Initiated by private hospital chains such as Asklepios and Rhön, and backed by the German Hospital Association (DKG), the eFA project is widely considered one of the most important IT standardisation projects in German healthcare.
Under the eFA umbrella, the Berlin-based Fraunhofer ISST has been working since 2007 on technical specifications for an EPR with decentralised data storage to be deployed in regional and supra-regional connected care scenarios. In Germany, because this type of EPR is not a life-long record but records only a specific treatment, it is referred to an ‘electronic case record’ (elektronische Fallakte).
Pilot projects of eFA at four hospital chains and another eight individual hospitals have been running for more than a year. Following the Berlin Connectathon, eFA is bound to leave the pilot stage: ‘This was an important step towards commercial products that are available for all hospitals as off the shelf solutions,’ said ISST-project manager Dr Jörg Caumanns.
The Connectathon provided three scenarios to test the solutions live and in public. All three solutions that entered the race – iSoft’s Lorenzo, Siemens’ Soarian Integrated Care, and Ispro’s Jesaja.net – were successful in the scenarios ‘eFA client compatibility’ and ‘eFA services compatibility’. The former means that it is possible to access and edit data in electronic case records of competing providers via an eFA client. ‘eFA services compatibility’ means that it is also possible to use eFA-related services, for example a search function.
Only the Siemens product received a certificate for the third scenario ‘eFA peer to peer compatibility’, which means that the system can build up regional networks with the electronic case records of other providers. This is essential, because otherwise a doctor in private practice who wants to communicate electronically with different hospitals would have to use different portal solutions to access different case records.
All in all, hospital representatives were quite satisfied with what they saw in Berlin, and announced that they will implement the current eFA specification 1.2 as soon as possible. ‘At Asklepios we will enter the national rollout at our hospitals beginning in April 2009,’ confirmed Uwe Pöttgen, head of IT for this hospital chain.
Dirk Herzberger of Helios is already using Jesaja.net: ‘We will finish the eFA rollout in our ten SAP-based hospitals in 2008, and will add another twenty hospitals without SAP in 2009.’ Rhön is running eFA pilots based on Soarian Integrated Care in Leipzig, Frankfurt/Oder and Hildesheim. Aachen University Hospital (UKA), which uses iSoft’s Lorenzo, has already implemented two eFA projects with cooperating hospitals and, next year, will start a third with cardiologists in the Aachen region. ‘We are also envisioning cooperation with Maastricht hospital, based on eFA standards,’ said Dr Silke Haferkamp of UKA. However, there is presently no time scale for this.
To make the eFA initiative sustainable, hospitals and hospital chains are now launching a non-profit organisation – the eFA Association (eFA-Verein). Membership fees will be used to update the eFA-specification and make it compatible with the German national health IT infrastructure, including its smartcard components. ‘Our ambitious goal is to create a nationwide standard in the end,’ said Uwe Pöttgen, who also proudly reminded the guests that the hospitals have invested a six digit amount of money so far into the development of the eFA standard, and that this standard nonetheless remains freely accessible for anyone.