Transcript The Sweden's first National Strategy for eHealth

Improving Swedish healthcare
by using eHealth solutions
– strategic decisions towards SNOMED CT
Daniel Forslund
Head of Section – eHealth
Ministry of Health and Social Affairs
Sweden
Ministry of Health and Social Affairs Sweden
New Government - New visions
Prime Minister Mr Fredrik Reinfeldt
Minister for Health and Social Affairs
Mr Göran Hägglund
Ministry of Health and Social Affairs Sweden
• The Liberal-Conservative
Government assumed
office on October 6.
• Replaced a SocialDemocratic Government,
in office 1994-2006.
• eHealth one of the main
agenda points in the new
Governments extensive
reform programme for
healthcare.
eHealth – an integrated part of
daily life in Swedish healthcare
• Electronic healthcare records (EHR’s):
– 95 percent of all documentation in primary care is
made in electronic healthcare records;
– over 69 percent EHR’s in specialized hospital care.
• e-Prescriptions:
– 55 percent of all pharmaceutical prescriptions in
Sweden are today issued electronically and transmitted
directly from the doctor’s office to Apoteket, thus
available at all 950 pharmacies in Sweden.
• Telemedicine important in sparsely populated areas.
Ministry of Health and Social Affairs Sweden
A strong need for co-operation
• Advanced usage of ICT in healthcare, but:
– most ICT systems in healthcare built for
storage of data, not exchange of data;
– current structure with self-governing regions
makes national decision-making challenging.
• Conclusion:
– co-operation between all relevant stakeholders
in the healthcare sector is the only way
forward!
Ministry of Health and Social Affairs Sweden
The
National High Level Group for eHealth
National High Level Group for eHealth
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Ministry of Health and Social Affairs
The Swedish Association of Local Authorities and Regions
National Board of Health and Welfare
Medical Products Agency
National Pharmacy Corporation (Apoteket AB)
Carelink
National Stakeholder/Reference Group
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National organizations for healthcare professionals
ICT Industry, Pharmaceutical Industry
Government Agencies and Legal Inquiries
Private Healthcare Providers
Research Community
Standardization Bodies
Ministry of Health and Social Affairs Sweden
Sweden’s National Strategy for eHealth
was presented in March 2006
• Main objectives in the National Strategy is to:
– improve patient safety, accessibility as well as quality
and continuity of care by creating a broad national
consensus on future investments in eHealth;
– enable patient mobility nationally and internationally;
– meet the increasing demands from citizens and
healthcare professionals to integrate healthcare
in the information society;
– encourage healthcare politicians and decision makers
to use eHealth as the main tool for renewal and
improvement of health services.
Ministry of Health and Social Affairs Sweden
• Services and benefits for
citizens, healthcare
professionals and
decision makers in
healthcare.
• Basic structures that has
to be in place for future
development on the
eHealth area.
Ministry of Health and Social Affairs Sweden
National Activities and Steering Documents
National High Level Group for eHealth
• Co-ordination and follow-up of actions related to the
National Strategy.
• Regularly analyze, report and follow-up implementation.
• Revision and adjustment of the National Strategy.
Action Plan
Regions
Action Plan
Municipalities
Project Plan
Proposal for a new
Patient Data Act
Ministry of Health and Social Affairs Sweden
Laws and
Regulations
National Strategy
for eHealth
Annual National
Action Plan
Action Plan
National
Information
Structure
Action Plan
SNOMED
Action Plan
National Library
for Terminology
Project Plan
Project Plan
Project Plan
Standards
Terminology
Regional
Projects
Swedish inquiry about SNOMED CT
• In April 2006 the National Board of Health and Welfare
was given the task to analyze whether Sweden should
become a member of SNOMED Standards Development
Organization (SSDO).
• The report was published in September 2006, creating a
basic knowledgebase for decision making:
– “Should Sweden join now or wait?”
• On October 26 the newly elected Government made the
decision to declare its ambition to join the SSDO by
January 1 2007 as Charter Member.
Ministry of Health and Social Affairs Sweden
• Possibilities with SNOMED CT:
– We need a terminology system like
SNOMED CT to improve healthcare
and use information systems in a
more efficient way.
– Patient safety most important – we
need a common terminology when
information about patients is shared
between many different healthcare
providers
– International harmonization and
co-operation necessary.
– Systemized information is required in
order to make decisions regarding
individual patients and facilitate
administration, control, follow-up,
development and research.
– Information must be a long-term
resource, independent of any
organization or technical solution.
– Uniform and unambiguous
definitions and agreements on terms
and concepts crucial to ensure
patient safety, high quality treatment
and follow-up.
Ministry of Health and Social Affairs Sweden
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Challenges with SNOMED CT:
– Parts of SNOMED CT not enough
validated.
– Not yet a full decision support
system.
– Not exhaustive, parts missing (social
care, occupational therapy,
physiotherapy).
– SNOMED CT does not cover
linguistic definitions, criteria's of
diagnosis, information models etc.
– SNOMED CT has to be translated.
– Expectations on SNOMED CT are
unrealistic – this has to be handled.
– The knowledge about SNOMED CT
is generally low in Sweden.
– SNOMED CT not detailed enough for
clinical use.
– Documentation about SNOMED not
openly available at present.
– There is a lack of references on
practical use of SNOMED CT.
– Expensive? Hard to estimate costs
and resources needed for translation
and implementation.
Considerations and proposals
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Sweden as a nation must decide which path to follow,
where the alternatives are:
1. to become involved in the international collaboration
on using and developing SNOMED CT, or:
2. follow its own line and develop a national system for
reference terminology.
The choice of direction must be linked to the desired
level of ambition in the future use of information
systems in the healthcare sector – and what time aspect
we have in the development process.
Ministry of Health and Social Affairs Sweden
Proposals for the Government
to consider before final decision
• The development of SNOMED CT has to be:
– a national responsibility
– developed to suit Swedish conditions and legislation
– given required resources and knowledge.
• We have to build an organization to pragmatically work
with development, translation, education and
implementation in ICT systems.
• Close co-operation with other SSDO countries is needed.
• SNOMED CT does not substitute ongoing local and
national work with classifications and linguistic
definitions of terms and concepts.
Ministry of Health and Social Affairs Sweden
Common objectives
All steps and initiatives
that are taken, should
try to achieve common
solutions.
Many initiatives
Many actors
Ministry of Health and Social Affairs Sweden
Common vision
and objectives
What is common? Find it!
Specialist Care
Find what is common / independent of
organisations
Primary Care
Social and elderly care
Ministry of Health and Social Affairs Sweden
Process of the patient
• The process of the care taker
• The kernel – a small common part
• Methods/models that can be used
• Benefits and effects
• Use and development standards
• Classifications
• Principles for security (business roles)
Expectations and different perspectives
The patient and relatives
• Information about planned
procedures and goals
• Information about procedures carried
out and achieved
results
Patient/Relatives
• Facilitate the patients right to
involvement
• Guard the patients right to privacy
The IT-market
• Clear and scalable model
• Compliance with standards
IT-market
• International value
• Reduce costs for
development
Management, governance and
research
• Provide possibilities in terms of
measurement, control and
Management/
follow up
Governance
• Patient safety, patient
satisfaction
• Quality, costs and effects
• Knowledge based clinical
research
Health care and social care
professionals
• Holistic view in relation to the patients
needs of health and community care
• Shared
information
othercare
health
Health
care andwith
social
professionals
care professional, actions taken and
planned care.
• Base for individual planning, decisionmaking and follow-up.
Ministry of Health and Social Affairs Sweden
It all comes together!
”enterprise architecture”
Common vision
and strategic
objectives
Effects
Common Care process
Business description
Description of patient information
National information
model
”the kernel”
Informationstructure
information specifications
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Systems and
solutions
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IT-systems
”legally system”
Technical
infrastructure
Ministry of Health and Social Affairs Sweden
IT-description
Contact Information
Daniel Forslund
Head of Section – eHealth
Ministry of Health and Social Affairs
mobile: +46 70 209 58 39
[email protected]
Monica Winge
Lotta Holm Sjögren
mobile: +46 70 484 18 99
[email protected]
mobile: +46 70 692 45 73
[email protected]
Project Manager - National Information Structure National Information Structure and SNOMED CT
National Board of Health and Welfare
National Board of Health and Welfare
Download the National Strategy for eHealth at: www.sweden.gov.se/health
Download the SNOMED Report at: http://www.sos.se/sosmenye.htm
Ministry of Health and Social Affairs Sweden