TRANSFORMING HEALTH SYSTEM WITH IT Ain Aaviksoo, MD MPH. Deputy Secretary General for eservices & Innovation Ministry of Social Affairs of Estonia
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1 TRANSFORMING HEALTH SYSTEM WITH IT Ain Aaviksoo, MD MPH Deputy Secretary General for eservices & Innovation Ministry of Social Affairs of Estonia
2 To be discussed 1. From data accumulation to information processing 2. From technology adoption to service redesign 3. The cornerstone for future healthcare
3 1 From data accumulation to information processing
4 Almost everyone has arrived to esociety! Internet users (%) by age group in Estonia y y y y y y
5 Estonian National Health Information System is successful - Nationwide medical data exchange platform launched in % of data by hospitals and family doctors is digital up to 30% process efficiency - more services for the same money 94% of prescriptions digital - citizen satisfaction l 100% insurance claims digital - precise state oversight and planning 97% of patients have countrywide digital record - exponential demand for new services 60% of limited workability assessments based on HIS documents only (i.e. without any additional paperwork or medical investigations) / /
6 Digital data availability drives the use Growth of Estonian Health Information System Usage No of queries per month Users among health care professionals +90% Users among citizens +100% No of services available +275% Data queries by professionals +450% Data queries by citizens +400% Queries by HC professionals Queries by Citizens
7 Vision since 2005 Impact Shared Care Simulation Environment Tracking Behaviour Tracking Online Intervention Lifestyle Value Added Decision Support Personal Guidelines Care Paths Service Brokering Integrated Statistics Social Networking Information Exchange Central EHR Health Portal Registries Integration Standardization Local EHRs Digital Claims & Reimbursement Time
8 Key strategic success factors (1) Universal mandatory digital data capture by all care providers (2) Universal mandatory secure data exchange platform ( X-road for everybody: all sectors and databases, private & public) (3) Data exchange requirement from day one (4) Clear and robust legal framework (5) Societal trust towards (health) data exchange 8
9 From technology adoption to service redesign 2
10 CASE 1: eprescription - very fast system-wide adoption of e-services eprescriptions ordered 80% of electronic prescribing achieved within 9 months eprescriptions dispensed E-Prescription in Estonia: Any doctor can prescribe to any patient, who can buy the medicine in any pharmacy - Jan/10 Mar/10 May/10 Jul/10 Sept/10 Nov/10 Jan/11 Mar/11 May/11 Jul/11
11 Inspiration from Mayo Clinic: Well-designed eservices are loved by everyone 98% of patients with mean age 68y used actively patient educational tool with ipad after heart surgery D.Cook jt Patient Education Self-Management During Surgical Recovery: Combining Mobile (ipad) and a Content Management System (Telemedicine and e-health. April 2014, 20(4): doi: /tmj )
12 CASE 2: Digital Health Certificate - integrating services beyond health system Health Certificates exchanged digitally between issuing physician and Road Administration Pilot start in July 2014 Digital certificates outnumbered paper-based certificates in 6 months Mandatory digital processing in 9 months Health certificates for driver s license application Jul 2014 Aug 2014 Sep 2014 Oct 2014 Nov 2014 Dec 2014 Jan 2015 Feb 2015 paper-based digital
13 The cornerstone for future healthcare 3
14 Strategic transformation goals in Estonia s ehealth Strategy for * Better information - more health! 1. Citizen-centered & Personalized medicine 2. Holistic case management and integrated health & social service network 3. Quality & outcome based service and health policy management 4. Teleservices & increased service efficiency 5. Data capture and information infrastructure for clinical services, R&D, economic development *draft, to be adopted by November 2015
15 Personalized Medicine Pilot Project An example of the impact of e-health in one strategic focus area Genome Bank (Est 2001) donors (5% of the population) Digital health data from 5 sources (>10y history) + + International investments for personalized medicine Government decision for Nationwide Personalized Medicine Pilot Project in (Dec 14) personalized services and stratified health system planning growth-factor for healthcare R&D and business development
16 The time of digital health has only begun
17 THANK YOU Ain Aaviksoo Transforming health system with IT
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