Industry agrees standardised interface for EPRs

After one year of negotiations – faster than expected – more than 30 health IT companies have agreed on a new standardised interface for electronic patient records (EPR).

The agreement will make it easier for EPR-solutions of different vendors to share personal medical data.

The new interface was being developed under the umbrella of the intiative EPA NRW in the German federal state of North-Rhine Westfalia. Companies involved include, among others, Agfa Healthcare, Careon, CompuGroup, DocExpert, fliegel, IBM, ICW, Microsoft, Siemens and T-Systems.

Like other federal countries, Germany is moving towards a system of regional eHealth networks of different providers with a high demand for interoperability. The basic concept is to have, next to each other, hospital-owned case records, life-long web-based personal health records (PHR), and regional server-based records for managed care-scenarios. All these electronic patient record solutions of different kinds will have to share data. This means that both a standardised interface and semantic standards are needed.

At Medica last week, the coordinating Zentrum für Telematik im Gesundheitswesen (centre for health telematics, ztg) published the second milestone of the EPA NRW-initiative.

It consists both of semantic standards and of an open standardised interface that the IT-companies have agreed on to use for their patient record solutions, said project-coordinator Stefan Kühn from ztg when talking to E-Health Europe about the issue.

The standardised interface is a web service, that was conceptualised by the Fachhochschule Dortmund, a technical university. If, for example, a hospital wanted to send data to the personal health record of a patient, it would do so by using the web service which forwards the data to the individual PHR of the patient.

"To make this possible, the companies have agreed to use HL7 version 3 CDA release 2 as a communication standard,"said Kühn. They have also agreed to use a standardised matrix for the medical content of referral letters like diagnoses, medication, or results of examinations. Kühn: "Originally, this matrix was developed by the health-IT-association VHitG for referral letters only. It now becomes part of the standards for EPR-projects as well."

Although the new interface is not a national standard, it provoked very positive reactions last week. "The new interface does definitely have the potential to become part of the national infrastructure," said Harald Sondhof of the PHR-provider Careon. "This is the first time that we have an online exchange of medical data which involves both EPR-solutions and PHR using an absolutely non-proprietary interface."

Sondhof said, that the EPA NRW-project was also the first public EPR-project which discriminates sharply between electronic patient records for every-day-use by medical professionals and PHR-solutions for the long term documentation of medical data under the control of the patient: "This clear separation makes it possible to fulfill the demands of privacy activists," said Sondhof.

"Big IT" also gave positive statements concerning the new standard: "We are already implementing it in our electronic health record pilot project in Bottrop in North-Rhine Westfalia," said Hubert Haag, global head of the section healthcare at T-Systems, the IT-branch of Deutsche Telekom.

Volker Wetekam, head of global solutions at Siemens Medical, stressed that interoperability was mandatory in federal countries like Germany, where nationwide centralised solutions are not possible for political reasons.