+ Håkan Nordgren, MD. Cell
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- Hillary Robertson
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2 + Håkan Nordgren, MD Background as: CIO/CMIO/CDO Karolinska university hospital Implementer of large EMR/EHR systems Medical Director big pharma Partner global management consulting Chief Medical Officer medtech industry and Swedish ehealth programme Chair Swedish ehealth architectural board Practicing Archipelago doctor and Pediatrician Cell
3 + Stockholm Sweden Dalarö 40km SouthEast
4 + Changes in healthcare domain Competition (service, quality & price) Decentralisation - more patients to GPs Centralisation - centers of excellence Financial situation Continuing subspecialization Patient choice and engagement Rapid knowledge turnover
5 + Integrity and privacy
6 + An IT- support for the Health Care of tomorrow
7 + Health expenditure per capita OECD 2011
8 Global Healthcare Challenges 2011 Spending (% of GDP) AU CA DK NL NO NZ SE SZ UK US Medical Errors (% in 2 yrs) AU CA DK NL NO NZ SE SZ UK US Mortality After Heart Attack (%) AU CA DK NL NO NZ SE SZ UK US
9 Care Coordination and Transitions of Care Care Coordination Problems (%) Key Information Not Shared Among Providers (%) Gaps in Hospital Discharge Planning (%) AU CA FR GE NE NZ NO SE SZ UK US AU CA FR GE NE NZ NO SE SZ UK US AU CA FR GE NE NZ NO SE SZ UK US
10 + Goal: Improve outcomes e.g. greater patient safety, effectiveness and efficiency as cited by U.S. Office of National Coordinator Health Information Technology (ONCHIT): 1. Avoid medical errors 2. Improve use of resources 3. Accelerate diffusion of knowledge 4. Reduce variability in access to care 5. Advance consumer role 6. Strengthen privacy and data protection 7. Promote public health and preparedness 10
11 + Three main issues The patient s participation in the care process Maintainig continuity of care in modern healthcare with many care providers A knowledgebased governance of healthcare
12 + Sweden Area: 449,964 km 2 Population: 9,6 M (2012) GDP $552 billion Three governmental levels with own taxation rights Healthcare funded by taxes (Beveridge system)
13 + Swedish Healthcare 21 County Councils 291 Municipalities Private Care providers 100% coverage of EMR/EHR >95% eprescriptions Very good outcome results
14 ehealth EHR/EMR/HIS Generation Experimental Period Organizational Functions Integration Research projects Documentation Scheduling 1st gen GP s office or Clinic based 2nd gen Hospital based or Primary care area 3rd gen County council or Regional based 4th gen National based (EU and epsos) + Medication + Lab report + CPOE + eprescription + PACS viewer + CDSS patient services by it self an integration
15 + Solution based on Intersystems technology Sweden NPÖ National Patient Overview Denmark NPI National Patient Index Slightly different technical solutions but same aim and same goal Based on International Medical Standards (ISO, HL7, WHO, IHE etc) Intergrates all major EMR/EHR/HIS systems in both countries (around 10 different in each country)
16 + National Patient Overview Counties are connected as producers and consumers 100 private healthcare providers are connected through care contracts with the counties 90 municipalities, 10 private caregivers and the Swedish Dental Service are connected as consumers Goal: 95% municipalities will be connected as consumers Some as producers
17 + National Patient Overview Regions are connected as producers and consumers 100 private healthcare providers are connected through care contracts with the counties 90 municipalities, 10 private caregivers and the Swedish Dental Service are connected as consumers Goal: 95% municipalities will be connected as consumers Some as producers
18 + Chronic conditions Diabetes mellitus! Caregivers! GP! Endocrinology! Internal Medicine! Nephrology! Ortopedics! Ophtamology! Podiatrist! etc
19 + InterSystems Italy InterSystems Italia s.r.l. Piazzale Biancamano, Milano Italy Tel.: Fax: InterSystems Italia s.r.l. Via Giordano Bruno, Cesena (FC) Italy Tel: Fax: [email protected]
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