ICT standards in the health sector: current situation and ... - empirica

ICT standards in the health sectorThe experts consulted for this report assessed the joint initiative in differing ways. Somewere generally positive; one expert said that the initiative could “put an end tocompetition”. One expert said it is “still unfolding” but “the potential influence issignificant”. Another expert was also generally positive but said that it may requireexternal funding for more influential activities in the future. A fourth expert assessed thepotential influence of the initiative as limited because CEN and HL7 compete with eachother; the initiative could only be strengthened if the roles and relationships of bothorganisations were realigned. A further expert stated that the most important questionwould be whether the initiative would be too dominated by what he considered “legacystandards” and a “legacy approach to health informatics standardisation”. There werediffering assessments among the experts whether other SDOs should join the initiative ornot. One expert said this would be useful, another one stated that it would only be usefulafter a “reorganisation” or “integration” of CEN and HL7.All in all, the stakeholders involved in e-health standardisation are increasingly becomingaware of a need to develop the market for standards, and they are more and more activein this respect. The Member States’ e-health large-scale pilot planned to start in thesummer of 2008, being funded by the ICT Policy Support Programme (PSP) in thecontext of the European Competitiveness and Innovation Framework Programme (CIP),is expected to become a further catalyst in this respect. 452.2.4 Electronic Health Records standardisationDefining and distinguishing types of EHRsIntroducing electronic health records (EHRs) and defining related standards is animportant issue on the political agenda of many European countries and also of theEuropean Commission. In its eHealth Action Plan, the European Commission states that“Member States, in collaboration with the European Commission, should identify andoutline interoperability standards for health data messages and electronic health records,taking into account best practices and relevant standardisation efforts”. 46 EHRs willtherefore receive particular attention in this report.Presently available hospital information systems have implemented limited versions ofEHRs. They already began to emerge in the late 1960s with the primary purpose ofimproving in-house communication and capturing charges. Since then, a large number ofterms have been used to categorise different variations of what one may generally call“patient data file”. Although they all contain patient and health administrative data of asingle person, they differ greatly in the inclusiveness of clinical information, e.g. whetherdata is available from one ward or unit, from one institution only, a collection of selectedinstitutions or a cradle-to-grave record with data from all involved institutions. Relateddefinitions have often been controversial or vague resulting in inconsistent and confusinguse of the term. The Medical Records Institute, 47 a not-for-profit advocacy organisation454647http://www.ehealtheurope.net/news/3727/paneuropean_sos_project_about_local_interoperability.See European Commission (2004), p. 14.See Waegemann (2002).25