Annick Sandeau, responsible for IT software in the hospital of Bordeaux
(France):
‘Conformity testing is an important step’
Since December 2013 IHE Services offers conformity testing for suppliers of
software in the field of healthcare ICT. With conformity testing suppliers are
able to even further increase their software quality. Necessary, according to end
users. We talk with Annick Sandeau, responsible for the patient domain and
engineer of the C.H.U Hospital in Bordeaux (France) about ICT connectivity
issues she encounters in the hospital.
Annick Sandeau was employed by an IT service provider, a software development
company in healthcare and hardware companies Bull and IBM. Now she has been
working for twenty years in the hospital sector. First, through an ICT service provider on
a secondment basis. She worked on assignments in the field of software installation,
project management and automation in healthcare. She also turned her attention to data
management. For ten years, A. Sandeau now works in the hospital at Bordeaux. She is
responsible for all IT software that is deployed in care units and administration. Annick
Sandeau says: "We provide the complete functional management, application
management and technical management of all projects. Amongst other we test
applications, install interfaces and prepare the roll out. This information goes to the
support teams who take care of the roll out in care units. I also have a team that
provides second line support; answering support calls received by our hotline. "
IHE
"In France not all applications in the hospital sector are compatible. IHE makes that
compatibility possible. Since the time when I first heard from IHE, in 2005, we have been
focussing on this organisation. IHE is important, ultimately important for the patient.
When we talk about patient identification, then we also talk about safety and
completeness of patient data. The identity of the patient must be implemented in an
application and stored. The next step is to pass this information in a homogeneous way
to all subsystems. Today we have about 60 subsystems. Systems that are in contact with
our patient database via interfaces - such as applications for radiology, biology,
chemotherapy, radiotherapy, medical records, blood transfusion center - which we would
like to have standardized.”
Interoperability
You say ‘would like’, can we say that with regard to standardization and interoperability
there are still many problems in hospitals? A. Sandeau: "Interoperability means the
ability to create technical connections, in which we generally are successful. But
interoperability is more. For example software suppliers say that their software is
validated according to HL7. This is the norm, ‘in this place we put that information’. Then
it seems to be good. But during testing - we test systematically all interfaces that have
been realized – we always encounter problems. It is not plug and play. There is always
something that requires verification or further adjustment. Because we encounter these
problems, we felt obliged to set up a small integration team. This team is responsible for
the technical interconnections and carries out technical tests for all data exchanges
between applications and for commissioning. Do you know what is difficult? The updates
of applications. That may have a significant impact on the stability of interfaces.”
A. Sandeau: “The integration team makes it possible to make improvements, where it is
about interconnections. This goes relatively fast. What takes time is that we have to deal
with different functional rules. Take for example the term 'pre -admission' (the phase
prior to hospitalization). A patient comes to the hospital. He is told to be operated in
three weeks. We already make his file; a number of documents have been prepared. Bu
all software vendors have different definitions of 'pre -admission'. The concept and the
use of terms and rules are different for each software supplier. And then sometimes
things can go wrong.”
Conformity testing
Already for years we are familiar with IHE Connectathons, test sessions in which software
suppliers test their products. About the Connectathon Annick Sandeau says: "During
these meetings software suppliers validate each other, but only in some types of data
exchange. In the medical world identity of the patient is very important. By mistake one
patient could be known in two different systems. The systems do not consider the patient
as one patient, and then it’s necessary to merge the data of this patient. Sometimes, this
will go wrong. So, we need to provide a monitoring tool or procedures to enable us to
make changes in systems in a manual.”
The tests that are performed by the suppliers on their products during the Connectathon
are on a voluntary basis. Certification is not there yet. However, from the end of last year
IHE Services makes it possible to perform conformity testing according to a higher
quality standard. What does Sandeau think of this development? She says: “It’s a
positive development, but still there is no obligation for suppliers. Though, I think that
conformity testing is an important step. Finally suppliers of software have to prove that
they provide good results in test scenarios. Scenarios that are the same for everyone.”
Test specifications on forehand
Are there still other important subjects Annick Sadeau wishes to mention in this context?
“It would be nice”, she continues “that test specifications given to software suppliers are
also available for end users, hospitals. This, because we also run tests systematically. I
have a team that deals only with testing. It’s important for us to make some strict rules
for software suppliers in the range of procurement. To have test specification on
forehand will save us a lot of time.”