Policies and Roadmaps for semantic interoperability in the eHealth domain

1. CNR-ITB RIDE Workshop, Brussels 2006-12-08 Policies and Roadmaps for semantic interoperability in the eHealth domain Angelo Rossi Mori, eHealth Unit, CNR-ITB

2. CNR-ITB RIDE Workshop, Brussels 2006-12-08 Policies and roadmaps GOAL: To develop a Roadmap for semantic interoperability for future research and development activities in the context of the eHealth action plan Communication COM (2004) 356, �eHealth � Making Healthcare Better for European Citizens: An Action Plan for a European e-Health Area�. to compare the strategies in different jurisdictions, to explore their construction and their limitations, to work out the principles for the development of a roadmap

3. CNR-ITB RIDE Workshop, Brussels 2006-12-08 disciplined vs. fuzzy environments disciplined environments diagnostic services (orders and reports), booking, admission, discharge letter, � systematic interactions, stable workflows inter-operability, standard messages fuzzy environments human co-operation, clinical communication clinical pathways, datasets, narrative co-operability, document-based approach

4. CNR-ITB RIDE Workshop, Brussels 2006-12-08 main principle successful ICT solutions should correspond to perceived communication needs of clinicians and citizens, rely on clear workflows, be supported by systemic actionsby healthcare managersand by adequate policies

5. CNR-ITB RIDE Workshop, Brussels 2006-12-08 IC (T) ? more emphasis on I nformation C ommunication less emphasis on T echnology the context for semantic interoperability what are the interactions ? how far are they systematic ?

6. CNR-ITB RIDE Workshop, Brussels 2006-12-08 1. Policies and strategies comparative analysis of strategies in different jurisdictions exploration of limitations of the current policies and strategies role of non-technological factors criteria for roadmap design preliminary activity:set up an Explanatory Framework

7. CNR-ITB RIDE Workshop, Brussels 2006-12-08 1a. analysis of strategies comparative analysis of strategies in different jurisdictions, e.g. : NPfIT in England, ONCHIT in US (and the RHIOs phenomenon) Infoway in Canada, OpenConnect in Australia + existing RIDE material + partners' contributions �

8. CNR-ITB RIDE Workshop, Brussels 2006-12-08 1b. limitations of current policies identify the limitations of the current policies and strategies: What was wrong with the process so far ? How to improve the effectiveness of deployment? How to obtain �a realistic approach and applicability in clinical settings�?

9. CNR-ITB RIDE Workshop, Brussels 2006-12-08 1c. non-technological factors regulations, education, economics, involvement of stakeholders, role of public agencies to support the deployment and the research, ways to involve the research community

10. CNR-ITB RIDE Workshop, Brussels 2006-12-08 1d. criteria for roadmap design criteria and metrics as an input to the roadmapping process to satisfy the EU eHealth Action Plan on the deployment; on the processes of change management; on the potential role of authorities

11. CNR-ITB RIDE Workshop, Brussels 2006-12-08 + Explanatory Framework work out a common languageto describe policies and strategies a preliminary activity to systematize: the driving factors for eHealth evolution the evolution of eHealth solutions the layers of interventions (as an adaptation of the ongoing activities  within the eHealth ERA Project and the EU Stakeholders' Group)

12. CNR-ITB RIDE Workshop, Brussels 2006-12-08 four layers of interventions L1. basic tools and services to enable other layers hw, sw, networks, regulations, identification L2. to improve efficiency of operational workflows booking, prescribing, reporting, ...(message formats, terminologies) L3. to improve quality of shared care synergy of actors, patient empowerment (clinical pathways, data sets) L4. to improve governance of healthcare system structural actions (indicators)

13. CNR-ITB RIDE Workshop, Brussels 2006-12-08 L1. basic tools and services to enable upper layers Various large jurisdictions are envisaging national (federal) and regional programmes, to develop coherent inter-sectoral infrastructures (e.g. by eGovernment actions and generic standard, e.g. HTML, XML) and health-specific infrastructures. In parallel, there is an increasing attention to define and adopt regulations and standards, and to make plans for specific educational activities for the public and healthcare professionals.

14. CNR-ITB RIDE Workshop, Brussels 2006-12-08 L1. basic tools and services to enable upper layers build the technological infrastructure; set up the proper regulatory framework, including connectivity, security, privacy; produce or adopt standards and reference material to achieve semantic interoperability; set up a certification process on quality and safety of eHealth solutions

15. CNR-ITB RIDE Workshop, Brussels 2006-12-08 L2. to improve efficiency of operational workflows to improve speed, quality, quantity of procedures performed with a given amount of resources. stereotypical situations (e.g. on prescriptions, discharge letters, test reports, �) were the topic for intense activities on interoperability standards in last 15 years largely independent from the actual patients conditions: most of them do not influence appropriateness of procedures and clinical decisions, i.e., the intrinsic nature of healthcare services is not altered

16. CNR-ITB RIDE Workshop, Brussels 2006-12-08 L2. to improve efficiency of operational workflows provide services to improve the current workflow-oriented services provide a basic electronic assistance to clinicians and managers provide support to Public Health Systems, on epidemiology, management and planning (derived usage of information).

17. CNR-ITB RIDE Workshop, Brussels 2006-12-08 L3. to improve quality of shared care rationalisation of the processes of care provision by a problem-oriented perspective: support the daily clinical decisions of multiple healthcare professionals and a more effective behaviour of patients and clinicians with the capture, storage and transmission of specific data items, depending on the particular context within the care plan

18. CNR-ITB RIDE Workshop, Brussels 2006-12-08 L3. to improve quality of shared care advanced services on information and knowledge for clinicians services for the empowerment of health consumers: citizens, patients, their families and caregivers programs supporting the current care processes

19. CNR-ITB RIDE Workshop, Brussels 2006-12-08 L4. to improve governance of healthcare system information support to discover bottlenecks to negotiate among stakeholders to decide for systemic actions more effective management of services and refinement of medium- and long- term policies, by the analysis of accurate and timely data, directly taken from the routine care processes of each individual patient increase in quality and better control on resources (appropriateness).

20. CNR-ITB RIDE Workshop, Brussels 2006-12-08 L4. to improve governance of healthcare system re-engineering care processes structural actions on the healthcare system to increase quality and appropriateness of care provision enabling innovative organisational models production and evaluation of eHealth roadmaps support change management processesfor eHealth deployment

21. CNR-ITB RIDE Workshop, Brussels 2006-12-08