Action Plan 2001 – 2003 “ Say @!” : Electronic interaction within the Health and Social Services

1. Action Plan 2001 – 2003 “Say @!” :Electronic interaction within the Health and Social Services

2. Ministry of Health Ministry of Social Affairs Division for Health Care and Social Services Department for IT-Strategy and Statistics Directorate for Health and Social Affairs

3. Healthcare - some relevant reforms • Ownership and organisation reform (Hospitals) • Free choice of hospital (1.1.01) • GP reform (1.1.01) • Reorganisation of central health & social welfare bureaucracy

4. ”Say @!” • Action-plan for IT- development in the health and social sectors, for the period 2001-2003. • Launched by The Ministry of Health and Social Affairs in January 2001. • Managed by the Norwegian Directorate for Health and Social Welfare. • Operated by local and regional parties in the health and social services sector

5. Objectives • Stimulate electronic interaction and exchange to strengthen and increase collaboration and efficiency in and between health and social services. • Improve contact with patients, clients, and those in need of care. • Improve the quality of services.

6. “Say @!” Four areas of eHealth action: • Infrastructure - National healthcare network • Electronic interaction and exchange • Telemedicine • Services for the public

7. A national health network: Provide a good and secure infrastructure for electronic interaction and exchange between health personnel, with adequate capacity and a set of basic services to facilitate this interaction. The net will be realised by the end of 2003.

8. National healthcare network: originally based on 5 regional health networks Action 2001/2002: Funding regional networks connecting hospitals Linking up GPs .

9. Action 2002/2003: • Central Infrastructure - NHN: • Connects 5 RHAs, • Clear responsibility towards each RHA • God scaling possibl./flexibility • Restricted ”channels” in the transport net • Run by central supplier • Common approach of firewalls etc. • All this: SHDir responsibility

10. National Healthcare Net (NHN) – Background • What is NHN? • Consists of RHAs regional net and SHdirs central infrastructure. These elements shall be linked up, and some basic services will be established. • Goal? • Equal possibilities for electronic interaction with all relevant actors and services, regardless of regional borders and point of access • Division of responsibility? • Each RHE: responsibility for regional net • SHdir: responsibility for central infrastructure with basic services (jfr. Infrastructure project): • Includes a transport net (transit net) between regional healthcare nets, offer some basic services and make possible interchange with important national actors

11. National Healthcare Net – Challenges/discussion points • Short term: • well-functioning and continuous co-operation with RHAs, suppliers, and other relevant environments • Clear areas of responsibility • Follow-up of relevant laws and regulations • Design economic principles and stimulative measures that enables further development • Long term: • Organise a central organisation that runs the net (minimum the role of demander) • Significant growth in daily use of the NHN

12. Electronic interaction and exchange • During the plan period, widespread use of electronic exchange will be realised for central messages such as referrals, medical records and reimbursements. • In addition the scope of electronic interaction within the sector will in time be expanded to include the care and nursing services in primary care as well as the social services.

13. Electronic interaction - current status • Most GPs have electronic patient records • Approx. 1000 GPs have communication solutions for message exchange (based on x-400) • Approx. 800 GP offices (of total 1840) will be connected to the National Healthcare Net by the end of 2003

14. Electronic interaction - current status • 34 hospitals offer electronic discharge reports to GPs • 600 GP offices receive electronic discharge reports – soon to increase in number • 4 pilots on electronic referral messages to hospitals • electronic booking - 6 pilots merging into a common specification for online booking services and related referral messages

16. Electronic interaction – actions 2002/2003 • Standardisation program: EPR-standardisation, message standards – information content, etc. • IT coordination funding to RHAs: electronic interchange with primary healthcare • Referral mssg./Discharge rep. Project: project support, coordination and follow-up, • Templates for ”The good discharge report” and “the good referral letter”. • ELIN: sector cooperation on developing new solutions for electronic interchange with GP offices

17. Electronic interaction – actions 2002/2003 • Demand that all hospitals shall offer electronic discharge reports til GP offices • Electronic sickness reports to the National Insurance Services (NIS) – • National framework contract for PKI/ digital signature (established by NIS) • Electronic reports to central health registers: Cancer register and medical birth register

18. Electronic interaction – challenges/discussion points • Stronger force behind standardisation demands– establish systems of accreditation? • Web solutions - alternative to message exchange - security issues • Need for investments in municipal sector

19. Telemedicine - goals • During the plan period, telemedical solutions will be put into use throughout the country to insure greater availability of services. • To a larger extent than before, telemedicine will enable people to be treated or nursed in their local environment or in their homes.

20. Telemedicine - actions • Teleradiology, IHE – program to achieve integrating PACS/RIS • Establish Telemedicine services between hospitals and primary care

21. Services to the public - goals • Throughout the plan period quality-assured information on public health and social services will be made available to the public. • Access to an increasing number of services for interaction between the general public and health and social service personnel via the net will be facilitated.

22. Services to the public – current status • 75 % of the Norwegian population have access to the Internet (Gallup, august 2002) • 31% use the Internet for health purposes (Andreassen, Tidsskrift for Den norske lægeforening 17/2002) • 45% wish to use e-mail in interaction with their doctor (Andreassen) • An increasing number of health sites is available, but the quality varies • New roles of the patient and health personnel • Use of the Internet and electronic communication can help fulfil patients rights

23. Services to the public – actions 2002/03 • Guidelines for establishing e-health sites • focus on ethics and legal issues • Pilots – electronic communication between patients and doctors. • Focus on security, health legislation, medical, organisational • An information site for free choice of hospital – waitinglists and qualityinformation • Accessibility for all • also people with disabilities • Web survey of e-health web sites • focus on quality

24. Services to the public – challenges/discussion points • Is electronic communication with your doctor ”safe enough”? • How can you satisfy patients rights when the patient is anonymous? • Can a patient “agreee” to reduced security? • What kind of information do patients/relatives want from a hospital web site?

25. Say @! - Status • Central Taskforce: 9 persons in the Directorate, working on Say @! Follow-up, in co-operation with the ministries, RHE group, SSIT/, eNorway + + • Regionally: RHEs are putting IT high on the strategic agenda, and focuses on central Say @! goals • RHE IT strategy integrates Say @!-goals

26. Funding • The regional health enterprises have major responsibility for building regional infrastructure, and for facilitating interaction with the primary health care and social services sector. • National funding is provided for the development of different services, standards and security guidelines.

27. Conclusion • Evaluation of results • A new action plan is on it’s way