“If anything emerged in the time of the pandemic that we are still going through, it was the value of interoperability in increasing the usefulness of healthcare data when it can be interconnected.” This is what the Head of the eHealth Applications and Services Centre (CeHA) of the Institute of Informatics of the Foundation for Research and Technology Hellas (FORTH) in Crete, Dimitrios Katehakis, tells me, on the occasion of the recent international recognition of the Foundation for eHealth Applications.
In order to understand the value of this interoperability, someone first needs to realise that optimal patient care requires effective access to all information related to their health, and that despite advanced technology, healthcare providers have not yet exploited the full potential of modern technologies to reduce medical errors, improve efficiency and enhance overall quality of clinical care. For this to happen, a framework for the exchange of information is required that meets the needs of the carers themselves, as well as of the patients. “There are standards that provide the basis for such a framework, but on their own they are not enough to solve the problem, since the way they are implemented depends on many parameters, such as the way the technical configuration, the agreed semantics, the organizational structure of the units that wish to inter-operate, as well as the existing legislation”, says Mr. Katehakis, adding that no formal map fits perfectly into the complex and constantly changing information sector of a healthcare provider.
Filling the gap between templates and their organized use requires the creation of a detailed framework for their implementation based on specific use scenarios (or integration profiles). And here comes the IHE (Intergrating the Healthcare Enterprise), which is an international initiative by health professionals and industry that aims to improve the way computer systems in healthcare exchange information, promoting organised interoperability based on existing interoperability standards specifically designed for the health sector. Such standards are, among others, those produced by the organization Health Level Seven (HL7) International for the exchange, integration and retrieval of electronic health information to support clinical practice, and DICOM for medical images.
Success of FORTH in interoperability capability tests
Every year dozens of manufacturers of software for the health sector, in order to confirm their support for interoperability, participate in an intensive “interoperability marathon” with the support of IHE Europe. IT engineers are participating in this special competition with the ambition to confirm that the applications they manufacture can inter-operate with third-party applications from all over the world. One of the participants that succeeded is FORTH, constituting, in fact, the first public sector organization in Greece that successfully passed the test of software compliance with specific IHE integration profiles. “At an international interoperability capability testing event against third-party manufacturers, we were asked to confirm the ability of our applications to inter-operate through specific use cases according to modern IAE compliance profiles, which determine the workflow of these applications, utilizing particularly high-level tools and standards”, describes the Head of the eHealth Applications and Services Center (CeHA) of FORTH, Mr. Dimitrios Katehakis, adding that CeHA’s mission focuses on developing innovative, user-friendly, personalized digital tools to support effective and sustainable health services for all. As he told us: “Standardization accelerates development when it is carried out in an organized way and can be confirmed by third-party, independent bodies.”
According to Mr. Katehakis, the digital “tool” that passed the relevant tests for five integration profiles and thirteen roles / options is the award-winning software suite “Integrated Care Solutions” (ICS), developed by the Center for Applications and Services of eHealth (CeHA) of the Institute of Informatics of FORTH, which consists of a set of applications for the global digital health market, which have been developed in our country by CeHA. Successful tests ensure that this software is compatible with standardised integration profiles and established standards, having confirmed its interfunctionality with third-party systems on the international market. The integration profiles tested by FORTH included cross-Enterprise Document Sharing, XDS.b), Sharing Laboratory Reports (XD-LAB), Patient Identifier Cross-Referencing (PIXV3), Audit Trail and Node Authentication (ATNA), Consistent Time (CT) and Laboratory Testing Workflow.
The value of successful participation in interoperability testing
The interoperability capability tests that this year, due to the conditions, were carried out online, as part of the “IHE-Europe Connectathon week” last June, involved 27 health software vendors from Austria, Germany, the United States, India, Spain, Italy, South Africa, South Korea, and other countries.Participating in such a process is a very serious matter and requires especially careful and targeted preparation. We have taken the first step. We hope that others will soon follow”, adds Mr. Katehakis.
But what does this recognition mean in practice at international level? “Having tested your applications with those of other suppliers, you are now able to work with all manufacturers on the planet. Having been listed in the register where the declarations of conformity are published, you can participate in the implementation of large projects on a global scale. You have commercial healthcare IT systems that have adopted interoperability solutions based on the standards used in the global market.” concludes the Head of CeHA.
It is worth noting that since February 2020, the Ministry of Health has begun to implement in Greece the project for the design and implementation of the national interoperability framework for eHealth (SRSS/SC2019/164 “Design and implementation of the national ehealth interoperability framework (NeHIFinteroperability)) with the support of the European Structural Reform Support Service (DG REFORM/SRSS), aiming at the design and implementation of the Greek National Framework for Interoperability in eHealth and the wider support of the implementation of the digital transformation of the Ministry of Health. This project aims to support the management of health data and e-health services, which are considered vital for the improvement, governance and rationalization of the health system as well as for improving the management of treatment outcomes.