1. Regional EHR and PHR in Catalonia
ICT Services for Integrated Care

2. TicSalut: Technology, Innovation & Health
Founded in 2006, TicSalut Foundation is an agency within the Ministry of Health
that works to promote the development and use of ICT in the health and social
care domain, acts as a trends, innovations and emerging initiatives
observatory, and provides services for the standardisation and accreditation
of products.

3. Current System
The Catalan healthcare model is a
multi-provider one integrated in a
unique public network.
It enhances the autonomous
management of each provider.
Providers are free to select their
information systems; however 85% of
the primary care centres have the
same system (eCAP)
Interoperability among systems must
be guaranteed.
Decentralized SystemCatalan Healthcare System

4. Catalan Healthcare System
 The history of the Catalan healthcare
system, made it highly fragmented at
a healthcare supply level:
 Around 80% of the specialized
care and around the 20% of the
primary care is provided by
suppliers not belonging to the
Department of Health
 Inexistent common Information
System for all the healthcare suppliers
due to the healthcare system
diversification
ICT’s Strategic component of the Healthcare System
Insurance Services
USER
CATALAN
HEALTHCARE
SERVICE
CONTRACTED
PROVIDERS
100%
DEPARTMENT OF HEALTH: Draws up Health Plan and
Transfers economic resources Plans
Governance
20%
Supplementary
Private
Insurers
CATALAN
INSTITUTE
OF HEALTH
Private Centres
20%
70%
10%

5. The Shared Medical Record is a virtual space to group
together the documents about patient’s healthcare process.
CENTRAL
REPOSITORY
HEALTH CENTER
REPOSITORY
SECURITY
CLINICAL WORK
STATION
Shared Medical Record - Definition

6. 1st
level
2nd
level
3rd
level
Citizens’
information
Hospitals
Primary care
centers
Patient
information at
health central
registries
Central insurance
registry
Healthcare centres
Primary care centres
Centres with reports and
documents to share
Database
Healthcare authority
Shared Medical Record – Data Sources

7. Primary healthcare
− Diagnosis
− Healthcare reports
− Immunizations
Specialized care, socio-
sanitary care and mental
health
− Discharge report
− Emergency reports
− Specialized outpatient
clinic reports
Diagnosis procedures
− Pathology and laboratory
reports
− Radiological image
− Imaging diagnosis reports
− Other diagnosis tests reports
− Interventions
Healthcare Centres Information
Health Department Information
Medical Activity DB
− Diagnosis
− Procedures
Prescribed / Dispensed
drugs
− Electronic prescription
Advanced directives
− Advanced directives
registry
Shared Medical Record – Available information

8. 94% of centres in Catalonia are connected to the SMR
Shared Medical Record – Deployment
0
50
100
150
200
250
300
350
400
450
500
Hospitals Primary Care Socio-Sanitary
Care
Mental Health
97%
98%
91%
84%
Healthcare centres
connected to SMR

9. • 132.546Professional accesses per month
• 1.895.692Average documents published per
month
2010 2011 2012
8.340.886 13.842.580 17.182.920
Documents published per year (not cumulative)
• 80.715.058Indexed documents
• 6.704.591Patients with reports
Shared Medical Record – Documents available
2013
23.097.493

10. Shared Medical Record – Look & Feel

11. Shared Medical Record - Reports & Structured Reports

12. Shared Medical Record – Image Diagnosis

13. Shared Medical Record – Structured Diagnosis

14. Shared Medical Record – Active prescriptions

15. EHR Evolution - iSalut
New Model
Communications platform standards compliant,
using iSalut as a network of information services.
Actual model
Different connections between
providers, SMR as a repository to
share information.
Advanced
Analytics
Interoperability
model and business
rules
Integrated clinical process
management model
Information management
Personal
Health
Channel
With platforms to integrate health and social care.

16. a virtual space where the Health Department stores and delivers to all
the Catalan citizens, online relevant information of their health
status in order to engage citizens in their own health care.
Shared Medical Record for
Professionals
Personal Health Channel for
Citizens
ICT tools to offer
quality care to
citizens
Personal Health Channel is...

17. Citizen
identification and
certification
ACCESS PHF
Customizable
items
P
INTERACT
No customizable
itemsO
ACCESS
INFORMATION
Secondary Care
Medical
Repository
Primary Care
Centre Repository
SELF-CONTROL
Diabetes, COPD and
Sintrom
OTHERS
Expert patient
Contact professionals,
entities, etc.
MANAGEMENT
PREVENTION
Physical and mental
exercise
Through the Personal Health Channel you can…

18. PHC - Access

19. PHC – Data access log & unauthorised access claim

20. PHC: Clinical reports
Search by:
- Report type
- Centre
- Date
Report search results:
- Report type
- Diagnosis
- Service
- Health Centre
- Date

21. PHC: Diagnosis control
Active health
problem
Non active
health problem

22. PHC: ePrescription – Available and printable
medication and chronic treatment
Online: always updated
Printable

23. PHC: Vaccination – Reports vaccines supplied
Reported from health provider
Reported from vaccination book
Reported verbally from patient
Duplicated

24. PHC: My controls
Telemonitoring
- Controlling of diabetic disease
- Preventive medicine (SISO)

25. PHC – Interoperability framework
Communication
 HL7 messages to exchange patient information
Identification
 Ensure system identification and data exchange
 Ensure single-sign-on
Portability
 Defines interoperable data
 Defines the used terminology by the accredited system
 Data transfer under user request
Publication
 Requirements to show content inside or through the PHS
 Alarm messages

26. Catalonia mHealth Ecosystem

27. mHealth services R&D
 Usage of clinical information in a mobility situation
‐ Out of my healthcare system
‐ Access to information
‐ Return information
‐ Treatment management
‐ Emergency clinical information easily accessible
Disease management with mobile devices
‐ Chronic condition CHF
‐ Data management by patient
‐ Supervision by clinician
‐ New sensors possible
Using a Pre Commercial Procurement process
‐ Market pull

28. Ignasi Garcia-Milà
igarciamila@ticsalut.cat
www.ticsalut.cat
www.flashticsalut.com
Questions?