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Preconditions for succesful implementation of eHealth

Thinking of the bigger picture: How Estonia designed future healthcare Madis Tiik MD, Scientific advisor EU eHealth Task Force group [EST]. e-Estonia. Preconditions for succesful implementation of eHealth. ICT and healthcare in Estonia. Patient empowerment.

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Preconditions for succesful implementation of eHealth

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  1. Thinking of the bigger picture:How Estonia designed future healthcareMadisTiikMD, Scientific advisorEUeHealthTask Force group [EST]

  2. e-Estonia Preconditions for succesful implementation of eHealth

  3. ICT and healthcare in Estonia Patient empowerment • Software's for hospital and for GP in 1994 • Digital claims since 1995 • Equipping GP-s with PC-s 1998 • Skipping paper claims 2002 • Legally allowed to use only digital patient record since 2002 Local EMRs Digital Claims & Reimbursement Time 1992 2010 2015 2020

  4. Information Society Strategy 2001 • By 2013 • All public services are digitaly available • Ehealth services • Public infrastruture is service oriented (x road) • Digital authorisation of users, based on the ID card, is the best available in the world • Data is stored were it is collected and exchange of the data is available those who need it

  5. Information society indicators • 100% of schools and government organisations have broadband connection • 71% of families have computer at home • 68% of homes have broadband connection (2011) • EstWin project- 98% of households gets a broadband connection by 2015 • 99% of bank transfers are performed electronically • 94% of income tax declarations made via the e-Tax Board • 24% of votes were cast over the internet on 2011 (Parlament elections) • 62%-E-census (jan2012) 815,467persons have completed the questionnaire digitally

  6. Estonian Information System X-Road was launched in 2001

  7. Some achievements • 2000: Launch of e-Tax Board • 2000: Launch of m-Parking • 2002 : Introduction of national electronic ID-Card • 2003: Launch of ID bus ticket • 2005: i-Voting was introduced • 2007: Introduction of m-ID • 2007: Launch of e-Police system • 2008: Launch of e-Health system • 2010: Launch of e-Prescription

  8. ICT and healthcare in Estonia Patient empowerment Central EHR 2005-2008 Health Portal 2009 Registries Integration ( non clinical) 2008 Prescription centre 2010Standardization 2007-2012 Integration of different user groups 2009-2012 Information Exchange Local EMRs 1992-2005 Digital Claims & Reimbursement Time 1992 2010 2015 2020

  9. Current situation ActivitY indicators

  10. Documents in EHR • There are 14 different types of standardized documents. • Most popular documents are: • Ambulatory consultation notes 1286203 • Hospital discharge letters 694974 • Image address links 742590 • Image reports 938594 • Immunization notes 24256

  11. E-prescriptions

  12. Paper prescriptions

  13. Electronic Health Record (EHR).Patient Portal • Services in portal • Medical files • Time critical data (allergy, chronic diseases) • General practitioners and hospital visits • Summary of ambulatory and stationary case • Link to medical images • Expressions of will/Preferences • Closing medical records(opt out) • Name trusties • Donation of organs • Overview of logs

  14. ICT and healthcare in Estonia Patient empowerment Health certificate 2010-2012 Integration with social care 2011-2012 EbmDS decision support service 2011-2012 Integrated statictics 2010-2012 Clinical registries 2011-2013 Secondary use of data Central EHR 2005-2008 Health Portal 2009 Registries Integration (non clinical) 2008Standardization 2007-2012 Integration of different user groups 2009-2012 Information Exchange Local EMRs Digital Claims & Reimbursement Time 1992 2010 2015 2020

  15. Secondary use of data • Integration with social care • Health status for disability pension • Inside healthcare • Health certificate for driver licenses • Virtual registris • Immunization registry

  16. ICT and healthcare in Estonia Patient empowerment Personal Simulation 2015 Integration wth -Environment data 2015? -Behaviour data 2015? -Genetic data 2013? Value Added services Health certificate 2010-2012 Integration with social care 2011-2012 EbmDS decision support service 2011-2012 Integrated statictics 2010-2012 Clinical registries 2011-2013 Secondary use of data Central EHR 2005-2008 Health Portal 2009 Registries Integration ( non clinical) 2008Standardization 2007-2012 Integration of different user groups 2009-2012 Information Exchange Local EMRs Digital Claims & Reimbursement Time 1992 2010 2015 2020

  17. Task Force raport: • Levers of change • My data, my decisions • Liberate the data • Connect up everything • Revolutionise health • Include everyone • Benefits • Partnership, active role • User focused, new services • Integration and useage of PHR data • Informed and empowered citizens to manage their own health • Greater involment, self care

  18. Thinking of the bigger picture...MadisTiikmadis.tiik@eesti.eeTHANK YOU !

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