Joint ITU-WHO Workshop on
e-Health Standards and Interoperability
(Geneva, Switzerland, 26-27 April 2012)
State of Interoperability in the Czech
Republic
Towards Personal Health Record
Miroslav Bursa,
CTU in Prague, FEE, Dept. of
Cybernetics, BioDat Research Group
miroslav.bursa@fel.cvut.cz
Geneva, Switzerland, 26-27 April 2012
Patient ID
Encoded birth date, sex and identifier
consistency check (mod 11)
error-prone
duplications might exist
Considered sensitive information (!)
Some hospitals create their own ID
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Standards
Many local standards exist
Interoperable standards
DICOM/PACS
Mutually incompatible HIS are used
No standard(s) for signal data, often
proprietary closed format
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Health Record
Usually in paper form
Often held in paper and el. form
Entered into HIS during night shift
Free text, duplications
Signals, reports only in paper form
Statistics must be provided to state
agency
tendency to fulfill the requirements only
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EHR
First attempt (IZIP) done via stateowned health-insurance company
Suspended funding
Not based on interoperable standard
Inconsistent with European efforts to
interoperability
Now called ‘health-book’
Smaller projects exist
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EP
In a pilot stage
8 doctors, 8 pharmacies
Still have to print
Insurance companies: no access
Runs since 2009, first EP on 04/2011
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Legislation
3rd party has right to look at the
documentation
problem: doctor has internal notes
Question
Owner of the data? Permission to use in
research?
Has the hospital right to obtain humanreadable data for processing? Raw data?
Draft on health documentation under
discussion. Does not cover EHR.
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Usual (mythic) reasons to reject EHR
MDs do not need computer to heal a
patient
40 % MDs do not have a computer
MDs do not want to be restricted by
computer
MDs are afraid of easier liability
claims
IT wants things that are not present
in paper form
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Age Structure of MDs in Czech Rep.
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Age Structure of DDs in Czech Rep.
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Age Structure of PDs in Czech Rep.
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Conclusions and Recommendations
No fully interoperable EHR
EP running in pilot stage
Problem of integration: no efforts
‘Crisis problem’: Cheap appliances
Loosing data for long-term studies
Isolated solutions (reinventing
wheel)
No force to unify standards
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