Continuity of care within and across borders. Lăcrămioara STOICU-TIVADAR President, Romanian Society of Medical Informatics. Challenges for European Health Systems. Demographic changes : more people will require prolonged care Increased prevalence of chronic diseases :
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Continuity of care within and across borders
President, Romanian Society of Medical Informatics
more people will require prolonged care
Increased prevalence of chronic diseases:
substantial part of the overall healthcare costs
Citizens’expectations and demands for high-quality care
Inadequate safety standards and quality control:
Inefficiencies and staff shortages
Reactive model of healthcare delivery:
treatment after appearance of symptoms
Rising healthcare costs:
faster than the economic growth itself
Increased life expectancy and the consequent increase in the prevalence of chronic illnesses pose serious challenges to the sustainability of the national health systems in Europe.
80 million senior citizens - population aged between 65 and 80 + years in Europe (EU-27) today
a doubling of this figure forecasted by 2050
the life expectancy is rising on average by 2.5 years per decade and the number of aged over 80 is expected to grow by 180% by 2050
e-Health - part of the solution, creating the basis for seamless care
2.7.2. Sustainable healthcare and ICT-based support for dignified and independent living
KA 13: Undertake pilot actions to equip Europeans with secure online access to their medical health data by 2015 and to achieve by 2020 widespread deployment of telemedicine services;
KA14: Propose a recommendation defining a minimum common set of patient data for interoperability of patient records […] by 2012
Foster EU-wide standards, interoperability testing and certification of eHealth systems by 2015 through stakeholder dialogue
Continuity of care is the process by which the patient and the physician are cooperatively involved in ongoing health care management toward the goal of high quality, cost-effective medical care.
the patient's experience of a 'continuous caring relationship' with an identified health care professional.
for providers in vertically integrated systems of care is the delivery of a 'seamless service' through integration, coordination and the sharing of information between different providers.
remote delivery mechanism,
proven capability to integrate with a wide variety of EMRs - a vey complex process to connect EMRs
provides an end-to-end solution that can overcome the challenges of integrating
the subscription-based model and scalable platform allows the flexibility to extend services over time to more practices, and connect with the broader community
“Interoperability is the only technical problem in telehealth; the other challenges are not technical"
Gerard Comyn, EC, DG ICT for Health
easy connection between software applications and between software applications and devices
wireless body or environmental sensors
Increased mobility of citizens and patients
“Europe needs a shared medical record to ensure the continuity of care and to deliver a “seamless service” across borders, through the sharing of information, co-ordination and integration between different providers.
Having one professional record and one patient record would lead to better continuity of care and decreased costs.”
Professor Eric Lepage, EPR Director for Assistance for Public Hospitals of Paris
e-Health Week, Budapest 2011
cooperation between member states in the field of healthcare has been strengthened
in the field of e-health and through the development of a Europeannetwork which will bring together, on a voluntary basis, the national authoritiesresponsible for e-health;
rare diseases, where the Commission willhave to support member states in cooperating in the field of diagnosis and treatmentcapacity;
epSOS enables continuity of care across national borders
30,000 healthcare professionals
1,113 point-of- care or general practice clinics.
(EH issue 02, 2010: ‘Crossing frontiers in e-health’)
Assisted Ambient Living and Welness
Augmented reality in healthcare
Personal healthcare systems
(MS SQL Server 2008)
(MS SQL Server 2008)
Sistem integrat de management al informaţiilor medicale utilizând standardul HL7
Continuity of care
Mihaela Vida, PhD student Oana Lupșe, MSc student
Valentin Gomoi, PhD student
Mihaela Vida, PhD student
A mobile EMR system will improve the legibility of clinical notes, will provide decision support for drug ordering, including allergy warning and drug incompatibilities. The system model proposed will supply a set of reminders to prescribe drugs or administrate them. Using a standard format for the lab results, will allow implementing the warnings for abnormal results.
Romina Pintea, PhD student
Results of tissues engineering studies can be
incorporated in patient‘s EHR for compatibility
Andreea Robu, PhD student
The data from the information systems of the hospitals are first converted into XML format, according to HL7 CDA standard and they are then saved in a database through webservice calls. The centralized data are then transformed into ARFF format, and analyzed with the data miningprogram WEKA, in order to extract new knowledge.
Raul Robu, PhD student
Domain: System engineering
Faculty of Automation and Computers
3 semesters + 1 semester diploma project