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Sundhedsinformatik Kapacitetsbaseret roadmap for e-sundhedsarkitektur Del 1: Oversigt over nationale e-sundhedsinitiativer - PDF
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1 DS-information DS/ISO/TR udgave Sundhedsinformatik Kapacitetsbaseret roadmap for e-sundhedsarkitektur Del 1: Oversigt over nationale e-sundhedsinitiativer Health informatics Capacity-based ehealth architecture roadmap Part 1: Overview of national ehealth initiatives
2 DS/ISO/TR København DS projekt: M ICS: Første del af denne publikations betegnelse er: DS/ISO/TR, hvilket betyder, at det er en international teknisk rapport, der har status som DS-information. Denne publikations overensstemmelse er: IDT med: ISO TR :2012. DS-publikationen er på engelsk. DS-publikationstyper Dansk Standard udgiver forskellige publikationstyper. Typen på denne publikation fremgår af forsiden. Der kan være tale om: Dansk standard standard, der er udarbejdet på nationalt niveau, eller som er baseret på et andet lands nationale standard, eller standard, der er udarbejdet på internationalt og/eller europæisk niveau, og som har fået status som dansk standard DS-information publikation, der er udarbejdet på nationalt niveau, og som ikke har opnået status som standard, eller publikation, der er udarbejdet på internationalt og/eller europæisk niveau, og som ikke har fået status som standard, fx en teknisk rapport, eller europæisk præstandard DS-håndbog samling af standarder, eventuelt suppleret med informativt materiale DS-hæfte publikation med informativt materiale Til disse publikationstyper kan endvidere udgives tillæg og rettelsesblade DS-publikationsform Publikationstyperne udgives i forskellig form som henholdsvis fuldtekstpublikation (publikationen er trykt i sin helhed) godkendelsesblad (publikationen leveres i kopi med et trykt DS-omslag) elektronisk (publikationen leveres på et elektronisk medie) DS-betegnelse Alle DS-publikationers betegnelse begynder med DS efterfulgt af et eller flere præfikser og et nr., fx DS 383, DS/EN 5414 osv. Hvis der efter nr. er angivet et A eller Cor, betyder det, enten at det er et tillæg eller et rettelsesblad til hovedstandarden, eller at det er indført i hovedstandarden. DS-betegnelse angives på forsiden. Overensstemmelse med anden publikation: Overensstemmelse kan enten være IDT, EQV, NEQ eller MOD IDT: Når publikationen er identisk med en given publikation. EQV: Når publikationen teknisk er i overensstemmelse med en given publikation, men præsentationen er ændret. NEQ: Når publikationen teknisk eller præsentationsmæssigt ikke er i overensstemmelse med en given standard, men udarbejdet på baggrund af denne. MOD: Når publikationen er modificeret i forhold til en given publikation.
3 INTERNATIONAL STANDARD ISO/TR First edition Health informatics Capacity-based ehealth architecture roadmap Part 1: Overview of national ehealth initiatives Informatique de santé Feuille de route de l'architecture de santé électronique fondée sur la capacité Partie 1: Aperçu des initiatives de santé électronique nationale Reference number ISO/TR :2012(E) ISO 2012
4 COPYRIGHT PROTECTED DOCUMENT ISO 2012 All rights reserved. Unless otherwise specified, no part of this publication may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying and microfilm, without permission in writing from either ISO at the address below or ISO's member body in the country of the requester. ISO copyright office Case postale 56 CH-1211 Geneva 20 Tel Fax Web Published in Switzerland ii ISO 2012 All rights reserved
5 Contents Foreword... v Introduction... vi 1 Scope Terms and definitions Abbreviations Initiatives reviewed Health Metrics Network Australia National health system Focus of national health system Components of the national health information system National ehealth policies National ehealth architecture stage of development National data warehouse Standards in use Standards Development Organizations (SDOs) and Health Informatics Associations National reporting infrastructure for individual and/or summary data Households with Internet access Brazil National health system Focus of national health system Components of the national health information system National ehealth policies National ehealth architecture stage of development National data warehouse Standards in use Standards Development Organizations (SDOs) and Health Informatics Associations National reporting infrastructure for individual and/or summary data Households with Internet access Canada National health system Focus of national health system Components of the national health information system National ehealth policies National ehealth architecture stage of development National data warehouse Standards in use Standards Development Organizations (SDOs) and Health Informatics Associations National reporting infrastructure for individual and/or summary data Households with Internet access India National health system Focus of national health system Components of the national health information system National ehealth policies National ehealth architecture stage of development National data warehouse and national reporting infrastructure for individual and/or summary data Standards in use Standards Development Organizations (SDOs) and Health Informatics Associations Page ISO 2012 All rights reserved iii
6 4.5.9 Households with Internet access Kenya National health system; focus of national health system Components of the national health information system National ehealth policies National ehealth architecture stage of development Standards in use Standards Development Organizations (SDO) and Health Informatics Associations National reporting infrastructure for individual and/or summary data Households with Internet access International Monitoring and Evaluation frameworks Overview Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM) Joint United Nations Program on HIV/AIDS (UNAIDS) Pan American Health Organization (PAHO) Framework Brazilian Health Indicators Framework Canadian Health Indicators Framework United States Health Indicators Frameworks Key findings Need for an ehealth Architecture Maturity Model (ehamm)...49 Bibliography...52 iv ISO 2012 All rights reserved
7 Foreword ISO (the International Organization for Standardization) is a worldwide federation of national standards bodies (ISO member bodies). The work of preparing International Standards is normally carried out through ISO technical committees. Each member body interested in a subject for which a technical committee has been established has the right to be represented on that committee. International organizations, governmental and non-governmental, in liaison with ISO, also take part in the work. ISO collaborates closely with the International Electrotechnical Commission (IEC) on all matters of electrotechnical standardization. International Standards are drafted in accordance with the rules given in the ISO/IEC Directives, Part 2. The main task of technical committees is to prepare International Standards. Draft International Standards adopted by the technical committees are circulated to the member bodies for voting. Publication as an International Standard requires approval by at least 75 % of the member bodies casting a vote. In exceptional circumstances, when a technical committee has collected data of a different kind from that which is normally published as an International Standard ( state of the art, for example), it may decide by a simple majority vote of its participating members to publish a Technical Report. A Technical Report is entirely informative in nature and does not have to be reviewed until the data it provides are considered to be no longer valid or useful. Attention is drawn to the possibility that some of the elements of this document may be the subject of patent rights. ISO shall not be held responsible for identifying any or all such patent rights. ISO/TR was prepared by Technical Committee ISO/TC 215, Health informatics. ISO/TR consists of the following parts, under the general title Health informatics Capacity-based ehealth architecture roadmap: Part 1: Overview of national ehealth initiatives The following parts are under preparation: Part 2: Architectural components and maturity model This part of ISO/TR complements and supports the general requirements for the use of information in health services which are to be set out in the proposed technical specification, ISO/TS 16555, Health informatics Framework for national health information systems. ISO/TS will provide specifications defining data sources and business processes supporting the more general use of information within the delivery, operation, management and planning of health services within a country. ISO 2012 All rights reserved v
8 Introduction This part of ISO/TR arises from the recognition that currently there is considerable diversity internationally in the approach and scope of development and implementation of national health information systems (HIS). Growing interest in health system strengthening in low-income countries (LIC) in the international community has led to increasing interest in and support of this activity [3]. In preparing this part of ISO/TR 14639, the original aim was to provide guidance for developing and emerging countries and for the many international groups that conduct health programs in the developing and emerging world. As the work proceeded, it became clear that the work is more widely applicable to all health services, for whom there are potential lessons to be learned as they examine the way in which information is used, produced and managed in various aspects of their work. The identification of relevant health informatics standards and the role of international standardization in support of ehealth were also important drivers. This part of ISO/TR builds on lessons from many countries, including those whose activities are summarized in this part of ISO/TR 14639, and was largely inspired by the Health Metrics Network (HMN) activities sponsored by the World Health Organization (WHO) [1][2]. This work has been motivated in part by a recognition that countries vary in terms of readiness and resources for health system strengthening, with the expectation that it will help to provide the tools needed for policymaking, strategic planning and ehealth architecture development for robust and appropriate country HIS. The particular focus of this part of ISO/TR is the potential for Information and Communications Technology (ICT) to assist in the collection, communication, storage, processing and use of information to support the delivery, planning and coordination of health services. However, it also recognizes the importance of initial measures that involve paper-based collection and the need for a migration path from manual to semiautomated to fully automated information management systems. This part of ISO/TR presents a description of contemporary national enterprise-wide HIS. The resulting landscape identifies key high-level categories for different aspects of such systems which should be considered in any national architecture design endeavour. While not an exhaustive inventory of systems or necessarily a description of best practices, it is roughly representative of all income levels and strives to illustrate the diversity of HIS in different information technology environments with varying levels of capacity. Supported by the findings from this review, this part of ISO/TR also proposes development of an ehealth architecture maturity model (ehamm) for expressing the extent of development of HIS and ehealth architecture. The model can be used to direct planning and assess progress of national HIS towards maturity. The maturity model will be elaborated upon in ISO/TR and includes a methodology for classifying HIS according to descriptions of architectural components. vi ISO 2012 All rights reserved
9 TECHNICAL REPORT ISO/TR :2012(E) Health informatics Capacity-based ehealth architecture roadmap Part 1: Overview of national ehealth initiatives 1 Scope This part of ISO/TR aims to identify the business requirements of an ehealth architecture as well as providing a generic and comprehensive context description to inform architectural structuring of Health Information Systems (HIS). This part of ISO/TR reviews international experiences in the construction of national ehealth architectures and introduces a methodology for strategic development of HIS [4], which will be elaborated upon in ISO/TR This part of ISO/TR is intended to assist nations which are in the early or mid stages of developing such systems. 2 Terms and definitions For the purposes of this document, the following terms and definitions apply. 2.1 architecture system structure of components, their functions and their inter-relationships, and the principles and guidelines governing their design and evolution over time, or a description of the structure and behaviour of a system, a system s components, its functions and inter-relationships NOTE 1 Adapted from Open Group Architecture Framework (TOGAF), 2009 [14] and Blobel, B., Application of the Component Paradigm for Analysis and Design of Advanced Health System Architectures, 2000 [86]. NOTE 2 This term also includes architecture and system architecture. 2.2 biosurveillance process of active data-gathering with appropriate analysis and interpretation of biosphere data that might relate to disease activity and threats to human or animal health (whether infectious, toxic, metabolic, or otherwise, and regardless or intentional or natural origin) in order to achieve early warning of health threats, early detection of health events and overall situational awareness of disease activity [CDC Concept Plan for the Implementation of the National Biosurveillance Strategy for Human Health [88] ] 2.3 clinical information information about a person, relevant to his or her health or healthcare [ISO :2008, definition 3.13] ISO 2012 All rights reserved 1