bangels

Building Bridges in Belgium: 

Building Bridges in Belgium Dr Marc Bangels Ministry of Public Health Informatics, Telematics & Communication Cell

Building Bridges in Belgium: 

Building Bridges in Belgium A national strategy with well defined priorities

THREE PRIORITIES=Three domains for norms: 

THREE PRIORITIES = Three domains for norms 1. Local applications : ambulatory and institutions 2. Messages and security : data access and transfer 3. Health network : shared health record and services

1. NORMS FOR LOCAL APPLICATIONS: 

1. NORMS FOR LOCAL APPLICATIONS Quality criteria for electronic patient records in general practice : homologation Recognition of a diploma for physicians specialists in health data processing Requirements for the organisation of hospital information management Quality criteria for hospital information systems Long term preservation of patients records

1. NORMS FOR LOCAL APPLICATIONS: 

1. NORMS FOR LOCAL APPLICATIONS Quality criteria for electronic patient records in general practice : homologation Recognition of a diploma for physicians specialists in health data processing Requirements for the organisation of hospital information management Quality criteria for hospital information systems Long term preservation of patients records

Long Term preservation of patients records: 

Long Term preservation of patients records Proposal to modify the current legal situation: - reduce to 20 years the preservation of the comprehensive record adjust to a modification in the Civil Code - require a synthesis (minimal record) after 20 years ° containing at least relevant reports (discharge, outpatient, surgery, pathology) ° a selection of the last problems list and specific follow up in some pathologies is recommended

THREE PRIORITIES=Three domains for norms: 

THREE PRIORITIES = Three domains for norms 1. Local applications : ambulatory and institutions 2. Messages and security : data access and transfer 3. Health network : shared health record and services

2. Standards for messages and security in health data transfer: 

2. Standards for messages and security in health data transfer Development of standard messages between health care practitioners in XML, selecting partially HL7, CEN TC-251, using LOINC, CNK, ... Implementation of a unique patient identifier derived from the unique national number Use of electronic certificates for signature and encrypted communication between health care professionals = Belgian identification card (2004) + attributes (certification, PKI, TTP)

2. Standards for messages and security: 

2. Standards for messages and security Development of standard messages between health care practitioners in XML, selecting partially HL7, CEN TC-251, using LOINC, CNK, ... Implementation of a unique patient identifier derived from the unique national number Use of electronic certificates for signature and encrypted communication between health care professionals = Belgian identification card (2004) + attributes (certification, PKI, TTP)

Kmehr-Bis: 

Kind Messages for Electronic Healthcare Records Belgian Implementation Standard Model Transactions XML Implementation Coding systems www.health.fgov.be/telematics/kmehr Kmehr-Bis

2. Standards for messages and security: 

2. Standards for messages and security Development of standard messages between health care practitioners in XML, selecting partially HL7, CEN TC-251, using LOINC, CNK, ... Implementation of a unique patient identifier derived from the unique national number Use of electronic certificates for signature and encrypted communication between health care professionals = Belgian identification card (2004) + attributes (certification, PKI, TTP)

Unique patient identifier : basic principles: 

Unique patient identifier : basic principles Created from the unique national citizen number Isolated from other data (taxes, justice, administration) - because “sensible” health data Linked to contexts-objectives - administration - health care - studies (research, statistics, …) Unique and not “significant” (no age, no sex, …) Readable and copyable by a human International use

Slide13: 

Citizen number TTP Health number TTP ’ TTP ’ Under N° 1 Under N° 2 Irreversible encryption Secret keys ADMINISTRATION CARE STUDIES Unique patient identifier : basic principles

THREE PRIORITIES=Three domains for norms: 

THREE PRIORITIES = Three domains for norms 1. Local applications : ambulatory and institutions 2. Messages and security : data access and transfer 3. Health network : shared health record and services

3. Health Network : the Flow project: 

3. Health Network : the Flow project eEurope 2005 eHealth Health information networks Member States should develop health information networks between points of care

3. Health Network : the Flow project: 

3. Health Network : the Flow project

3. Health Network : the Flow project: 

3. Health Network : the Flow project F Facilities (S3 infrastructure and services) L Legal implementation O Organisations (loco-regional teams) W Wisdom (coordination center)

3. Health Network : the Flow project: 

3. Health Network : the Flow project Development of a S3 prototype Patient oriented mailbox Shared health record : emergency + history Data from - general practice EPR (asynchronous via messages) - hospital EPR and HIS (synchronous via links) Dissemination of the S3 prototype

3. Health Network : the Flow project: 

3. Health Network : the Flow project

3. Health Network : the Flow project: 

3. Health Network : the Flow project Hôpital Brugmann S3 Client Internet Hôpital Saint-Pierre Server S3 Identification - Authentification - Encryption Flow Center

Building Bridges in Belgium: 

Building Bridges in Belgium Commission For Telematics In Health Care

THE BELGIAN COMMISSION FOR TELEMATICS IN HEALTH CARE: 

THE BELGIAN COMMISSION FOR TELEMATICS IN HEALTH CARE Organisation that recommends how to apply appropriate standards Created by Royal Decree (3 May 1999) - 11 Flemish speaking and 11 French speaking members - Representatives of Council of Physicians, Privacy Commission, social insurances (INAMI), patients organisations

THE BELGIAN COMMISSION FOR TELEMATICS IN HEALTH CARE: 

THE BELGIAN COMMISSION FOR TELEMATICS IN HEALTH CARE Makes recommendations to Ministers of Health and Social Affairs in order to promote standards and organisation for electronic health data exchange between health care professionals health practitioners and authorities contributing to the development of quality of care and of industrial products

THE BELGIAN COMMISSION FOR TELEMATICS IN HEALTH CARE: 

THE BELGIAN COMMISSION FOR TELEMATICS IN HEALTH CARE Working Groups Security Data = Messages + Records + Codes Hospital Label + Transfer Network Citizens

USE OF RECOMMENDATIONS OF THE COMMISSION: 

USE OF RECOMMENDATIONS OF THE COMMISSION By Ministers of Health and Social Affairs Laws, royal and ministerial decrees Financing pilot projects Financing common infrastructures Financing health care services in relation to results - quality standards - standard messages

Slide26: 

Thanks ! Marc Bangels