Lars Hulbæk Lars Hulbæk Deputy Manager [email protected]”From the home and the body - to the nurse and the GP” The vision: • Simple and easy connectivity between home monitoring systems and the national eHealth infrastructure - and existing EPR systems in all parts of the Danish health care sector • Support of a multi-supplier strategy and the market of home monitoring systems 1. National action plan for Telemedicine 2. National infrastructure and standards for home monitorering 3. The long and winding road to national dissemination
”From the home and the body - to the nurse and the GP”
The vision:
• Simple and easy connectivity between home monitoring systems and the national eHealth infrastructure - and existing EPR systems in all parts of the Danish health care sector
• Support of a multi-supplier strategy and the market of home
monitoring systems
1. National action plan for Telemedicine 2. National infrastructure and standards for home monitorering 3. The long and winding road to national dissemination
Lars Hulbæk
What is MedCom?
MedCom is a partnership of authorities, organisations and private enterprise associated
with the Danish health sector. In the 1999 financial agreement between the counties and
the government, it was decided to make MedCom permanent, with the following aims:
“MedCom shall contribute to the development, testing, dissemination and quality
assurance of electronic communication and information in the health sector with a view to
2001 Small scale pilots Focus on hospitals Radiology, pathology Today Focus on large scale implementation of mature telemedicine concepts Cooperation between hospital and district nurses Video conference Home monitorering
Telemedicine in Denmark - 12 years after…
Lars Hulbæk
National action plan for dissemination of telemedicine (August 2012)
A common plan for the Public Health Sector • Danish Government • Danish Regions • Local Government Denmark
Dissemination of mature telemedicine concepts 80 million DKK (10.7 million Euros) from the Danish Government and a significant contribution from regions and municipalities A part of the eGovernment Strategy 2011-2015 and the National eHealth Strategy 2013-2017
Moving from pilot projects within telemedicine to national scale implementation
What is a mature telemedicine solution? 1) Well functioning technical solution and infrastructure 2) Good user experiences or even clinical evidence 3) Positive businesscase
• Good Danish tradition for IT supported cross sector cooperation • Lack of national IT standards and IT infrastructure to the patients’
home • Lack of large scale experience and strong documentation • Lack of knowlegde about how to share the costs and benefits between
the hospitals, municipalities , and GPs • Lack of national tariffs for cross sector telemedicine
National action plan for dissemination of telemedicine (August 2012)
Clinical Integrated Home monitoring
• Large scale demonstration
• 2012-2014 (4,5 million euros) • Large scale demonstration of home monitoring • 5 clinical trials/patient groups, 1000 patients • 2 regions and 5 municipalities Technical part: • National database for data from patients home • National standards/profiles for integration to EPR and the national
eHealth portal • Developed in cooperation with the ”Tele Care Nord” project
• Version 1.0: 18 typical home monitorering parameters (”KIH and Telecare Nord”) • Generic interface – easy to extend with further parameters • Based on international NPU codes for laboratory medicine • Documented in OIO-XML and translated to HL7/PHMR (MedCom HL7 profile)
Technical status on Clinical Integrated Home monitoring
National database version 1.0 in use Placed in Region Nord, accessible from the National Health Net Interface for data collection from different home monitoring systems Interface for data sharing with EPR / health portal Interfaces based on OIO-XML (Laboratory Report) Interfaces based HL7/PHMR standards (Personal Health Monitoring Report)
Solution prepared for adoption in the National Service Platform Solution prepared for XDS (national/regional patient index) Access to data for patients at the national eHealth Portal sundhed.dk Status January 31, 2014 • 734 uniqe patients in the national database • 67.233 specific home monitoring results in the national database Primary focus in 2014: Support to the 5 clinical pilot-projects in ”Clinical Integrated Home monitorering” and ”Telecare Nord”: Clinical usefullness and Business Case validation Secondary focus in 2014: Test and integration with different suppliers of home monitoring solutions Reuse in any other Danish home monitorering projects / activities
Three steps to cross sector dissemination
- The MedCom way…
1) National consensus • Standards and infrastructure: To ensure a multi-supplier strategy • National business case and project plan: To ensure the marked for
eCollaboration
2) Pilot projects • ”First pilots”: Testing in daily use --------- National infrastructure for Home Monitoring, February 2014 ---------
• ”Secondary pilots: Implementation in all relevant IT systems
3) National dissemination - all relevant users
• Patient groups • Hospitals • Municipalities • GPs
Implies huge investments • Healthcare organisations • IT vendors Requires strong leadership • Courage: Selecting priority areas within telemedicine • Persistence: Ongoing support - all the way • Patience: The long and winding road to full dissemination…
