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Road map to Denmark's healthy future Strategy for digitalization 2013-2017 Nanna Skovgaard - Head of Division, Ministry

Road map to Denmark's healthy future Strategy for digitalization 2013-2017 Nanna Skovgaard - Head of Division, Ministry of Health Flemming Christiansen - Director, National Board of eHealth. Agenda. 1. The Danish healthcare sector at a glance

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Road map to Denmark's healthy future Strategy for digitalization 2013-2017 Nanna Skovgaard - Head of Division, Ministry

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  1. Road map to Denmark's healthy future Strategy for digitalization 2013-2017 Nanna Skovgaard - Head of Division, Ministry of Health Flemming Christiansen - Director, National Board of eHealth

  2. Agenda 1. The Danish healthcare sector at a glance 2. Government goals for health and digitalization 3. Facts and priorities for a new digitalization strategy 2013-2017 • Every day-use and benefit realization • Connected care and better use of data • Citizen involvement and telemedicine • Governance, standards and mobility 4. Choices and dilemmas to be handled in coming years

  3. 1. THE DANISH HEALTHCARE SYSTEM – MAIN CHARACTERISTICS • Free and equal access to public healthcare (5,5 mio. people) • Universal coverage (same system for everyone) • Tax financed (84 pct.) – 4.348 USD pr. capita • Private co-payment in certain areas (16 pct.)

  4. Regional responsibilities • Hospital and psychiatric treatment • Primary health care / public health care scheme • General Practitioners (family doctors) • Private practicing specialists • Adults dental services • Physiotherapy

  5. Municipal responsibilities • Preventive care and health promotion • Rehabilitation outside hospital • Treatment of alcohol and drug abuse • Co-financing regional health care • Child nursing • Child dental services and special dental care • School health care • Home nursing

  6. Responsibilities at national level Basic decisions regarding structure of healthcare sector Agreements on finance, quality, service targets etc. Clinical guidelines and clinical path ways Collect and present data on quality of treatment, activity and cost etc. Provide regulation and common standards, fx ICT Provide it-infrastructure

  7. Prerequisites for ehealth in Denmark • An IT-ready population: Broadband penetration is the among the highest in Europe - 95% of the population have internet access. • A unique personal identifier is issued to all Danish citizens at birth and a digital signature is widely used • National Health Databases maintained for more than 30 years • Law revisions in recent years have established a broader access to personal health data for medical staff – liberal use of data – BIG DATA • eGovernment-strategy 2011-15: Digital Letterbox & text messages

  8. Basic challenge and ambition:* When we want to do more with data, we face more mutual dependencies * Commitment on information, tasks, competences, flows - end to end* Systematic reliability and systematic semantic

  9. 3. New Digitalization Strategy 2013-2017 HIS is key to efficient, coordinated, reliable and equal health services: 1. Focus on use of HIS - benefit realisation - ”no paper journals” 2. Connected care: Cross sector cooperation and better use of data 3. Patient empowerment - treatment at home and patient-centred data 4. Transparency on progress/commitment - Business case-driven strategy - pragmatic case by case

  10. Howdoes ICT look inside of hospitals? Number of regional EHR landscapes • Legacy of many systems - different levels of maturity • No ”one system-strategy” – interoperability is key

  11. Single Sign-on in place

  12. EMR –registrations done within 24h?

  13. Electronic registration boards for emergency care in all hospitals

  14. 3.1. Focus on the use of HIS - benefit realisation • Mobile and easy access to full patient summaries and CBI • No-paper hospitals: Get rid of paper based work processes • Close (old) competing it-solutions • Making solutions work to support clinicians in every day work

  15. eCommunication between sectors • Electronic messages have to a large extent replaced handwritten messages between GPs and hospitals:

  16. Communication between local municipalities and hospitals (MedCom-messages) Messages sent to municipalitites Messages sent from municipalities

  17. eCommunication between hospitals and municipalities – by Q1 2013 exp. 90 pct. green

  18. Shared Medication Record 19

  19. Shared Medication Record – implementation, status

  20. Digital infrastructure - National Serviceplatform

  21. 3.2. Connected care and patient flows – liquid data • By 2017 - Full digital communication between sectors – more stability and systematic related to tasks and communication • Continued work on national infrastructure and shared patient information and data cross sectors

  22. 3.3. Treatment at home and patient empowerment • Large potential in involving patients and relatives in own treatment, care, rehabilitation and prevention. • Collecting and use of data at home • Building national infra structure for data – up take of new solutions • Logistics and ownership related to devices and data • Presentation and sharing of data end-to-end • New ways of organising tasks and responsabilities –> how?

  23. 3.3 Goals regarding treatment at home and patient empowerment 2017 – connected care on personal data • Cross sector booking and view of calendar on “health”.dk • Basic data accessible • Patients diary • Presentation and transmission of biometric data from own ”wearables” • Diary notes • Mobile access • Telemedical initiatives where sound business cases • Strong commitment on common standards and infrastructure

  24. Communicating with Citizens ”Sundhed.dk” - the official Danish eHealth Portal for public healthcare services. Citizens have access to personal health data such as: • Info on prescription medicine • Selected information from Electronic Health Records • Organ Donor Registration • Citizens can participate: • Building “My dairy” with data and stories – shared national platform

  25. Public acceptance health.dk HealthTech Counsil

  26. Telemedicine • National Action Plan for Telemedicine 2012 • Based on positive experiences in a series of municipalities and regions • Agreement between government, Danish Regions and Local municipalities to large scale initiatives and pilots: • On ulcers – nation wide • On COPD – all patients in one region • Building infrastructure (Continua HA) • Testing tele-psychiatry The goal is better treatment, better economy and better jobs.

  27. Reference architecture for collecting health data from citizens Vision • Data coming from the citizen can be used on equal terms with data coming from within the health care system. • Health data coming from the citizen can become available for all relevant health professionals across organisational borders and IT systems.

  28. Reference architecture for collecting health data from citizens Purpose • Reach consensus and act as a guideline on how to collect, communicate and store health data from the citizen, making data available in a simple and transparent way. • Establish a framework for Danish profiled standards for: • collection, communication and storage of data from equipment used for monitoring and collecting data in the patient’s home • communication of data to the health IT systems processing and collecting data • Establish ownership and data responsibility • Establish technical and security standards for measuring and collection equipment, lines of communication and storage of the data collected.

  29. Reference architecture for collecting health data from citizens Process • Working group established September 2012 • Presentation to the advisorycommittee January 2013 • Public hearing planned at the beginning of 2013.

  30. 4. Transparency & commitment between parties • Transparency on shared goals and progress – shared plans for projects and implementation both local and national • Mechanisms for daily management and payment of shared infrastructure • Direction, closer coordination and follow-up in the National Board on Health-it

  31. 4. Some real choices – and dilemmas • We have a history of collecting and sharing data on patients and treatment that are second to none internationally. In a new are of “intelligent health” – what does it take to keep that position? • We base our infrastructure on international standards • We want to make full use of data between sectors – this puts high demands on shared definitions and standards both when it comes to local systems , local work processes, competences etc. • We want to cooperate internationally. We are too small to do it our selves – we need broad mandate, speed to compete – and a pull also from industry

  32. Thank You! For more info: • sum.dk • nsi.dk

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