Patient-centered diabetes management via XDS
32-year-old Ira Beddingfield has type II diabetes mellitus. As part of his disease management program he regularly visits different healthcare facilities, from his GP to an ophthalmologist. All medical data that are collected during these visits as well as the blood glucose values Ira measures himself are fed into Ira’s electronic patient record. Ira is the owner of his data and grants access to the data as the need arises.
Sounds like science fiction? Well, right now it still is. Indeed, Ira Beddingfield is the creation of seven companies, amongst them VISUS‘ Dutch partner Alphatron. Ira‘s disease history was created to showcase the potential of IHE profiles such as XDS (Cross Enterprise Document Sharing) for real-life healthcare. Ira’s “case”, initiated by IHE, was presented at the 2016 eHealth Week in Amsterdam. And while it is “fiction” the networking capabilities Ira illustrates are technically feasible today. In many countries, it is simply the framework that’s missing for Ira to become reality.
Document exchange with JiveX
In Ira’s case JiveX handles data retrieval from the patient record and makes new exam results available. JiveX XDS Consumer allows the patient record data to be accessed and viewed. Sounds straight forward but indeed the process is still fraught with – external – challenges such as the lack of interoperability between IT systems of different manufacturers due to the fact that many systems are not yet equipped with IHE interfaces. Moreover there are a number of unresolved privacy issues that prevent implementation in many countries, i.e. how the patient is supposed to grant permission for third-party access or how the patient decides when and which data are to be deleted and whether it is in fact the patient who decides and initiates deletion. Another technical problem is unambiguous patient identification across medical facilities and disciplines.
Despite these snags VISUS is busy implementing the IHE XDS profile. One of the beneficiaries of the development is Elizabeth Tweesteden Ziekenhuis in Tilburg, the Netherlands. Here VISUS, via partner Alphatron, provides a pilot XDS solution for trauma care and for simple data exchange with a cooperation partner in radiotherapy. In the Netherlands, two factors facilitate data exchange: firstly, regional care networks are in place and secondly nation-wide patient IDs are assigned which allow cross-facility patient identification.
The foundation for XDS has been built
For Elizabeth Tweesteden Ziekenhuis creating a network with healthcare partners via XDS was a logical step since internally the prerequisites had been established: digitalized image management – even outside of radiology – with JiveX PACS II Integrated Imaging means that the relevant data exist in digital form, in a system that is strictly standards-based and thus allows the data to be easily transmitted to external systems using the IHE profile. The example of the Tilburg hospital shows the relevance and currency of “Ira Beddingfield”. And the good news is: the successful demos at eHealth Week showed the technical feasibility when – and if – the parties involved create the necessary framework and cooperate.