be symposium 7 December 2006 Agenda: Agenda Presentation of the ePrescript project ePrescript scenarios and implementation options Demo of ePrescript services Challenges and Roll Out issues Is there an added value? Debate Conclusions andamp; Invitation to participate The ePrescript Project: eTen project for the validation of e-prescription prototypes (ePrescribe / eTranscript) ePrescribe: the 'assisted' prescription (with or without EHR) eTranscript: the 'transfer' services via a prescription pool server International consortium: Belgium, Ireland and Poland Belgian partners: MediBRIDGE NV, coordinating partner OmegaSoft (Medical as well as Pharma) Ministry of Health Dates: from June 1st 2006 to November 30th 2007 The ePrescript Project ePrescript specific services: ePrescript specific services Web-based 'full' electronic prescription Secure prescription transfer services International equivalence search services Cross border transcription services A prescription issued in another country (border pharmacy) (syntax translation) Dispensing message services Initially a copy of the prescription with a status 'dispensed' Later on including relevant products dispensed without any prescription ePrescript is NOT…: ePrescript is NOT… a permanent drug prescription repository a drug delivery database for for pharmaco-epidemiology or pharmaco-economics for prescription research for billing purposes nor for prescription profiles! there is even no ID of the prescribing physician in the PPS prescription message !! ePrescription validation status: ePrescription validation status Yet available within ePrescript: Standard prescription INN prescription Foreseen: Magisterial prescription From a formulary A reference to the pharmacy register Based on the composition Only ingredients Ingredients and pre-packed medicinal products Completed with a minimal set of clinical data, e.g. allergies Agenda: Agenda Presentation of the ePrescript project ePrescript scenarios and implementation options Demo of ePrescript services Challenges and Roll Out issues Is there an added value? Debate Conclusions andamp; Invitation to participate ePrescript scenarios: ePrescript scenarios Two main options: Non addressed prescriptions (default) Addressed prescriptions (on explicit individual request of the patient or in special settings) Two files/messages: A header with ID of sender, patient and prescription message + encryption key addressed to a TTP – Trusted Third Party The prescription message as such with solely the prescribed medicinal products, addressed to the PPS – Prescription Pool Server Slide10: TTP PPS Non-addressed Message Slide11: TTP PPS Addressed Message Slide12: TTP PPS Feedback (Addressed Message) ePrescript security issues: ePrescript security issues The prescription remains permanently encrypted: Decryption is done by the addressee/receiver based on a key obtained through the header message Content of the prescription never accessible by the PPS provider The prescription as such does not contain identification data Identification data (patient as well as the physician) are only available on the TTP server. The TTP doesn’t have the prescription as such (no recombination of information possible) Content of the electronic prescription: Content of the electronic prescription Should contain at least everything legally required in a paper based prescription … but the message definition needs to allow the inclusion of all possible elements of a prescription Content will obviously depend on the kind of prescribed products, e.g.: A national code (CNK) can be sufficient sometimes More data required for a magisterial prescription The ePrescript prescription contains some clinical data, e.g. allergens, some risk factors, co-treatment aspects… Structure of the electronic prescription: Structure of the electronic prescription Kmehr based with 'officially approved' additions / changes Introducing the concept of 'specialised transactions' as foreseen in Kmehr2. Kmehr2 enables transactions with a different content in the same message: prescription (s), essential/important clinical data Full validation through x-schema approach One transaction of the type 'prescription' per message Completed with a transaction of the type 'Sumehr', restricted, with some clinical data. Per prescription: one to n items (prescribed medicinal products). Content of a dispensing message: Content of a dispensing message In principle a copy of the original prescription message: Without any clinical data transaction With a status flag added to each item: Dispensed Refused Cancelled if not dispensed within a reasonable timeframe Or still 'Prescribed' if not yet processed In case of an INN prescription: replacing the INN name with the name of the dispensed product What is CardSpace?: What is CardSpace? CardSpace is a Indentity Selector Mechanism for users Available on Windows XP, Windows Vista andamp; 2K3 Available on other platform in the future Goal Simplify and improve the safety of accessing resources and sharing personal information on the Internet Based on the experience of Microsoft Passport Why CardSpace?: Why CardSpace? The Internet is a dangerous place! Identity theft, spoofing, phishing, fraud, misuse Username + password is weak and overwhelmed Poor choice Poor management Poor (re-)use How do we safely, reliably identify a site to a user… …and a user to a site? 'Good phishing sites fooled 90% of participants' – Harvard The weak link is often the user himself The « laws » of identity: The « laws » of identity User control and consent Minimal disclosure for a defined use Justifiable parties Directional identity Pluralism of operators and technologies Human integration Consistent experience across contexts CardSpace fulfills all these requirements Windows CardSpace: Windows CardSpace Reduces reliance on usernames andamp; passwords Consistent experience for login and registration Helps end users avoid some phishing attacks InfoCards: InfoCards Simple abstraction for digital identity Metaphor of physical cards Virtual cards for managing claims Self-issued cards Authority Issued cards Link to smartcard like Belgian EID Secure subsystem Protected UI, anti-spoofing, encrypted storage Vista, XP, Server 2003, IE7 Slide22: Relying Party Identity Provider Relying Party CardSPACE eTClient Identity Provider Relying Party Demo: Demo In the EHR Configuration of the ePrescription function Production of a prescription Export of the prescription Collection of the prescription from PPS Display of the content of the prescription within the pharma application Delivery of the medicinal product In ePrescribe: production of a prescription Slide24: Slide25: Slide26: Slide27: Slide28: Slide29: Slide30: Slide31: Slide32: Slide33: Agenda: Agenda Presentation of the ePrescript project ePrescript scenarios and implementation options Demo of ePrescript services Challenges and Roll Out issues Debate Conclusions andamp; Invitation to participate Challenges: Challenges Legal issues Content related issues IT Framework andamp; Context Structure related issues Operational issues Legal issues: Legal issues Royal Decree nr 78 of 10th November 1967 on the exercise of medical profession Art. 21 mentions that any prescription has to be signed and dated by a doctor or dentist Modifications by the Law of 22nd December 2003: Modifications by the Law of 22nd December 2003 Article 21 opens the possibility to use e-signature A Royal Decree can determine the modalities Slide38: Legal Conclusion The possibility to use an e-prescription is inserted in the legal framework The e-signature must be: advanced (based on asymmetric encryption) realised by a qualified certificate And through a secure way A Royal Decree can modalize the use of an e-prescription but is not necessary and not yet adopted Management of the “Informed consent” & the Dispensing Message: Management of the 'Informed consent' andamp; the Dispensing Message There is no unanimity regarding the need of 'informed consent' for the electronic prescription the delivery feedback Initial implementation: informed consent foreseen Is there a difference between the holder of the GMD/DMG and the other prescribers? Informed consent is 'shared' between the involved parties… but how do we handle 'conflicting' consents? Recording an informed consent does not harm… Challenges: Challenges Legal issues Content related issues IT Framework andamp; Context Structure related issues Operational issues Content related challenges: Content related challenges Definition of 'relevant OTC' products delivered Standardisation of / consensus on a large number terminologies. The terms used in CBIP/BCFI, in APB, in Kmehr and in some proprietary databases are different! =andgt;Consensus required on Pharmaceutical (product) forms Dispensing forms and dispensing units Ingredients / substances Physical forms and 'generic' pharmaceutical product forms (for the INN prescription) Route of administration =andgt;Can be handled within a closed environment =andgt;Work to do at national level before national roll out!! Challenges: Challenges Legal issues Content related issues Structure related issues IT Framework andamp; Context Operational issues Importance of structuring: Importance of structuring Purpose of the electronic prescription: improved processing of the prescription The model is very (ideally) structured. Not all the providers are able to produce this now. Processing of free text still immature (at least within low end applications…) Better to limit export than to use free text Challenges: Challenges Legal issues Content related issues Structure related issues IT Framework andamp; Context Operational issues Challenges: IT framework & context: Challenges: IT framework andamp; context Availability of authentication services Legal validity of the electronic prescription and/or acceptance by the social security authorities A solution for the regulated medicinal products Validation and acceptance of Kmehr2 Granularity of the prescribing applications… are they able to produce structured prescriptions? Challenges: Challenges Legal issues Content related issues Structure related issues IT Framework andamp; Context Operational issues Challenges: operational issues: Challenges: operational issues Weekend andamp; Urgency Partial delivery Simultaneous prescriptions / renewals Validity and expiration date Need for autoregulation Roll out strategy ePrescript roll-out strategy: ePrescript roll-out strategy First operational pilot sites: Q1 2007 Hove/Lint Leuven / Kortenberg Heist-op-den-Berg Domino based roll-out Important rate of 'users' of applications Sufficient level of local goodwill between physicians and pharmacists Open documentation involving other 'providers' of EHR systems and/or PhIS e-Ten ePrescript pilot goal: e-Ten ePrescript pilot goal ePrescript added value?: ePrescript added value? The realisation of an 'added value' in a 'win/win' approach is a prerequisite for e-prescribe services to succeed A win/win is not possible without goodwill of the main stakeholders: the prescriber, the pharmacist and the patient Added value for the pharmacist: Reduction paper (archive) Exchange / availability of some reliable clinical information Less fraud Impact on stock management Simplify dispensing process, especially when linked to a robot Improvement of service level to the patient ePrescript added value?: ePrescript added value? The realisation of an 'added value' in a 'win/win' approach is a prerequisite for e-prescribe services to succeed A win/win is not possible without goodwill of the main stakeholders: the prescriber, the pharmacist and the patient Added value for the pharmacist: Reduction paper (archive) Exchange / availability of some reliable clinical information Less fraud Impact on stock management Simplify dispensing process, especially when linked to a robot Improvement of service level to the patient ePrescript added value: ePrescript added value Added value for the physician: No more paper… mobile prescription Dispensing message as a starting point for improved compliance management.. Increasingly important, more especially also for INN prescriptions Less fraud Some information on the dispensed OTC products Added value for the patient: Pre-preparation of prescribed medicinal products, e.g. the extra-temporaneous prescriptions, leading to an enhanced comfort (only for the addressed prescription) Completeness of the patient file resulting a more secure care providing Is it possible to get even more added value?: Is it possible to get even more added value? ePrescript message already enables the transfer of social security information (e.g. an 'approval for reimbursement'): Potential for an important added value for physician and pharmacist Concept transmitted to RIZIV/INAMI and Ministry Sick funds seems to have 'technical problems'… The mobile prescription… Cooperation: Cooperation All documentation available for free Domain experts requested for the coding tables EHR providers andamp; PhIS providers should produce / integrate the electronic prescription 28th February: technical meeting for developers Info can be obtained anytime at the partners offices or at eprescription@eurorec.org Questions?: Questions?