This is a presentation on use case extensions to the revised eHealth interoperability framework by the eStandards project.

1. eStandards
eHealth European Interoperability Framework
Use cases Extension
Karima Bourquard, IHE-Europe
21 April 2015 - Berlin
643889
H2020-PHC-2014
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2. Objective
• Interoperability is a key challenge of Healthcare IT
in the coming years
• Standards and profiles in healthcare are essential
and are now ready for deployment
• The link between the user needs and the
implementation in IT solutions is not obvious for
an end-user
Guidance and tools were developed for bridging
business processes to technical steps and
implementation
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3. Introduction
• The eHealth European Interoperability
Framework (eEIF) was published in 2012 where
1O use cases and its related profiles and
standards were described
• It was refined in the Antilope project (January
2015):
The Antilope Refined eEIF consists on
• A refined model for interoperability
• A set of templates for uniform description of use cases
• A set of use cases as the basis for interoperability projects
• A glossary of healthcare interoperability terms and
definitions
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4. Introduction
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• From Antilope to
– The adoption by the eHN of the common
Refined framework for managing
interoperability and standardisation challenges
in the eHealth domain in Europe
– The eStandards extension of the EIF use cases
Nov 2015
Jan 2016

5. The Refined EIF
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Provide to healthcare providers (national/regional or
local projects) a set of tools and guidance to implement
exchanges or sharing health data in their projects
based on
• Use cases describe the user needs in
specific domain
• Realisation scenarios describe interoperable
architecture based on profiles and standards

6. Use Cases
• Easy for a clinician or patient to describe their needs with
natural language
• Formalise the process using the template provided by the
ReEIF
High level description
Request and results distribution workflow for Laboratory within
the Hospital
Test results from clinical laboratory services may be requested and
should be made available to medical caregivers who work in
multiple medical departments within the hospital organisation on a
need-toknow basis. This use case should ensure the availability of
timely, complete and consistent patient information as well as
avoidance of potential duplicate testing within the hospital
organisation.
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7. Realisation Scenario
Translation of the use case in technical process steps and delivery of a
selection of supporting profiles and standards (high level description)
• Technical process steps:
– Order placer requests laboratory tests through electronic testing and
adds relevant medical information
(Laboratory assistant takes a blood sample from the patient, and brings it
to the laboratory)
(Blood sample is analyzed in the Laboratory Information System)
– Results are stored in the Laboratory Information System
– Results are copied to the Hospital Information System (internal link)
– HP views the laboratory results in the HP EHR system
• Selection of profiles and standards
– Patient and professionals identification: PAM,PIX, PDQ, HPD
– Worflow and terminology: LTW, LCSD
– Security: ATNA, CT
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8. Benefit for Users
• Harmonisation of the use cases description by
using common templates
• Repository of existing analysed use cases as a
starting point for a new project wanted to specify
its own implementation
• Offer facilities to share its own experience with
other projects
Facilitate common understanding and acceptance of
profiles and standards by sharing same process of
project description
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9. eStandards extension
• ReEIF describes 10 uses cases at different
scales: intra-organisation, regional/national
and Europe
• Current Use cases cover different domains:
– Medication, Radiology and laboratory
– Patient Summary, Referral and discharge
reporting
– Participatory Healthcare, multidiciplanary
consultation
– Telemonitoring
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10. New Use cases and realisation scenarios
• The new needs were collected among divers
stakeholders:
– eHealth Stakeholders group (Europe – DG-CNECT)
– HOPE (European Hospital and healthcare
federation)
– Eu projects: VALUEeHEALTH, OpenMedecine,
Decipher, Trillium Bridge,…
– ESR/ECR: European Society of Radiologist
– Partners of the eStandards project (Danish use
cases for example)
• Profiling organizations: IHE, CHA
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11. Selection of Use Cases/Realisation Scenarios (1/2)
• eS1: Integrated neonatal care
– This use case is related to the summary of the antepartum ambulatory
care (Accessibility of the Antepartum information from the perspective of
the clinical care needs for a future baby and its mother)
• eS2 : Mobile services to empower patient with heart failure
(realization)
– This is a realisation scenario of the ReEIF Use Case 6: Involvement of
chronic patients in electronic documentation of healthcare information.
• eS3: Exchange of Patient Summaries across Atlantic (realization):
– This is a realisation scenario of the ReEIF Use Case 4 Patient summary
sharing on a cross-border scale extended to the Cross Atlantic (EU/US
exchanges)
• Use case eS4: Structured report in radiology ((realization):
– This scenario is updated and the IHE MRRT profile (Management of the
Radiology report Manager) is added
– In this scenario, the requesting and performing of the diagnostic study is
done within a healthcare institute, and the viewing of the results is done
from outside the healthcare institute.
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12. Selection of Use cases/Realisation Scenarios
• eS5 : Monitoring the radiation exposure (realization)
– This is a new of realisation scenario of the ReEIF Use Case 2 request and results of
sharing workflow for radiology.
– In this scenario, the dose information is collected when the exams in an imaging
XRay modalities or equipment are performed for a specific patient.
• eS6: Immunization use case
– This use case is a new use case related to a new domain: Public Health.
– Healthcare professionals need to determine if a vaccination should be
administered at the time of a clinical encounter. The reporting to public
health that a vaccination has been administered to a patient
• eS7 : Healthcare Provider (realization)
– Transversal and is related to all use cases. As for Patient identification
Management use cases that are made generic and present everywhere, the
healthcare provider will also be part of all realisation scenario. The profile used is
HPD.
• eS8 : Workflow care plan management (realization )
– This use case is a support to several realisation scenarios already developed in the
ReEIF when a care plan shall be developped and maintained (for example follow-
up of chronic patients with heart diseases by a care manager)
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13. Use Case Repository
https://usecase-repository.ihe-europe.net/
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15. Use case Repository: Realisation scenarios
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17. Link to the list of IHE profiles for referencing in public
procurement
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On 28 July 2015 the European
Commission announced that 27 IHE
Profiles are eligible for referencing in
public procurements as technical
specifications.
Official Journal of the European Union:
http://eur-lex.europa.eu/legal-
content/EN/TXT/?uri=OJ:JOL_2015_199
_R_0011

18. Lessons learned
• Integration of new Use Cases and implementation
scenarios with the support of the Antilope templates
• Same health information exchange architecture serves
several use cases as demonstrated by the selection of
common set of profiles and standardisation in different
use cases
• Finally, by building a database repository, we expect an
easy access of the use cases from stakeholders wanting
to design their own infrastructure or implement
profiles and standards.
A step forward for increasing the deployment of
interoperable solutions in order to increase the
development of a single digital market in Europe
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19. QUESTIONS ?
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