Healthcare Content Management

from Wikipedia, the free encyclopedia

Healthcare Content Management (HCM) describes the digitization concept of consolidating all medically relevant data of a healthcare facility and making it available across the facility as well as across facilities. It is the modern, intelligent approach to managing all structured and unstructured document and image content in a uniform system.

It combines medical document management with image management. These include the areas of PACS ( Picture Archiving and Communication System ) or Enterprise Imaging (EI) and Vendor-Neutral Archives (VNA), Enterprise or Universal viewers as well as workflow and connectivity solutions for medical image and video capture are special.

Tasks of a healthcare content management system

Data management in healthcare is subject to special framework conditions that make digitization a challenge. Special laws and ordinances must be observed and thus set a comparatively narrow framework for the handling of patient and treatment data. Enterprise Content Management (ECM) cannot therefore be transferred one-to-one to healthcare facilities, even though the five essential tasks of the ECM are also relevant for healthcare facilities. Because here too it is important to have medical data

  • to capture (capture),
  • to manage (Manage),
  • to store (Store),
  • to preserve (Preserve) and
  • to provide (Deliver).

HCM is a concept, not a system. Solutions that are used to implement this concept in practice are known as healthcare content management systems (HCM systems). These are, so to speak, specialized enterprise content management systems . HCM is therefore a product-neutral concept or a solution approach for implementing digitization in the healthcare sector. Of course, software products are also used for this, which implement the concept in various forms or parts of it.

Features and characteristics of an HCM

The data should be organized in an HCM system in such a way that they offer added value for users and patients. This added value is primarily due to the fact that all diagnosis and therapy-relevant data are available in a consolidated form on a case-by-case basis in order to reduce incorrect medical decisions and double examinations and to maximize the quality of care for the patient.

Data formats and standards

In order for the data to be permanently interoperably stored and exchanged across institutions, it must be available in formats that are widely recognized and most likely can still be read in a few decades. Wherever possible, international standards are used here. In healthcare, this can be Digital Imaging and Communications in Medicine (DICOM) , PDF / A (Portable Document Format), Health Level 7 (HL7) or Clinical Document Architecture (CDA) . In addition, the data should not be trapped within a single IT system (silo). Rather, they must be available to all authorized users at any time via standard interfaces.

While this is the logical first step, HCM involves much more than just unifying document and image management to enable shared storage and a universal display for all unstructured content, DICOM and non-DICOM. The clinical and administrative work processes that are to be supported are particularly important. In addition, it should be noted how the entire document and image content (metadata) should be organized and handled before being saved and accessed. These are complex but essential aspects of an HCM concept.

Exemplary use cases for an HCM

  • Support with the changeover from analog to digital data storage and the establishment of a paperless hospital with electronic patient files
  • Process support for the use of medical data by clinicians for diagnostics and therapy
  • Cross-institutional communication with referring physicians, the Medical Service of Health Insurance (MDK) or other medical institutions
  • Compliance with regulatory requirements (legally secure documentation and archiving)
  • The provision of data in accordance with the Patient Rights Act and GDPR

Patient and case context

An HCM system is also characterized by the fact that it can put data in a medical context and optimize it for use in a medical setting. This distinguishes an HCM system from generic ECM systems, which archive data regardless of the application context. The aim is to serve the different needs of users in medical facilities and thus to make the everyday work of all users easier.

First of all, this requires an assignment of the data to patient and treatment case , because these two context units are particularly important in the medical environment. In order to enable such a context-specific administration, an intelligent administration of the patient IDs must first be guaranteed, which are generated in different IT systems in different number ranges. The second prerequisite is an automatic and constant update of patient and case data, so that it is ensured that the complete, current data can be accessed at any time and any place.

Classification and keywording of content

In order to ensure fast and secure access to the medical data, it is important to be able to classify the data similar to the file plan of an analog paper file. In contrast to the analog world, digitization also enables multi-dimensional assignments with simple methods, e.g. B. according to specialist departments, diagnostic procedures (e.g. EKG , MRT, etc.), data content (doctor's letter, laboratory results, OP report , X-ray image, etc.) or diagnosis classification ( international statistical classification of diseases and related health problems , ICD). Ideally, a classification already takes place when the data is recorded or received. In addition to the full text, documents often have valuable additional information or metadata that are well suited for automated classification. These are, for example, the place of origin, the examination time, examination parameters, etc.

In order to plan ahead for cross-facility communication and long-term storage when introducing an HCM system, it is advisable to use international standards as far as possible when classifying the data. The IHE initiative (Integrating the Healthcare Enterprise) has developed so-called IHE profiles for this purpose. For example, IHE Germany is developing the so-called IHE Value Sets.

Regulatory features in Germany

The § 291a para. 5 sentence 7 of the Fifth Book of the Social Code and the Data Protection Regulation demand (DSGVO) that hospitals and doctors to their patients or further processing authority on request, all medical data collected provide complete and digital. This still poses considerable problems for many institutions, as the data is often still distributed over several IT systems and cannot be called up via standard interfaces.

In the medical environment, there are certain special features to consider when managing data. This includes in particular the medical device regulations such as the Medical Device Act and the Medical Device Operator Ordinance . Here it is regulated, for example, that a viewer that is used for diagnosis or therapy planning must meet the requirements of medical device class IIa and must be approved. In addition, the users of this viewer must be trained accordingly.

Qualified electronic signatures and time stamps

In order to ensure the integrity of documents, they are given so-called qualified electronic signatures or time stamps . When data is received, these signatures and time stamps must be checked for validity. The HCM system should provide methods to provide unsigned documents with qualified electronic signatures and time stamps.

Qualified electronic signatures and time stamps should ensure, among other things, that violations of the data integrity of documents are detected immediately. They are based on cryptographic algorithms approved for this purpose and fulfill an important task in generating revision security .

HCM in the IT system landscape

The hospital information system (HIS) is simply put the leading system of a hospital with an administrative center of gravity. It controls and organizes the patient flow through the hospital from admission to discharge. It also supports the scheduling and documentation of examinations and treatments as well as their billing with the payers.

Clinical subsystems are integrated into the process by the HIS and have specialized in subtasks. This often arises from department-related requirements such as in radiology ( radiology information system ) , the laboratory ( laboratory information system ) or the operating theater with its very specific requirements. In addition, a wide variety of systems are used for diagnostics and patient monitoring, which are often closely linked to medical devices. These include, for example, the Picture Archiving and Communication System (PACS) and EKG management as well as PDMS for intensive care medicine and anesthesia.

In addition, there are a large number of other special and sub-systems, which can vary greatly in their characteristics depending on the focus of the hospital. All these systems have one thing in common. They are not designed for long-term archiving or, if at all, only for archiving self-generated data. This gap is closed by HCM, which not only consolidates and archives all data from this multitude of systems. It also enables central provision in the patient or case context as well as universal viewing, which in turn can be integrated into the HIS and thus closes the data cycle.

The principle is similar in the outpatient area, only the number of IT systems used is usually not as extensive and the medical information system (AIS) takes the place of the HIS. Nevertheless, it can make sense to implement the HCM concept here as well. This is especially true in complex structures that are particularly dependent on consolidating data management.

Market analyzes for healthcare content management systems

  • Research N Reports: Global Healthcare Content Management System Market Report 2017
  • Markets and Markets: Healthcare Content Management System Market by Traditional and Emerging Solutions (Document Management, Web Content Management, Digital Rights Management, Rich Media, Social Media Management, Enterprise Mobility, Data Records) - Global Forecast to 2019 (Publication: November 2018)

Healthcare content management system provider

  • Alfresco
  • GRM information management
  • Hyland
  • Lexmark
  • Nearshore Technology
  • NEXUS
  • Streamline Health
  • synedra IT GmbH
  • Visus Health IT
  • Xerox

Sources and literature

  • Healthcare Content Management: Achieving a New Vision of Interoperability and Patient-Centric Care (Whitepaper)
  • Directions in Healthcare Content Management: Building a Solid Foundation for Data Ownership, Interoperability and a Complete Patient Record (Whitepaper)
  • Healthcare Content Management for Dummies, Wiley-VCH 2018

Web links

Individual evidence

  1. https://www.linkedin.com/pulse/evolution-ecm-healthcare-advances-hcm-content-management-amie-teske/ An Evolution: ECM for Healthcare advances to HCM, Healthcare Content Management by Amie Teske, accessed on November 14, 2018
  2. https://www.visus.com/landingpage/hcm-fuer-dummies.html Healthcare-Content-Management for Dummies, Wiley-VCH 2018, accessed on November 2, 2018
  3. https://www.himss.eu/sites/himsseu/files/education/whitepapers/Healthcare-Content-Management_White-Paper-Final.pdf Healthcare Content Management: Achieving a New Vision of Interoperability and Patient-Centric Care (Whitepaper) , accessed on November 14, 2018
  4. https://www.xerox.com/downloads/usa/en/services/white-paper/modern_holistic_ecm_strategy_for_healthcare.pdf Designing a Modern, Holistic ECM Strategy for Healthcare (Whitepaper), accessed on November 14, 2018 (English)
  5. DICOM standard. Available at: https://www.dicomstandard.org
  6. https://www.linkedin.com/pulse/evolution-ecm-healthcare-advances-hcm-content-management-amie-teske/ An Evolution: ECM for Healthcare advances to HCM, Healthcare Content Management by Amie Teske, accessed on November 14, 2018
  7. https://www.visus.com/landingpage/hcm-fuer-dummies.html Healthcare Content Management for Dummies, Wiley-VCH 2018, accessed on November 14, 2018
  8. http://www.ihe-d.de/projekte/xds-value-sets-fuer-deutschland/ XDS Value Sets for Germany, accessed on November 2, 2018
  9. Integrating the Healthcare Enterprise. Available at: http://www.ihe.net/
  10. https://www.visus.com/landingpage/hcm-fuer-dummies.html Healthcare Content Management for Dummies, Wiley-VCH 2018, accessed on November 14, 2018
  11. https://www.researchnreports.com/healthcare-it/Global-Healthcare-Content-Management-System-Market-Report-2017-155916 Global Healthcare Content Management System Market Report 2017, accessed on November 2, 2018 (English)
  12. https://www.marketsandmarkets.com/Market-Reports/healthcare-content-management-system-market-226529823.html Healthcare Content Management System Market by Traditional and Emerging Solutions (Document Management, Web Content Management, Digital Rights Management, Rich Media, Social Media Management, Enterprise Mobility, Data Records) - Global Forecast to 2019, accessed on November 2, 2018 (English)
  13. https://www.alfresco.com/industries/healthcare/health-content-management-platform Alfresco Software, accessed on August 21, 2019 (English)
  14. https://www.grmdocumentmanagement.com/healthcare-information-management/ GRM Information Management, accessed on November 2, 2018 (English)
  15. https://www.onbase.com/en/solutions/healthcare Hyland Software, accessed on November 2, 2018 (English)
  16. https://www.lexmark.com/en_gb/solutions/healthcare/healthcare-content-management.html Lexmark, accessed on November 2, 2018 (English)
  17. https://www.nearshoretechnology.com/industry/healthcare/healthcare-content-management-software Nearshore Technology, accessed on November 2, 2018 (English)
  18. NEXUS / MARABU GmbH Enterprise Content Management for Healthcare. Retrieved October 31, 2019 .
  19. https://www.streamlinehealth.net/coding-cdi/enterprise-content-management/ Streamline Health, accessed on November 2, 2018 (English)
  20. https://www.synedra.com/hcm/ synedra IT GmbH, accessed on March 30, 2020
  21. https://www.visus.com/hcm.html Visus Health IT, accessed on November 2, 2018
  22. https://www.xerox.com/en-us/services/healthcare-solutions Xerox, accessed on November 14, 2018 (English)
  23. https://www.himss.eu/sites/himsseu/files/education/whitepapers/Healthcare-Content-Management_White-Paper-Final.pdf Healthcare Content Management: Achieving a New Vision of Interoperability and Patient-Centric Care (Whitepaper) , accessed on November 14, 2018
  24. http://corpcom.frost.com/forms/PerceptiveSoftwareWhitepaperDownloadLeadgen Directions in Healthcare Content Management: Building a Solid Foundation for Data Ownership, Interoperability and a Complete Patient Record (Whitepaper), accessed on November 2, 2018 (English)
  25. https://www.visus.com/landingpage/hcm-fuer-dummies.html Healthcare Content Management for Dummies, Wiley-VCH 2018, accessed on November 14, 2018