National Clinical Data Repository

• When the NCDR project started, Edenlab had already built the National MPI system, ensuring that each patient had his or her unique personal health record. Solving the problem of data duplication ensures data accuracy as well as fraud protection.

• The doctors sign the records they’ve saved or changed with their electronic signatures. Therefore, they bear full responsibility for data accuracy.

• All information is stored as data in the MongoDB database and as documents. The data are linked to corresponding signed documents. Thus, all documents are legally valid and easily accessible.

• The NCDR stores a huge number of pseudonymized health records. The architecture of the repository ensures security. Even if some data leaks, it couldn’t be linked to particular patients and taken advantage of.

• The Attribute-Based Access Control Module (ABAC) was developed for securing access to the data. Access is granted or denied by the attribute-based model. It takes into account different rules of access to information and the rights of users by analyzing specific attributes. For instance, a doctor from a particular medical institution can access the records made by colleagues from the same institution but not others.

• Granting access to a health record requires the patient’s approval. The doctor can access the data only after being authorized by the owner. At present, access confirmation via an SMS has been implemented.

• To ensure that enough data will be available to the doctors for treating the patient, the Edenlab team created the Patient Summary solution, containing the most important information about the patient. It is populated from the data saved in the NCDR.

• The summary is accessible to a doctor during the patient’s first visit as well as to paramedics. It is of critical importance in emergencies when the patient is unconscious and can’t provide the required medical information (for instance, blood type, intolerance of certain medicines, allergies, etc.).

Also, Edenlab used an uncommon and unique approach of updating the Patient Summary automatically from the central database.

The NCDR is built using the HL7 FHIR data transmission standard, ensuring the highest level of data interoperability.

We used FHIR resources and FHIR documents and produced Ukrainian profiles for the following FHIR resources (separately for primary and secondary care):

• EpisodeOfCare
• Encounter
• Observation
• Condition
• Immunization
• AllergyIntolerance
• RiskAssessment
• Device
• MedicationStatement