Transcript Document

eHealth State Policy and
Projects in Estonia
Oliver Lillepruun
Estonian eHealth Foundation
19.04.2007
Estonian eHealth Foundation I
• The Estonian eHealth Foundation is an
organisation created by the Ministry of Social
Affairs of Estonia and leading Estonian health
care service providers
• The purpose of the Estonian eHealth
Foundation is to develop and manage the
information system of Estonian health care
• Founded in 2005
Estonian eHealth Foundation II
– Develops and administrates nation-wide health
registries and infosystems;
– Plays an active role in development and
publishing of standards and classifications in
health care sector;
– Coordinates development of nation-wide
medical guidelines;
– Cooperates with health care providers and with
other institutions involved in health care
provision.
E-projects of Estonian state
• Electronic Health Record
– One of the most practical public administration services
– One of the largest public IT development projects
– The most important ID card application in Estonia in the
nearest future
– The world’s first national eHealth system 
• eHealth solutions supplement today’s public
administration e-services:
– Electronic school
– Internet elections
– Electronic Commercial Register, etc.
2007: four eHealth projects
• The three primary nation-wide services developed by
Ministry of Social Affairs and Estonian eHealth
Foundation are
– Electronic Health Record
– Digital Images
– Digital registration of treatment queues, i.e. Digital
Registration
• Digital Prescription – developed by
Estonian Health Insurance Fund
Background of eHealth projects I
• 2004 – Ministry of Social Affairs applies for aid from
the European Union structural funds
• April 2005 – Ministry of Economic Affairs that
coordinates allocation of structural funds made the
funding decision for four eHealth projects:
– Electronic Health Record (EEK 25 mln)
– Digital Registration (EEK 3 mln)
– Digital Images (EEK 3 mln)
– Digital Prescription (EEK 3.7 mln)
• September 2005 – Ministry of Social
Affairs announces tenders
Background of eHealth projects II
• Nov 2005 Estonian eHealth Foundation is founded:
– Manages the projects of Electronic Health Record (EHR),
Digital Registration (DR) and Digital Images (DI)
– Administers the information system of EHR
• July 2006 Winning consortium for the tender on EHR:
– Estonian affiliate office of Hewlett-Packard OY
– AS Microlink Eesti
– AS Icefire
• Nov 2006
– Tender for the Digital Registration was won by AS
Medisoft and AS Cell Network
– Tender for Digital Images was won by AS Microlink Eesti
Legal environment of eHealth
• The Health Information System Act is being
prepared to
– regulate the development and maintenance of the
health information system
– Lay down the necessary requirements to the patient,
health service provider, etc
• The bill was drafted by Law Firm Raidla & Partnerid
• Debate of the bill
– Government (spring 2007)
– Parliament (autumn 2007)
ELECTRONIC HEALTH RECORD
What is Electronic Health Record?
• A national health information
system
• A way for medical doctors to
exchange health records
• Access for the patient to his or
her health records through a
designated patient’s portal
• Health care providers are able to
enquire patients’ time-critical and
general data
• The system stores the patient’s
medical history and is a vital
information source for physicians
Benefit to patients
• Patient Portal – access by one’s ID card to his or
her medical data regardless of time and place
• Patient no longer needs to carry papers between
different physicians
– Physicians have an objective and accurate overview
of the patient’s health history
– In collecting data to the EHR it is no longer
necessary to recall earlier diseases or drugs
– Better overview of the health history improves the
medical quality
Benefit to physicians
• Improves and speeds up exchange of information
– between physicians of different specialisation
– between specialised and family physicians
– for mutual counselling, considering second opinions
• The system provides and overview of time-critical
data of the patient
• A more comprehensive and faster overview of the
medical history
– earlier visits and diagnoses
– results of research and analyses
– issued prescriptions
Treatment
Decision
Referrals
Medical
Records
Prescriptions
Queue
18/07/2015
Images
eHealth IS
Emergency
physicians
Interfaces with
external
databases
Ministry of Defence
Agency
(Defence Force doctors,
of
Defence Force lists)
Medicines
Ministry of Justice
(prison medicine,
forensic medicine)
Social Insurance
Board
Medical registries:
Birth Register
Cause of Death Registry
Medical units
Cancer Register
of institutions
...
(kindergartens, schools,
prisons)
Emergency
medical care
~30
Ministry of Education Health Care
(Education Information
Board
System)
Ministry of Interior
Health Insurance
(Population Register)
Fund
Ambulatory
medical care ~450
X-Road
Pharmacies ~350
Family
physicians
~800
Information
systems
of family
physicians
Prescription centre
(Health Insurance
Fund)
Electronic Health Record
Doctors
Certification Centre
Hospitals
~50
Citizen Portal
eHealth Portal
Doctor Portal
Citizens
Doctors
Statistics
Statistics
users
Medical
researches
Time-table
Project
Electronic Health Record
Digital Registration
Digital Images
2005
2006
2007
2008
At the moment
we are in the
developement
stage
The next stage: Pilot Project
• Pilot project: June 2007- May 2008
• Solutions are tested in 6 establishments and 1 register:
– North Estonian Regional Hospital (NERH), Tartu University
Hospital (TÜH), East Tallinn Central Hospital (ETCH)
– Centres of family physicians in Järveotsa and Koeru
– Tartu Ambulance
– Register of Causes of Death
• NERH, TUH and ETCH:
– 45% of Estonian health care budget and 55% of all
specialised medical treatment
Pilot Solution
East Tallinn
Central
Hospital
North
Estonia
Regional
Hospital
Tartu
University
Hospital
Järveotsa
centre of
family
physicians
Koeru
centre of
family
physicians
Tartu
Emergency
Aid
Registry of
Causes of
Death
X-Road
Patient’s
Portal
State
Registers
Message Exchange
Logic
Data
Security Layer
Internet
Digital documents - Epicrisis
Epicrisis – HL7 v3 XML
OTHER eHEALTH PROJECTS
Digital Images
• Electronic Health Records has separate links to
analysis results
• No need to make repeat analysis because of loss of
images
• Disease progress can be monitored over years since
data is stored at least 110 years
• (Foreign) experts can be
easily included in medical
procedures
• More efficient use of analysis
made with complex
diagnostics equipment
Digital Registration
• Overview of vacant reception times of all medical
specialists of the given area and a possibility to
book/cancel the reception time through a web portal
• Registration systems of medical establishments
continue to work in parallel
• Enables to remind the patient
about the reception time
• Provides an objective and
accurate survey of the length of
treatment queues in health
care establishments for health
care management and national
statistics
For further information please visit:
www.digilugu.ee
Thank You
For further information please contact:
Oliver Lillepruun
Project manager
Estonian eHealth Foundation
[email protected]