Transcript Document

eHealth Strategy for Lithuanian
Health Care Development
Andreas Wikholm, Håkan Håkansson, Staffan Nyed, Arunas Lukocevicius
2004-04-14
Andreas Wikholm © 2004 TietoEnator Trigon
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Contents
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Background
Aim
Methods
Results/Conclusion
Experiences
Questions
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Geography lesson…
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Lithuania
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Total population
GDP per capita
Total health expenditure per capita
Total health expenditure of GDP
Life expectancy at birth
Healthy life expectancy at birth
Child mortality
3.465.000
7.978 USD
478 USD
6.0 %
72 years
63 years
10/1000
Source: WHO Country files (Statistics from 2002)
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Why an eHealth strategy?
• Lithuanian Health Care is under rapid
development and we want to replace an
otherwise fragmented and disparate
development with a consistent, balanced and
coordinated set of actions.
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The eHealth strategy project…
• Started in February 2003
• Financial support mainly from World bank
(loan) and SIDA
• External consultants engaged for developing
an eHealth strategy
• Ambition to use results from accomplished
information and infrastructure analysis as
baseline for the strategy
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Deliverables from the eHealth project
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Inception report (plan of activities)
Report optimal model of eHealth structure based on experience of
European countries
Benchmarking activities; Study tours and conferences
National eHealth strategy; Information management and technology
development for 2003-2008
Implementation action plan for 2003-2008
Detailed investment project on the implementation of the strategy,
including technical specifications and biding documents for procurement
of equipment and services.
Workshop for county representatives (local implementation of the
strategy)
Workshop for the MoH and other institutions staff on management of
IS\IT development processes
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Our general working methods
• Information collection/check/anchoring:
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Documents
Interviews
Observations
Workshops
• Limited time has put much workload and
responsibility on the consultants
• Often more top-down than bottom-up
• Raised high demands of a close and effective
cooperation with skilful local expertise
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Simplified project organization
Ministry of Health
World Bank
Project Management Unit
Coordination/Steering
Committee
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Responsible
Consultants
(TietoEnator)
Andreas Wikholm © 2004 TietoEnator Trigon
Partners to consultants;
•Kaunas University of Technology
•Region Skania
•Health Economics Centre
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From Vision to Action: Way for development of the Strategy
Driving Needs of Key-Groups
Health Care Reform
Potential of Technology
Purpose & Goal for eHealth Development
Strategic Objectives for affected Health Care Processes
Communication with
Citizens & Patients
Actual Care,
Clinical Operatios
Management &
Administration
Capacity &
Competence
Strategic Objectives for affected Health Care Services
Access
services
Clinical
services
Records
services
Knowledge
Management services
Infrastructure,
Basic
Communication
Management Decision
support services
Central Components of the Strategy
Electronic/
digital
services
Technology base
& Technical
Infrastructure
Security,
Integrity &
Confidentiality
Governing &
Management
Operation
Process
Development
Education
&
Motivation
Financing
Strategytargets
Implementation
Action
Specific
and actionand
planning
Key Success Factors
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Organisation
Road Map
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Planning support
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Driving needs of key-groups
For Patients:
For Health Care Professionals:
•Faster access to high quality care
•Guidance for seeking medical advice and care
•Access to understandable and quality assured
information on disease and treatment
•Fast access to reliable patient information
•Direct and indirect communication with other
institutions
•Access to decision support
•Decreased paper work
•Access to effectiveness information
•Competence development
Strategic goals
supporting the
driving needs of key
groups
For Citizens:
For Managers & Administrators
•Access to understandable and quality assured
information on healthy lifestyles and health risks
•Availability of accurate information for
management and planning
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Purpose and goal for eHealth development
• The purpose is to lever, enable and support
the evolution of an effective, comprehensive
Lithuanian Health Care delivery
• The goal is to create an integrated eHealth
system and supporting structures that will
fulfill that purpose, at all levels
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From Vision to Action: Way for development of the Strategy
Health Care
Reform
Driving Needs of Key-Groups
Potential of Technology
Purpose & Goal for eHealth Development
Strategic Objectives for affected Health Care Processes
Communication with
Citizens & Patients
Actual Care,
Clinical Operatios
Management &
Administration
Capacity &
Competence
Strategic Objectives for affected Health Care Services
Access
services
Clinical
services
Records
services
Knowledge
Management services
Infrastructure,
Basic
Communication
Management Decision
support services
Central Components of the Strategy
Electronic/
digital
services
Technology base
& Technical
Infrastructure
Key Success
Factors
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Security,
Integrity &
Confidentiality
Governing &
Management
Operation
Process
Development
Education
&
Motivation
Financing
Strategytargets
Implementation
Action
Specific
and actionand
planning
Organisation
Road Map
Andreas Wikholm © 2004 TietoEnator Trigon
Planning support
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Strategic Objectives for HC Process
“Actual Care, Clinical Operations”
Example:
• High quality and good accessibility of HC and short waiting
for patients
• A rational and efficient working and cooperation environment
for care professionals including horizontal and vertical
integration
• Good access to the latest guidance and evidence on diagnosis
and treatment
• A secure handling of medical records that doesn’t jeopardize
patients’ personal integrity
• A fast and efficient ambulance service in coordination with the
general rescuing service
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From Vision to Action: Way for development of the Strategy
Driving Needs of Key-Groups
Health Care Reform
Potential of Technology
Purpose & Goal for eHealth Development
Strategic Objectives for affected Health Care Processes
Communication
with Citizens &
Patients
Actual Care,
Clinical Operatios
Management &
Administration
Capacity &
Competence
Strategic Objectives for affected Health Care Services
Access
services
Clinical
services
Records
services
Knowledge
Management services
Management Decision
support services
Infrastructure,
Basic
Communication
Central Components of the Strategy
Electronic/
digital
services
Technology base
& Technical
Infrastructure
Key Success
Factors
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Security,
Integrity &
Confidentiality
Governing &
Management
Operation
Process
Development
Education &
Motivation
Financing
Strategy targets
Implementation
Action
Specific
and actionand
planning
Organisation
Road Map
Andreas Wikholm © 2004 TietoEnator Trigon
Planning support
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Basic logic and criteria for choosing actions
out of strategic goals
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Priorities given by legislation, political decisions, intentions and goals
concerning HC in Lithuania (and degree of support to the “Information
Society”)
Compliance concerning the addressing of strategic goals
The set of different strategic goals served by the action in question
The degree of benefits from a certain effort
Consistency between initiatives made and projected
The pace in which the effort will produce measurable benefits
Possible demands on consequential efforts and investments to make a certain
initiative effective
The projected total life cycle cost of an investment
Availability of means and methods for financing of the investment and
measures on the return on the investment (indicators)
The degree of empowerment and/or use of investments done already
The expected/projected spin-off or useful side effects
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Results/Conclusion
• Lithuania has a golden opportunity to develop eHealth
solutions that are clearly in accordance with, and a
driving force for, the Health Care development
• The first step is to furnish the Primary Care level with
necessary services (and equipment)
• The second to enable hospitals and specialist
organisations for interaction with those services
• The third to establish sufficient communication facilities
• All these efforts must comply with chosen standards for
the exchange of information, sufficiently compatible
with the European standards framework for medical
informatics
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General experiences
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Stakeholder analysis
Local involvement
Benchmarking activities
“The strong ones” expect financial support
It takes time…
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Any questions?
Or later…
[email protected]
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Thank you for your attention!
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The Lithuanian Case –
Conditions and Peculiarities
• Lack/unevenly distribution of basic tools, i e
computers and basic programs
• The staff in different parts of the HC organisation
have limited experience and routine concerning
comprehensive implementation projects
• A lot of people in the HC organisations need to
enhance their knowledge and skills concerning using
computer support
• A limited legacy makes it easier to introduce
common solutions
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Key-factors for success
• Top-down commitment and bottom-up involvement –
engage people at all levels
• A broad understanding and acceptance of goals and
strategy
• A decisive and sustainable implementation
• Good incentives/financial solutions; Motivation
• A supportive management and administration aiming
to voluntary compliance
• Applying/using standards and other common
infrastructure
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Prioritized Actions
Prioritizing of the patient turns focus on the access and
quality of the crucial sources of information for treatment.
Action: The generation, handling and use of that information
together with means for communication peer to peer and
between institutions are the prime areas for development.
Other initiatives refer to these parts and evolve around them,
based on the firm core information base generated.
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Prioritized Actions
Connectivity and communication are necessary qualities in
the services to come, integration is essential – and that
demands standardization.
Action: To manage standardization and other aspects of
common interest, roles must be established and organised.
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Prioritized Actions
Introducing these services automatically results in adding
basic infrastructure such as computers.
Action: That in turn calls for education concerning both
generic skills regarding IT Technology and specific
knowledge on the services and software supplied and
applied.
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