Video-supported teleconsultation and data donation based on the Electronic Case File
Pandemics require digital solutions to maintain health care structures and at the same time improve health research. With the Electronic Case File (EFA), the Fraunhofer ISST has already provided a central building block for ensuring and improving the care of COVID-19 patients (Technology Readiness Levels (TRL): 9). Within the framework of the "Virtual Hospital NRW", COVID-19 specialists from specialist and university hospitals use this teleconsultation to exchange information with doctors from smaller hospitals on treatment issues. Since the start of operation of the EFA on 30 March 2020, many requirements for further improvement have already been taken up. Since a license agreement for the existing range of functions already exists, it can be assumed that an expansion of the function portfolio will increase the further spread of EFA.
The Federal Ministry of Health aims to make digital health care for patients in Germany possible with the help of the telematics infrastructure (TI) and an electronic patient file (EPA). However, this will not be feasible before 2021. The EFA, on the other hand, is already available today and is already widely used for a wide range of indications. Migration concepts are in place to transfer EFA as a value-added service to TI.
It should be noted that the EFA with its components such as the video consultation hour is not a medical device.
The Fraunhofer ISST will compile the existing and new requirements into a structured requirements specification. The institute will be supported by established partners: The Fraunhofer ISST is part of the Medical Informatics Initiative in the SMITH project funded by the Federal Ministry of Research. This existing cooperation is to be used to export data from the EFA directly and in a structured way after the consent of the patients.
For dissemination and evaluation, the ISST works closely with the University Hospital Aachen and the Krankenhausgesellschaft NRW (KGNW) as representative of the 344 hospitals in NRW.
The Fraunhofer ISST aims to expand the Electronic Case File with the following core functions:
- conducting a video-consultation directly from the secure environment of the IJP: The teleconsultation currently requires external, possibly insecure, systems from third-party manufacturers. Furthermore, this forces physicians to use several software tools simultaneously. The video consultation is to become part of the existing IJP portal in order to have video and medical documentation in one place.
- making the data available in the sense of data donation to the Medical Informatics Initiative: A mechanism for a structured export of data (HL7 FHIR) is to be implemented in order to release the data for pandemic research purposes - provided the consent of the patients. To this end, the Fraunhofer ISST is working closely with two cooperating companies to ensure that the system is operated in accordance with the legal requirements
- Fraunhofer-Gesellschaftwithin the framework of the anti-corona program