National Model and Implementation Guidelines for EHR in Denmark

Transcription

1 National Model and Implementation Guidelines for EHR in Denmark Morten Bruun-Rasmussen Denmark 1

2 Disposition The Danish EHR Observatory The Danish IT strategy for Health The Danish Basic EHR model Implementation Guidelines 2

3 Organisations behind the EHR Observatory EHR Søren Vingtoft, Morten Bruun-Rasmussen, Knut Bernstein Aalborg University Stig Kjær Andersen & Christian Nøhr Funded by the Ministry of Interior and Health, Danish Regions, Copenhagen Hospital Corporation 3

4 EHR Observatory activities Monitoring and analysing EHR development Dissemination, experiences, barriers Analyse strategic implementation projects Clinical & technical validation EHR standards development Integration, architecture, technology Information, promotion and networking Annual conference and report EHR 4

5 Information Report 150 pages Annual conference EHR October, 500 participants International experiences ProRec is our international branch 5

6 00% National EHR coverage of Hospital beds EHR 80% 60% 40% 20% Undersøgelse 2002 Undersøgelse 2003 Undersøgelse %

7 Disposition The Danish EHR Observatory The Danish IT strategy for Health The Danish Basic EHR model Implementation Guidelines 7

8 IT strategy for the Health Sector : IT political action plan Health Care Network (Medcom) 1996: Action plan for Electronic Health Record (EHR) Decentralized initiatives, central funding 1999: National strategy for IT Electronic Health Record Communication of patient related data Technical and organizational challenges 2003: National IT strategy for the Health Sector Update in

9 IT Strategy : Goals and initiatives 100% coverage of EHR in hospitals by 2006 based on a common Basic Model for EHR Large scale national XML communication between & inside hospitals by 2005 Internet based secure health network by 2005 National health portal by 2004 Estimated: What is billion EURO the cost? 9

10 Disposition The Danish EHR Observatory The Danish IT strategy for Health The Danish Basic EHR model Implementation Guidelines 10

11 Basic model for EHR (National Board of Health) Activities Conditions Mandatory 1. Period of Care oriented Diagnostic Consideration Evaluation 2. Problem/diagnose 3. Cross professional documentation Diagnose Goal Result 4. Structured Planning Execution Intervention 11

12 Structured data and coherence is mandatory Information in focus Diagnostic Consideration ning Evaluation Diagnose Goal Result Plan- Execution Intervention 12

13 Use-cases Business rules Data-descriptions XML-schema 13

14 Disposition The Danish EHR Observatory The Danish IT strategy for Health The Danish Basic EHR model Implementation Guidelines 14

15 Evaluation of the Basic EHR model Initiative in the IT strategy Clinical evaluation : Examine, if Basic EHR can be used to maintain and communicate clinical content, within realistic conditions Expose the organizational condition and consequences 15

16 Clinical evaluation Test battery Change readiness analyses Assessment of clinical functionality Work flow analyses with video documentation Implementation indicators Analyses of the data stored in the system Usability analyses 16

17 EHR pilot project: Based on Basic EHR To full scale pilots, with all BEHR functionality implemented: Amager Hospital Aarhus County Four pilots, with a subset of BEHR functionality implemented: Roskilde County Ribe County Ringkoebing County Viborg County 17

18 Preconditions for the clinical evaluation EHR in daily use for at least 3 months Include minimum 500 patient-days and relevant diagnosis The test staff has been educated sufficiently. Minimum 3 days, maximum 2 weeks. Allocation of necessary post education That the EHR system is based on the Basic HER model 18

19 Quality labelling: Technical validation B-EHR documents Use cases Rules B-EHR test documents Specification Test-set Logical model Other docs. Scenes Test-data Test plan EHR prototype Test protocol Test log Usability Delivery report Approved Not Approved 19

20 Start 1. week 2. week 3. week 4. week 5. week 6. week Vendor Self evaluation Valida tion Vendor Fault correction Valida tion Test Protocol Test Protocol Delivery document Test Protocolc Delivery document

21 Result of the B-EHR evaluation from the 2 full scale prototypes Amager Hospital 90% of the test-set was examined 55% of the tests was approved Aarhus County 100% of the test-set was examined 65% of the test was approved Conclusion for the test The core use cases was implemented and the systems can be used for the clinical evaluation 21

22 Conclusion: Fundamental for a EHR system Ambitious but realistic EHR EHR system system which which are are able able to to exchange and and reuse reuse data data Implementation guidelines are needed Proces/Information model model National SNOMED CT project January 2005 Terminology system system Focus in the next 5-10 years Clinical Clinical content content 22