Leping

VOLIKIRI 10.02.2023 nr 1-17/14 Tallinna Tehnikaülikool, registrikood 74000323, volitab käesolevaga teadusosakonna töötajat Marika Lunden’it, isikukood 46408090294, esindama Tallinna Tehnikaülikooli: - programmides ja projektides, millega seotud toimingud tehakse struktuuritoetuste registris (SFOS, sh varasemalt kasutusel olnud SA Keskkonnainvesteeringute Keskuse andmesüsteem KIKAS) ja Eesti Teadusinfosüsteemis (ETIS), samuti muudes siseriiklikest allikatest rahastatud projektides. Esindajal on nimetatud programmides ja projektides kõik esindatava õigused, sh õigus: - esitada toetuse taotlusi ja nendega seotud kõiki muid dokumente, - esindada Tallinna Tehnikaülikooli suhtlemises kõigis taotluste menetlemise ja taotlustes sisalduvate projektide elluviimist puudutavates küsimustes, - allkirjastada ja süsteemidesse sisestada lepinguid, aruandeid ja maksetaotlusi ning anda selgitusi. Esindaja peab tehingute tegemisel järgima ülikooli asjakohaseid õigusakte ja täitma nõuetekohaselt talle pandud kohustusi. Volikiri kehtib tagasiulatuvalt alates 01.02.2023. Volikiri on antud edasivolitamise õiguseta ja kehtib kuni 31.12.2025. a, kuid mitte kauem, kui esindaja eespool nimetatud ametis oleku lõpuni. Teadusprorektoril on edasivolitamise õigus vastavalt rektori 22.12.2016 käskkirjale nr 186 (muudetud 28.11.2017 käskkirjaga nr 116). (allkirjastatud digitaalselt) Maarja Kruusmaa Teadusprorektor AMENDMENT NO 1 OF PARTNERSHIP AGREEMENT FOR THE IMPLEMENTATION OF PROJECT FROM THE NORWEGIAN FINANCIAL MECHANISM UPON APPLYING FOR AND USING THE GRANT Estonian Ministry of Social Affairs, registry code 70001952, Suur-Ameerika 1, 10122 Tallinn, represented by Secretary General Maarjo Mändmaa (hereinafter “Applicant of the Grant”), Tallinn University of Technology (eMedicine Laboratory of School of Information Technologies), registry code 74000323, Ehitajate tee 5, 12616 Tallinn, represented by Maarja Kruusmaa (hereinafter “Project Partner 1”), hereinafter individually or collectively also referred to as “Applicant of the Grant” / “Project partner” or “Project partners” or “Parties”, considering the extension of the project end date until 30.04.2024, the Parties amend the partnership agreement no 2-2.1/1343-1, signed 01.02.2021 as follows: 1) article 5.11 is amended and worded as follows: “to store the original documentation related to the performance of the application, grant, and Project at least until 31 December 2031;” 2) replace current annex with the annex of this agreement (Annex 1); 3) the amendments will enter into force after signing the agreement. Applicant of the Grant: Maarjo Mändmaa Estonian Ministry of Social Affairs /name, signature/ Project partner 1: Maarja Kruusmaa Tallinn University of Technology /name, signature/ ANNEX 1 The aim of the Project “Development of universal data model and continuity of care processes based on international standards for new generation health information systems” is to find appropriate model for digital health care data that could be used for data collection and storage in new generation TIS with the feasibility to implement the same model in other large scale Electronic Health Records (EHR). This data model will be foundation for health care professionals to use digital decision support systems in context of Electronic Medical Record. The definition of data model would lead to the development of EHR processes where minimal set of health status summaries are defined for each specialty/health issue to make evidence-based decision possible. In turn, defined health status summaries are needed for development of continuity of care processes and training of artificial intelligence and development of intuitive Electronic Medical Records. The information in TIS has been collected since 2008 based on the HL7 CDA Data Exchange Standard. There are defined 17 documents, most of which are in XML. Analysing such data is laborious because XML is a format that is “excluded” by analysis tools. The data elements with the same content have been collected in the TIS through various documents. In essence, the same data element (such as blood pressure) is collected in very different forms throughout history, from free text to structured data items. It is planned to introduce the HL7 FHIR standard in the development of new generation TIS. When switching from older standard version to new one, one has to take into account that the older version documents must be converted to the widest possible extent to new and that it must be possible to receive the data and documents sent under both standards. The project has 3 main outcomes: 1. Outcome 1. Development of data model for digital medical data capture and storage to achieve semantic interoperability for new generation TIS Description of data sets based on HL7 FHIR standard. This approach makes it possible to systematize the data in the new generation TIS and to understand the possibility and extent of data conversion if they are to be used in parallel with TIS data. ContSys standard process based TIS architecture with real data will be tested in context of actors, processes and activities. The main goal is to move to event based TIS architecture. Data that already exists in the TIS are converted into "pseudo-event based" data by separating these data in documents into events. The development of a data model in addition to the process model to move to event based data collection based on the FHIR standard and agreement about the terminology that covers the widest possible usage area. These activities together provide the basis for developing a data warehouse data model that is capable of receiving all the data to be collected and be dynamically developed. Indicators: - 3 data models on selected care processes (stroke, diabetes and its complications, cancer) are piloted. - Optimal data sets needed for decision making in selected care process are presented and approved by the Applicant of the Grant.  2. Outcome 2. Development of universal continuity of care process standard for new generation TIS The development of the new generation TIS processes based on ContSys/ISO13940:2015, the standard for the use of health data, which defines semantic interoperability essential to the continuity of care process. Process-based approach to context as well as the relationships between the context of these processes and the content of concepts in the standard will be explained. Processes for new generation TIS will be developed in the manner that they are built-in activities that affect process objects and can be aggregated and/or split into different parts that can be considered as processes. Existing TIS documents will be assigned on different episodes of the care process on the basis of ContSys, and their data sets will be disassembled and mapped as much as possible according to the new data models developed in Stage 1. Investigation of current processes in Estonian health care service provision to define minimal set of inputs to achieve targeted outputs of the process is performed. Workflow for selected care services and sequence of the activities in a corresponding process is defined. Also, definition of actors and their roles in the selected care processes is done. Indicators: - New generation TIS processes are developed and presented as a documented standard for continuity of care of TIS development. 3. Outcome 3. Development and localization of terminology database for the use of new generation TIS data model and continuity of care standard in clinical practice Data models and used terms are systematized and incorporated in respective taxonomies according to international Health Data Dictionary development procedures. Taxonomies are discussed with and approved by health care professionals’ societies. Indicators: - The structure of the terminology database (Health Data Dictionary) is created and introduced to medical specialists. The projects outcomes presented in this project will be dealt with in parallel throughout the entire period. It has become clear during the project that processes which have been established previously may need to be supplemented due to the continuous flow of information. Considering this, the first priority of the project has been to map out the Indicators (stroke, diabetes and cancer data models and data sets) presented in Outcome 1. It is important to go through this step first in order to understand which data fields exist in the project and which information is currently being collected. It provides input for the creation of a new generation of TIS and helps to better understand the interoperability of databases based on the HL7/FHIR standard. Total budget of the partnership Personnel Time costs (incl. Workload (months) taxes) Total Data analyst (Analysis of TIS data) 1 8 2800 22 400 Data analyst (Analysis of TIS data) 1 8 2800 22 400 Senior IT specialist (Data model) 0,25 7,5 5000 9 375 Senior IT specialist (Standards) 0,25 7,5 5000 9 375 Medical professional (Process development - ContSys, terminology) 0,25 14 6000 21 000 Medical professional (Process development - ContSys) 0,25 14 6000 21 000 Indirect costs (15%) 15 832,50 Total 121 382,50