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eHealth Services for the Citizen Provided by Patient Portals in Estonia

eHealth Services for the Citizen Provided by Patient Portals in Estonia. Peeter Ross Estonian eHealth Foundation, Estonia e-HEALTH FOR A ROMANIAN HEALTHY POPULATION 6 th edition, May 26, 2011, Athenee Palace Hilton Hotel , Bucharest. Estonian Electronic Health Record System

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eHealth Services for the Citizen Provided by Patient Portals in Estonia

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  1. eHealth Services for the Citizen Provided by Patient Portals in Estonia Peeter Ross Estonian eHealth Foundation, Estonia e-HEALTH FOR A ROMANIAN HEALTHY POPULATION 6th edition, May 26, 2011, Athenee Palace Hilton Hotel, Bucharest

  2. Estonian Electronic Health Record System • Patient Portal • iPatient portal – patient on-line access to medical data and images

  3. Architecture of Estonian Healthcare IT STATE AGENCY OF MEDICINES - Coding Centre - Handlers of medicines HEALTH CARE BOARD - Health care providers - Health professionals - Dispensing chemists POPULATION REGISTRY BUSINESS REGISTER HOSPITAL (HIS) integration 2009 FAMILY DOCTORS 2009 PHARMACIS 2010 january SCHOOL NURSES 2011 september EMERGENCY MEDICAL SERVICE 2012 X-Roads, ID-card, State IS Service Register eHealth FoundationEHRSYSTEM2009 Health InsuranceINSURANCE REGISTERCLAIMS & REIMBURSMENTPRESCRIPTION CENTRE 2010 January PATIENT PORTAL 2009HCP PORTAL 2011 XROADS GATEWAY SERVICE2009 PHARMACIS AND FAMILY DOCTORS2009

  4. 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

  5. EHR – Access rights • Authentication of the person accessing patient portal is based on the ID-card which is a compulsory document for the purposes of personal identification in Estonia • Patient has the right to close his/her own data collected in the central database (opt out) • Citizen can • access their own data • can declare their intentions and preferences • monitor visits to their EHR • view issued and dispensed e-prescriptions

  6. www.etervis.ee

  7. East Tallinn Central Hospital, Estonia

  8. East Tallinn Central Hospital, Estonia

  9. Why iPatient? • Results of the user satisfaction surveys showed for several years that • Patients would prefer on-line booking • GPs needed better and quicker access to their patients data gathered in the hospital • Patients would prefer on-line access to their electronic medical record (EMR) • Competitive advantage in the health care market

  10. Content of iPatient? • On-line booking of appointment times • Rescheduling • Cancelling • SMS and e-mail reminders • Access to all medical data • Medical history, results of exams and analyses • Up-to-date information (24h from any location) • Access to medical images • General information

  11. Results (1) • The results of the first three years • Use of shared web-based EMR by patients has grown steadily • The average monthly number of users is 2 900 (2011) • Users are in all age groups: • main users are younger women • parents viewing their newborn medical data • elderly viewing their medical data • Medical data is the main interest • On-line booking as an alternative tophone is growingservice

  12. Results (2). Users of the patient portal (2008 – 2010)

  13. Results (3). The aimof patient portal usage(2008 – 2010)

  14. Results (4). Users of the patient portal

  15. Results (5). Viewing of radiology images (2010) During 12 months (Jan-Dec 2010) there were 3750 (11/day) patients accessing theirimages from outside the hospital.

  16. Difficulties • After launching iPatient the main difficulties have been: • General acceptance of hospital personnel to share medical data in the EMR with with patient • Much attention had to be paid on the security and electronic authentication of the EMR users • In some cases users could not log in as their ID-card software or certificates had not been updated • Also some data saving problems during the appointment time booking were observed

  17. Registered complaints (2009)

  18. Change management • Change of the medical data ownership paradigm • Patient Portals bring along principal change in the patients´attitudesin relation to the access to own EHR • It leads people to become more responsible concerning their health • Transparency • Hospital specialist and patient have equal access to medical data and images 24/7 • Easy authentication • Use of existing infrastructure (X-Road, ID-card) • No need for the patient to contact the hospital and receive login names and passwords

  19. Thank you for your attention! Peeter.Ross@itk.ee

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