Introduction of an Integrated IT Environment for the Healthcare Process
C. Nerhed1, B. Ehrs2, J. Lindqvist1, L. Lyttkens2 and B-E Erlandson1
1 Medical Informatics and Engineering, University Hospital, S-751 85 Uppsala, Sweden,
2 University Hospital, S-751 85 Uppsala, Sweden
A new IT architecture was introduced in 1998 in the County Council of Uppsala, which is the main healthcare provider with two hospitals, primary care and it supports the health care to the communities. The University Hospital has a yearly turnover of 4,8 billion Euro and 1.300 hospital beds. The vision is to implement a common IT infrastructure with integrated systems for the whole County, including the patient at home, supporting the healthcare processes to all healthcare providers.
Introduction of IT solutions is managed by healthcare professionals in cooperation with IT professionals. The user requirements and the need for changes of routines are in focus. The introduction is focused on operational issues, and the development is firmly supported by the management. Technically, we want to use standard systems on the market. New applications will be developed in close collaboration between users and vendors. Systemintegrations are performed using standards e.g. XML messages are used for communication with laboratories and pharmacies. Electronic Patient Records is based on the CEN pre-standard HISA.
Functionality for Patient Administration, i.e. planning/booking, order/request, billing/reimbursement and reports/statistics has already been implemented. Today we have over 9000 users. Functionality for Patient Documentation is now being introduced, including support for basal documentation and for medication. All healthcare professionals, all units and clinics within the County will use the system.
Efforts have been made in developing the functionality to reach a high usability level. One major issue is to integrate many systems, delivered by different vendors, built with different architectures. Open systems and collaborations between vendors and customers are needed. Integrated systems have to be easy to use and easy to manage. As systems are getting more and more interconnected coordination of activities when updating the systems for function, data integrity and uptime, are increasingly needed. Work has been initiated for integrating applications from two Swedish vendors. A national initiative from CareLink has been made, where vendors and healthcare providers are working closely to develop a “Reference Architecture” with the main purpose to enhance interoperability, and it is supported heavily by Uppsala University Hospital. We must be able to purchase “moduls” of functionality on a competitive market.
We are moving forward towards our vision, where information about the patient always will be accessible for care providers and the patient, where and when needed. On the road ahead a lot of challenges must be overcome. Special attention will be given to integration of our applications including technical and operational aspects.