eHealth Strategy for Romania

Dr. Andrei KOZMAMinister of Health’s Adviser

Sep 2010

Ministerul Sanatatii

Integrated Health Information System (IHIS)

eHealth vision

Future expectations

Electronic Data Management

Ministerul Sanatatii

Medical practice evolution:

From the treatment of acute illness, to the prevention of disease;

From considering each patient as an isolated entity, to perceiving the patient as a member of a population;

From a focus on the individual, to the broader perspective of public health

From paper documentation to an electronic, paperless environment

eHealth vision

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In order to obtain optimal results, a National Health Information Strategy is required:

Interoperability

Security

Data confidentiality

Cost-effectiveness

Standardisation

IHIS

eHealth visionMinisterul Sanatatii

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The eHealth system should be designed in a manner that would offer the best possible results for its main beneficiaries: the patients

IHIS

eHealth visionMinisterul Sanatatii

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Electronic Data Management

Patient related medical data, gathered in a consistent and uniform manner, nationwide, constitutes the Electronic Patient File (EPF), sometimes referred to as Electronic Medical Record (EMR)

EPF is generated at birth, is updated throughout the patient’s life and is stored in the system for an undetermined period of time.

EPFs must be interoperable, secure, consistent, safe and must ensure data confidentiality.

IHISMinisterul Sanatatii

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All medical service providers must contribute in the EPF in a standardized format.

This does not mean all medical service providers must use the same Health Information System, but the Ministry of Health should enforce the use of a minimum set of standards, in order to ensure interoperability.

The medical data stored in the EPF can be accessed by the authorised clinicians at any time and from any location.

Electronic Data ManagementIHISMinisterul Sanatatii

eHealth objectives (1/2):

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Improved quality, safety and efficiency of the clinical processes

Timely access to patient electronic medical data whenever and wherever they are needed

Patient access to their own medical records and to relevant health information

Communication and information exchange between multi-disciplinary medical teams

Future expectationsIHISMinisterul Sanatatii

eHealth objectives (2/2):

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Extensive use of international best practice guides and procedures

Unified national healthcare and health insurance data collection, both in the public and private health system

High level of security, confidentiality and control in relation to information management

Continuous health system improvement by ensuring a transparent and optimized reporting process

Implementation of a better informed health strategy

Future expectationsIHISMinisterul Sanatatii

Chronic Disease Management

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Chronic diseases: are long term conditions (over 6 months) are not contagious produce certain disfunctionalities or handicaps in most cases, do not improve over time are rarely healed completely

Chronic diseases are the main cause of death and morbidity, e.g. Europe (87% of all deaths, in high income countries, according to WHO – World Health Organisation)

Future expectationsIHIS

CDM represents a systematic approach to improving the quality of the medical services provided for the chronic disease patients.

Chronic Disease Management

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Instrument: an efficient system for the remote monitoring of chronic disease patients and the prevention of related medical complications

Future expectationsIHISMinisterul Sanatatii

Remote medical monitoring enables medical professionals to monitor a patient

remotely using various technological devices Improves the quality of life for chronic disease

patients, by reducing the number of hospital admissions

e.g. Electrocardiogram by phone

Telemedicine

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Interactive telemedicine services Teleradiology and teleconsultations:

shorter waiting lists, optimized use of resources

Future expectationsIHISMinisterul Sanatatii

Telemedicine

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Homecare devices and applications

Glycaemia measurement devices

Blood pressure measurement devices

Devices for the recording of vital signs and other clinical indicators

Future expectationsIHISMinisterul Sanatatii

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IHIS Major Components

Electronic Health RecordCDM – Chronic Disease Management

e-PrescribingHealth Cards

Ministerul Sanatatii

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Health Cards

Only after interoperability and infrastructure availability are ensured can we talk about a viable Electronic Health Card system implementation.

IHIS Major ComponentsMinisterul Sanatatii

The experience of other EU states regarding Health Cards indicates that, whenever an implementation was successful, the cards were used as identification devices, rather than data storage.

[ In Germany, the efforts made over the last 8 years to implement a National Health Card System have not materialized yet.]

Even so, we consider that the introduction of a Romanian Health Card could have beneficial effects if proper approach and goals are adopted.

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IHIS Major Components

Health Cards

Ministerul Sanatatii

Stores administrative information regarding health insurance.

Confirms the right of the patient to have access to medical treatment.

Health Card Functions

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Health CardsIHIS Major ComponentsMinisterul Sanatatii

Requirements:

new forms

new types of printers

reliable Internet connection

Introduction

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The existance of a well structured EPF system offers the basis for the implementation of a national ePrescribing system

e-PrescribingIHIS Major ComponentsMinisterul Sanatatii

Advantages of an electronic prescribing system:

clear prescription text

minimization of human errors, through the implementation of a prescription validation expert system

limitation of fraud risks to the system

facilitates efficient resource management

automatic reporting process

Introduction

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e-PrescribingIHIS Major ComponentsMinisterul Sanatatii

Prescription example (standard form)

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Medication details

2D Barcode – contains details about the medication and the patient

Unique identifier

Patient related data

1D Barcode – contains form number and doctor’s ID number

e-PrescribingIHIS Major ComponentsMinisterul Sanatatii

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Pre-requirements:

Standardized, complete and correct electronic medical data collection

Existence of IT tools for data analysis and statistical reports generation

Action: National EHR (Electronic Health Record) implementation

Objective: resource allocation and management according to national or even EU-level policies

Electronic Health RecordIHIS Major ComponentsMinisterul Sanatatii

EHR – Electronic Health Record

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EHR is a complex system (comprising of hardware, software, people, policies and processes) which:

Gathers data from multiple sources

Is used by clinicians as a primary information source at the point of care

Offers decision support in evidence based healthcare.

The term describes the highest level of functionality in medical data computerized management

Electronic Health RecordIHIS Major ComponentsMinisterul Sanatatii

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Information systems

Electronic Patient File

Medical service providers

Primary level

Decision level Decision

makers

Medical dataEconomic data

Electronic Health Record

eHealth system structure

Decisions

IHIS Major ComponentsMinisterul Sanatatii

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Conclusion

eHealth Strategy

Ministerul Sanatatii

This presentation, too brief - considering the importance of the issues in hand, aims to mark the importance of:

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Conclusions

eHealth Strategy

a coherent and stable (at least – for mid-term) eHealth strategy

proper definition of the roadmap and milestones

appropriate funding for each of the steps to be taken

Ministerul Sanatatii

Benefits:

Deployment at a national level of an integrated eHealth

system, part of a national eHealth Vision

Reuse of solutions and experience from similar

countries

Use of the state of the art technologies

Unique patient health record

Infrastructure and information to support the long term

health strategies

Improved health services and quality of lifeApril 11, 2023 26

Conclusions

eHealth Strategy

Ministerul Sanatatii

Thank you for your attention!

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eHealth Strategy for Romania

Dr. Andrei KOZMA

Ministerul Sanatatii