e-prescriptions ETP - Denmark
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1 e-prescriptions ETP - Denmark Danish Centre for Health Telematics Ib Johansen, MI Deputy manager, MedCom
2 e-prescriptions Denmark MedCom Danish Health Sector Danish Health Care data Network e-prescribing Manual Electronic Support systems Results Future National level European level
3 Copenhagen Danish Centre for Health-telematics
4 MedCom The Danish Health Care Data Network FynCom The Funen Health Care Data Network International Projects CoCo, Primacom, Wise, Picnic, Prestige! Regional Networks! Using EU standards! Creating a market Coordination and Continuity in Primary Health Care... Danish Centre for Health-telematics
5 Danish Health Sector 63 (41)Public hospitals Beds >10 private hospitals- < 150 Beds 3400 GP s (2000 clinics) 800 Private specialists Part time 331 Pharmacies 2700 Dentists (1650 clinics) 1700 Physiotherapist (550 clinics) 250 Chiropractors 15 Counties/Kbh/Frberg/Bornholm 271 Municipalities 1 private Health Insurance
6 How many? Pharmacy systems = 4 100% GP - EPR systems = 15 92% Hosp. Medication syst = 3 100% Reimburs. systems = 3 100% Wholesalers = 4 100% Private Health Insurance = 1 100%
7 VANS All using national MedCom EDI-standards
8 Strategies - Plans MedCom Developing nationwide EDI-standards 1996 National strategy for EDI - Health Care data Network, 66 % within Y HEP. National strategy for EPR in hospitals 2000 National strategy for IT in hospitals, Quality, cost outcome, EPR problem and process oriented, telemedicine, communication prim/sec. National Databank Support patient EPR architecture exchange of EPR information 2003 National strategy for IT in Health Sector EPR in 2005 XML communication within hospitals Internetstrategy
9 Why making Prescriptions electronic?
10 Why making Prescriptions electronic? Readable Reuse of data from GP to Pharmacy No retyping Correct data Acknowledge for receiving Faster No misuse Regular dataflow Medicine ready when patient show up
11 MedCom -The Danish Health Data Network Messages/Month GP s with EDI : 2000 = 92 % Specialists with EDI: 494 = 62 % Hospitals with EDI : 63 = 100% Pharmacies with EDI: 331 = 100 % Doctors on Call : 15 = 100 % Health Insurance : 17 = 100 % 64 messages /min O1 O2 O3 O4 Prescriptions = 73% Disch. Letters = % Lab. reports = % Referrals = 45 % Reimbursement = 66 %
12 e-prescriptions Denmark VANS
13 E-Prescriptions Supporting systems-patient
14 E-Prescriptions Supporting systems-patient
15 E-Prescriptions Supporting systems-patient
16 E-Prescriptions Supporting systems, GP X
17 E-Prescriptions Supporting systems, GP Common Data Foundation(CDF) Updated electronically every 2nd week Drug ID Content generic, Strength, Package: size, price, Form(i.e. tabl, liq) Substitution ATC code Dosage and indication Warnings, traffic Dosage text, coded Indication text, coded And more
18 E-Prescriptions Supporting systems, GP Patient Electronic Medicine profile (PEM)
19 E-Prescriptions Supporting systems, GP Updated electronic adress register (DNBH) MedCom MedCom - det danske sundhedsdatanet 4 The Danish Health-sector GP EDI-GP s Specialists EDI-Specialists EDI-Pharmacies Physioteraphists Municipalities EDI-Health-Insurance EDI-Physiotherapists EDI-Henvisninger ospitals EDI-Call centers EDI-Dentists EDI-Chiropractors EDI-Municipalities Yellow EDI pages February 2004 Sundheds-telematik Rugårdsvej 15,2.sal, 5000 Odense C Telefon: [email protected] Indenrigs- og Sundhedsministeriet Slotsholmsgade 10-12, 1216 København K Telefon:
20 e-prescriptions Denmark VANS
21 E-Prescriptions Supporting systems, Pharmacy, Common Data Foundation
22 E-Prescriptions Supporting systems, Pharmacy, National Medical Account database CTR <75, , Common Data Foundation
23 E-Prescriptions Supporting systems, Pharmacy, National Medical Account database CTR Common Data Foundation
24 E-Prescriptions Supporting systems, Pharmacy, National Medical Account database CTR Reimbursement County (1/month) Common Data Foundation
25 E-Prescriptions Supporting systems, Pharmacy, National Medical Account database CTR Reimbursement County (1/month) Private Health Insurance (1/day) Common Data Foundation
26 E-Prescriptions Supporting systems, Pharmacy, National Medical Account database CTR Reimbursement County (1/month) Private Health Insurance (1/day) Common Data Foundation PEM
27 How is the data used by the Pharmacy? Pharmacy system print 2 labels when receiving an EDIFACT prescription One for the package with the patients name, dosage and indication text. One for the printed prescription for further control
28 E-Prescriptions Pharmacy and Patient
29 E-Prescriptions Lessons learnt Implementation of CDF and updating at the same time in the GP s EPR and the Pharmacy systems Codes for Dosage and Indication text Ordination process included in recommandations Test and certification a must No problems in EDI communication All partners must agree Prescriptions readable No waiting time Even workflow during the day Several benefits when electronic Generic substitution Pricing, adjustments Possible acces for patients to own data using Internet Control!! Reuse data Developing by bottom up is not bad Savings
30 80 County West-Sealand % all messages Mailbox offered Hospitals starts Lab. reports Reimbursements Prescriptions Disch. Letters
31 SAVINGS Time study of making up EDIFACT prescription contra paperprescription 90,00 80,00 70,00 60,00 1/100 minute 50,00 40,00 30,00 EDIFACT Paper 20,00 10,00 0, Number of prescription Savings equals 500 hours/year in each Pharmacy (DUR report)
32 Plans for future CENTRAL STORAGE and server Clinical
33 CENTRAL STORAGE and server
34
35 e-prescriptions ETP Denmark Danish Centre for Health Telematics Ib Johansen, MI Deputy manager, MedCom
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