Workshop on the New Global Electronic Health Record Communication Standard

Wednesday, 21 July 2010

This five part standard, whose final part was published jointly by ISO and CEN in February of this year, defines the way that clinical information should be represented so that part or all of a patient's health record can be transferred between systems within or between countries in a way that faithfully preserves its meaning and its confidentiality. The EN13606 standard has been strongly supported by many countries during its development and balloting in CEN (in Europe) and ISO (Internationally), and is now starting to feature in large-scale eHealth programme architectures in countries such as Sweden, United Kingdom, Slovakia and Brazil (State Minas Gerais). In parallel to the meeting the State Minas Gerais published its EN13606 EHR-infrastructure specifications for vendors to connect to the State EHR-infrastructure on June 28th 2010.

The EN13606 standard provides strong support for semantic interoperability between EHR systems and aligns with the new Digital Agenda for Europe launched by the European Commission in May.

The standard builds on over 20 years of international EHR research and on vendor experience gained from two previous European EHR standards from 1995 and 1999. It incorporates and standardises the clinical archetype methodology, an innovative approach to designing information structures that organise the content of EHRs in ways that reflect the needs of clinicians.

This invitational workshop, organised by the Biomedical Informatics Group (IBIME) of the ITACA Institute at the Universidad Politécnica de Valencia and Electronic Record Services BV, and hosted by Instituto de Salud Carlos III in Madrid, was the first occasion when the early adopters of the standard, including those implementing EHR systems based on ISO/CEN EN13606 and those responsible for adopting it as a national strategy, could meet to share progress and practical experiences. It included representatives from: EHR projects in Spain, United Kingdom, Norway, Sweden, Slovakia, Ireland; several SMEs, IHTSDO, the openEHR Foundation; academic institutions from England, Australia, Germany, Ireland, Austria and Spain; plus hospitals and health organisations.

Vendors reported being able to use EN13606 and archetypes to generate clinical applications in close to real time i.e. reducing the process of developing systems for any specific clinical community from months to days. This extremely short production time will be of great value for the creation of national EHR infrastructures, enabling much flexibility, local adaptability, reducing cost, increasing quality and supporting co-operation in healthcare.

Professor Dipak Kalra, UCL, London, who led the development of the EN13606 standard in CEN and ISO told attendees that this workshop was the launch of a global community working towards the success of this innovative standard. "I am delighted by the speed with which many of you have brought this standard into your product development cycle and are close to deploying systems which will significantly advance the sharing of patient records."

Gerard Freriks, former chairman of the information models working group within the CEN technical committee for health Informatics, director of ERS BV. "I observe that more national and regional projects are looking seriously to this ISO/CEN EN13606 standard for their EHR-infrastructure."

Professor Montserrat Robles, director of the IBIME group, ITACA Institute, Universidad Politécnica de Valencia, Spain performing research with her group for ten years on the topic of EN13606 based EHR solutions and tools for standardisation of existing clinical information. "With the project going live in Minas Gerais in Brazil it has been proven that this EHR standard can and will play an important role in national projects."

The attendees agreed to collaborate on:

• developing technical artefacts that enable to the standard to be adopted more easily and used consistently, such as XML Schemas and implementation guides;
• tools to design archetypes, guidelines on how to design archetypes for use with SNOMED CT and other terminologies;
• EHR profile of a complementary standard for data types (ISO 21090);
• educational resources about the standard and good practice of its adoption;
• developing an EN13606 community of users and study other future mechanisms of collaboration with the goal of guaranteeing publication in the public domain of best practices based on real implementations, providing input for work in CEN and ISO and in conjunction with existing organisations like IHTSDO, HL7, EuroRec and openEHR.

A second workshop will be held in November, to be hosted by Sweden.

For further information, please visit:
http://www.en13606.org