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EHealth in Austria
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eHealth in Austria Establishing a high level coordination committee for implementing the eHealth strategy. Karl P. Pfeiffer Department of Medical Statistics, Informatics and Health Economics Innsbruck Medical University, Austria Chairman of the WP 1: National eHealth Strategy

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Karl P. Pfeiffer Department of Medical Statistics, Informatics and Health Economics

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Karl p pfeiffer department of medical statistics informatics and health economics

eHealth in AustriaEstablishing a high level coordination committee for implementing the eHealth strategy

Karl P. Pfeiffer

Department of Medical Statistics, Informatics and Health Economics

Innsbruck Medical University, Austria

Chairman of the WP 1: National eHealth Strategy

karl-peter.pfeiffer@uibk.ac.at


Content

Content

  • The Austrian eHealth Initiative (EHI)

    • Aims of the Austrian EHI

    • Current situation

    • Strategic goals

    • First results from the working parties

  • Expected benefits from e Health

  • Discussion


The austrian ehealth initiative

The Austrian eHealth Initiative

  • Established in April 2005

  • >100 members from

    • IT-companies

    • Hospital organisations

    • Social and private insurance companies

    • Chamber of doctors

    • Chamber of pharmacists

    • Universities

    • Ministry of health and woman

    • eGovernment


Working parties in the ehealth initiative

Working Parties in the eHealth Initiative

  • AK1: National eHealth strategy

    • The results of AK2 – AK7 will be summarized in AK1 to a national eHealth strategy

  • AK2: Interoperability – standardisation

  • AK3: Patient identification and archiving

  • AK4: Network of the health care and social system, infrastructure

  • AK5: Customer related information systems

  • AK6: Health care system related information systems

  • AK7: Telemedicine


Ehealth mission

eHealth Mission

  • eHealth is a service for the citizen for continuous improvement of the Austrian health care system

eHealth is a service

for the citizen!


Ehealth vision

eHealth Vision

  • An ubiquitous management of health by supporting the processes of all health care professionals by using information technology with special attention to privacy and data safety

  • In some years all necessary data are available electronically for the person who has the right to access to this data

    • Independent of time and location


Ehealth topics

eHealth Topics

Strategy

Evaluation

Feasibility

Business Processes

Applications

Technology


Current situation of ehealth in austria

Current Situation of eHealth in Austria

  • Health Telematics Law

    • MAGDA-LENA

    • Guideline for secure digital communication in the health care sector

  • eCard

    • Introduction in 2005

  • EDIVKA

    • Standardized communication for reimbursement

  • eVGA

    • Registry of doctors and pharmacies

  • Austrian DRG system for inpatient financing since 1997

    • Standardized Minimum Basic Data Set

      • Diagnoses, procedures

  • ELGA – Elektronischer Gesundheitsakt

    • Electronic Health Care Record

    • Feasibility study is ongoing

  • Many (different) hospital and physician information systems


Karl p pfeiffer department of medical statistics informatics and health economics

The problem of the health care system

is not medicine,

it´s the organisation of health care!


Strategic goals of ehealth

Strategic goals of eHealth

  • Improvement of the quality of health care

    • by streamlining processes

    • by integrating processes

      • Improvement of the efficiency, effectiveness, safety, timeliness, …

  • Access to patient centred data for an optimal treatment and better patient management

  • Access to best medical knowledge

    • For citizen

    • For professionals

  • Access to data for a better management of health care institutions

  • Data for planning, quality assurance

Integrated health care


Content of ehealth

Content of eHealth

  • Patient centred electronic health care record

    • ELGA … Elektronischer Gesundheitsakt

    • Includes an active participation of the citizen

  • Health information networks

    • Presentation of medical knowledge

  • Telemedicine services

  • Mobile equipment

    • Especially monitoring systems

  • Decision support systems

  • Tools for processing of data for planning, management


Scope of the ehealth strategy 1

Scope of the eHealth Strategy /1

  • Documentation

    • Structured

    • Standardized nomenclature

    • Standard architecture for documents

    • Standardized document header or envelope

  • Communication

    • Based on standards

      • SOAP (XML, UTF8, MIME)

        • E.g. Letters for names of foreign citizen

      • IHE

      • HL 7 (V3)

      • DICOM

      • Recommendations from CEN TC 251

    • Secure and save

    • Hardware specifications for mobile equipment

      • ISO / IEEE 11073

Information autonomy

of the citizen!?


Scope of the ehealth strategy 2

Scope of the eHealth Strategy /2

  • Archiving and identification management

    • Key card

  • Role concept for access

    • Usability of a 4 step model?

  • Long term availability

  • Fast access

  • Registries and archives are organized by a trusted party

  • “A document should exist only once!”

  • Protocols of access

  • Processing

    • Decision support

    • Implementation of clinical pathways

    • Analysis for planning, quality assurance, management, financing, …

    • Scientific use


  • Participants in the ehealth strategy

    Participants in the eHealth Strategy

    • Citizen

      • Passive: patient

      • Active: diary of health care activities, sending data from mobile equipment

    • Actors, providers

      • Hospitals, ambulatories, doctors, pharmacies, dentists, nurses, …

    • Financiers

      • Social insurance companies

      • Private health insurance companies

      • National and provincial health care agencies

    • Science

      • Health economics, epidemiology

    • Politics

      • Planning

    • Public

      • Information about quality

      • Information about capacities

      • Medical knowledge


    Key elements of the ehealth strategy

    Key Elements of the eHealth Strategy

    • Unique person and patient identifier

    • Unique identifier of all health care providers

      • Registry with up to date data

    • Unique nomenclature for diagnoses, procedures, products, implants, …

    • Technical standards

    • Standardized architecture of key documents

    According to

    European standards!


    Infrastructure for ehealth

    Infrastructure for eHealth

    • Management of patient identification

      • eCard

    • Management of an up-to date registry of providers

      • Professional card

    • Pseudonymisation of data sets for data analysis

    • Master Patient Index

    • Archives

      • Centralized

      • Distributed environment

        • RHIO … Regional Health Information Organization

    • Meta data

      • Standardized terminology

      • Medical knowledge

    • Network infrastructure

      • Performance, security

    Interoperability


    Expected benefits of ehealth 1

    Expected Benefits of eHealth /1

    • Efficiency

      • Case and disease management

      • No doubled examinations

      • Data are available just in time

        • Decision can be made earlier

    • Effectiveness

      • Treatment according to newest medical knowledge

      • Seamless clinical pathways

      • Better admission and discharge management

    • Safety

      • Warning for drug interaction

      • Warning for allergies

    Quality

    Cost


    Expected benefits of ehealth 2

    Expected Benefits of eHealth /2

    • Patient centred

      • Basic data for anamnesis are available

      • Automatic reminder e.g. for vaccination

      • Interactive patient education

    • Timeliness

      • Identification of critical trends

        • E.g. electronic diabetes diary

      • Identification of patients at risk

    • Equality

      • Use of telemedicine services

      • Access to centres of excellence

    • Cost reduction

    Quality

    Kosten


    Discussion

    Discussion

    • Development of a road map

    • Identification of the most promising projects

      • Demonstration of

        • Benefit, utility, feasibility, cost

          • eMedication, eLab, eScheduling, eDischarge letter, eDiary, ePrevention, eEmpowerment, e…

          • Reminder for vaccination

          • Mother and child booklet

          • Disease management

        • Quality assured patient information

        • Quality assured information for professionals

          • Responsibility for the content

    • Setting up a legal framework for eHealth

      • Prohibition of non-care related misuse


    Road map

    Road Map

    Goal

    • Select use cases

      • Fitting in the global framework of eHealth

    • Identify the processes and the participants in this processes

    • Define the technology

      • Which standards are available?

      • Guarantee interoperability

    • Start with pilot projects

      • Coordinate with EU projects

    Start


    Main challanges expected

    Main Challanges Expected

    • Resistance to reorganisation

      • Change Management

      • Usability of the software

      • Structuring and standardization of documents

    • Responsibility for the infrastructure

    • Are the current technical standards the standards of the future?

    • Acceptance by the citizen


    Conclusion

    Conclusion

    • eHealth is the key for modernization of the health care systems

      • It is a long term, well organized process

      • It needs new legal regulations

    • We have to start now!

      • Otherwise the IT-systems are to heterogeneous

      • IT-investments should be in accordance with technical standards

    • We have to set up coordinated pilot projects under a European perspective

    • The benefits are evident!


    Karl p pfeiffer department of medical statistics informatics and health economics

    Thank you!


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