E-health croatia: National healthcare information system
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1 E-health croatia: National healthcare information system Andrea Budin, M.Sc.C.S. Karlo Guštin, MBA ICT for Industry & Society Ericsson Nikola Tesla, Croatia April 2015
2 What would you say about the industry where Focus is on the process and the seller not the customer Costs are fragmented, isolated, not easily manageable Processes are fragmented and isolated Decisions are often made upon individual knowledge and experience Ordering process is manual and paper based Experience is mostly individual and not truly shared Information for any participant in the process is fragmented, isolated and not always available What about future costs? What about quality in the future? Yes, this is can be a mess! Ericsson e-health Croatia National e-health Seminar LMF Page 2
3 What if that industry was healthcare...? Focus is on the process and seller not the customer Costs are fragmented, isolated, not easily manageable Processes are fragmented and isolated Decisions are often made upon individual knowledge and experience Ordering process is manual and paper based Experience is mostly individual and not truly shared Information for any participant in the process is fragmented, isolated and not always available What should we do? What can we do? How can we do it? Ericsson e-health Croatia National e-health Seminar LMF Page 3
4 What can/should we do? Focus is on the process and seller not the customer Costs are fragmented, isolated, not easily manageable Processes are fragmented and isolated Decisions are often made upon individual knowledge and experience Ordering process is manual and paper based Experience is mostly individual and not truly shared Information for any participant in the process is fragmented, isolated and not always available Ericsson e-health Croatia National e-health Seminar LMF Page 4 Patient centric Centralized cost management Managed processes, clinical pathways and guidelines Guidelines, evidence-based and personalized care Automated Best practices Consolidated, centralized, comprehensive; available wherever and whenever needed
5 How can we do it? How to collect and distribute information? How to trust that information? How to measure success? How, how, how? Transformation Where to start? Ericsson e-health Croatia National e-health Seminar LMF Page 5 Re-Organization, new processes, new & reused knowledge and competences Through Using ict!
6 E-health main building blocks Discharge summary from PHC E-prescription Ehr (electronic healthcare record) Prevention programs Reporting infectious, malignant diseases E-referral Patient portal Retrieving administrative info (insurance status, medical aids availability ) Ericsson e-health Croatia National e-health Seminar LMF Page 6
7 The begining was hard legal, process, architectural, technical, motivation, resistance to change issues!!! You need to choose the right partner experienced solution builder rather than a solution supplier Each new step is easier from previous Each new step brings significantly more benefits than previous After some point, momentum is there and you should only not ruin it Is it possible? The real cases show that there is no single, right strategy for implementing interoperable EHR and eprescribing systems. The most transferrable features from different projects are the experiences and capabilities gained, and requirements for success identified. Ericsson e-health Croatia National e-health Seminar LMF Page 7 European Commission, The socio-economic impact of interoperable electronic health record (EHR) and eprescribing systems in Europe and beyond, October 2009
8 ehealth in croatia Laboratory Hospitals Patients CEZIH Physician app Nurse app General practitioner Pediatrics CEZIH is integration platform with selected business process mechanisms Gynecologist EHR Patient portal Pharmacy Audit Business registries (resources, patients coding lists ) BI & reporting Messaging Dentist Selected nationwide applications are part of CEZIH too Auxilliary databases Specialized applications (e.g. national prevention programs, hospital information system, central ebooking...) Authentication & authorization Healthcare insurance School medicine Ministry of Health Public Health Specialist care Outpatients care Ericsson e-health Croatia National e-health Seminar LMF Page 8
9 CROATIA E-prescription (50m/YEAR) Prevents errors & saves lives EPSOS E-refeRral 15,000 people do not need to drive each day 4 Million patients benefit from ehe Ericsson e-health Croatia National e-health Seminar LMF Page 9 E-referral in all hospitals (12m/YEAR) e-booking in specialist care & hospitals
10 CROATIA Administrative services DISCHARGE LETTERS Primary health care providers in daily use by 18,000+ healthcare professionals Ericsson e-health Croatia National e-health Seminar LMF Page 10 Electronic healthcare record Patient portal
11 Electronic healthcare record Central electronic healthcare record is the only system where authorized user can access comprehensive lifelong patient medical record Source of the data is any application/system connected to cezih Ericsson e-health Croatia National e-health Seminar LMF Page 11
12 patient portal Comprehensive view on your own health Managing dashboard for different activities Administrative information Communication platform with different healthcare professionals Reminders, general info Ericsson e-health Croatia National e-health Seminar LMF Page 12
13 our efforts have not gone unrecognized... Ericson Nikola Tesla Ericsson e-health Croatia National e-health Seminar LMF Page 13 The top 3 performers for eprescription are Estonia (100%), Croatia (99%) and Sweden (97%) (EC, 2014)
14 Carewell Multi-level integration for patients with complex needs Ericsson Nikola Tesla COPD Diabetes cardiovascular Overall coordinator of Croatian pilot site 2. mhealth technology provider - Ericsson Mobile Health - System Integration 3. Pilot site deployment and maintenance 4. Service and organization design 36 months 18 months operational pilot period targeting multiple chronic diseases Ericsson e-health Croatia National e-health Seminar LMF Page 14 8 Countries Spain, UK, Denmark, Germany, Belgium, Poland, Croatia, Italy Croatia Pilot Execution
15 Faculty of Electrical Engineering and Computing Health Center Zagreb Center (Healthcare Service Delivery) Croatian Society for Pharmacoeconomics and Health Economics Technology provider Organizational change managment Quality and security managment Technological Interoperability assessment Ericsson Nikola Tesla Overall coordinator of Croatian pilot site mhealth technology provider Healthcare service design and use-case creation Pilot site deployment and maintenance Patient recruitment Health professionals and decision makers involvement Data analysis and market research Pilot evaluation and socioeconomic performance analysis Ericsson e-health Croatia National e-health Seminar LMF Page 15
16 Field nurse service in Croatia Technology status Technology missing in filed nurse care: In place EHR eprescription ebooking erefferal - 64 hospitals - 46 health centers: 960 field nurses 5000 GP s Communication tools between professionals on first line (GP and Field nurses) Communication support between patient and healthcare staff Digital educational materials for patient empowerment Ericsson e-health Croatia National e-health Seminar LMF Page 16
17 Ericsson e-health Croatia National e-health Seminar LMF Page 17
18 Integrated Care Coordination home support And patient empowerment Data Sharing Education materials on multiple devices: - About disease - Prevention - Therapy adherence - Regular Workouts - Nutrition Communication Ericsson e-health Croatia National e-health Seminar LMF Page 18 Medical Measurements
19 Added value for healthcare system Increased amount of accessible information Increased speed of data flow on patient-doctor pathway Increased adherence to therapy and compliance with specialist examinations decrease in number of GP visits and unnecessary travel for patient Data Sharing Integrated Care Coordination home support And patient empowerment Medication Therapy adherence Regular Workouts Nutrition decreased number of hospitalizations and excessive health resources usage Communication Medical Measurements Ericsson e-health Croatia National e-health Seminar LMF Page 19
20 The future depends upon the decisions made today Will we look into the eyes of our children and confess that we had the opportunity, but lacked the courage? that we had the technology, but lacked the vision? * THANK YOU! Ericsson e-health Croatia National e-health Seminar LMF Page 20 * Energy Revolution Greenpeace, Pachauri foreword 2009
21 Ericsson e-health Croatia National e-health Seminar LMF Page 21
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Table of Contents. Page 1
Table of Contents Executive Summary... 2 1 CPSA Interests and Roles in ehealth... 4 1.1 CPSA Endorsement of ehealth... 4 1.2 CPSA Vision for ehealth... 5 1.3 Dependencies... 5 2 ehealth Policies and Trends...