Having the right information available at the right time can save a patient’s life. Information on intolerances, allergies, previous illnesses and medication is vital to diagnosis and treatment. Medical treatment is becoming increasingly complex as a result, and networked information processing is now indispensable. A variety of stakeholders are involved along the patient’s chain of care—from the primary care doctor to the hospital—all of whom contribute to successful treatment outcomes.
These developments place heavy demands on hospital information technology (IT) systems. IT is no longer restricted to administrative and medical processes in individual departments and divisions; now it facilitates information processing along individual patient pathways using state-of-the-art analytical and networking methods. Thus IT provides the platform for networked medicine, where the network encompasses both departments within a hospital and external facilities, such as hospitals, physician practices, emergency medical services, nursing homes, etc.
Together with the Bad Kissingen Center for Telemedicine, we are moving networked medicine forward in hopes that this will provide patients with the best possible care. The entire patient treatment process chain is IT-supported. The key factors include availability of patient information at every treatment location, effective communication between treating entities, and the patient’s ability to decide at every stage of treatment which doctors at which facilities will have access to their information.
We are using a two-pronged approach to realize this vision for networked medicine: In the hospitals, we are working toward universal digitalization using KAS 4.0 by integrating mobile devices, medical devices, and materials management into the processes. Building on that, we are developing WebEPA+, a physician-guided, cross-enterprise networked electronic record. This allows for efficient and effective mobile information processing within the hospital, with the option of networking with other stakeholders. We have years of experience in developing intersectoral networking solutions, which the organization plans to use to further advance the communication and standardization process with KAS 4.0 and WebEPA+.
“RHÖN-KLINIKUM AG’s WebEPA+ facilitates secure intersectoral communication between partners.”
With WebEPA+, cross-campus virtual service networks will be formed to benefit patients. Structured communication channels will be created between primary care doctors, specialists, expert centers, and partner hospitals. This means that every doctor involved in the treatment process will also have a case-based overview of the patient and their medical history at all times. Even doctors at remote locations can directly contribute their particular expertise to the assessment and treatment process in the form of consults.
WebEPA+’s function modules
WebEPA+ is based on the cross-enterprise patient record in the ICW eHealth Suite, which acts as both an IHE-compliant repository and a document registry. The patient record can store all medically relevant data for each patient, from images to reports to vital signs. Once released, data can be received by WebEPA+ via standardized interfaces and processes (HL7, DICOM, and IHE), and then retrieved based on the permissions that are in place.
In developing WebEPA+, we were particularly focused on interoperability. This is vital when established systems need to be integrated. Interoperability makes integration possible using standard tools and communication server modules in combination with the hospital information system interfaces already in place. A web-based user interface facilitates simple and secure access for all clinicians, and provides numerous communication and messaging options.
To bring in private-practice physicians, we connected two healthcare networks, both of them using CompuGroup Medical’s JESAJANET and ICW’s eHealth Suite, by means of an integrated IHE-based communication link. The IHE-compliant modular product components in WebEPA+ and the resulting IHE-compliant communication between all these elements made it possible to create an XDS affinity domain. Useful function modules are constantly being added in order to improve intersectoral communication. At the same time, it provides a future-secure and highly modifiable networking and communication platform, with the ability to expand flexibly as needed.
WebEPA+ provides secure intersectoral communication for numerous partners. There are already plans to integrate more healthcare networks and systems from other manufacturers, which will be implemented using the P2R Connect module in the ICW eHealth Suite. P2R Connect is a lightweight Windows application that can be installed in a medical practice. The primary purpose of this application is to transfer health data from non-IHE-compatible physician information systems via WebEPA+’s standards-compliant interface.
In addition, WebEPA+’s consult functionality makes it possible for clinicians to compare notes easily, quickly, and securely for the benefit of their patients. This functionality is integrated directly into the highly secure WebEPA+ platform and is impressively user-friendly. The consult functionality is similar to web-based e-mail communication, and allows for the exchange not just of reports but also of entire DICOM studies in a matter of moments. Imaging studies for the consultant’s evaluation do not need to be imported, as WebEPA+’s consult function includes a full DICOM web image viewer from CHILI. WebEPA+’s full consult functionality is available to all linked physicians.
Looking ahead and conclusions
WebEPA+ does not replace local patient records within individual medical facilities, but acts as a link between them. It enables a complete, real-time overview of a patient’s case data. Physicians can continue to work with the primary systems they are familiar with; they simply specify which types of documents will be released for which patients, and which doctors will be given access to them.
WebEPA+ lays the groundwork with integrated networking of various healthcare service providers and stakeholders; the patient must now become the focus of future developments. RHÖN-KLINIKUM AG’s networked digitalization strategy supports patient care by optimizing the doctor-patient relationship through digital services. Future development of the WebEPA+ will need to accommodate even more extensive data protection regulations, so we are considering ways for patients to control access to their information and interact with their doctors via digital media. There are already a multitude of proposals for patient apps. The ability to link both worlds is likely to have great potential for acceptance and impact among patients and physicians.