Estonian Electronic Health Record System (EHR) MD.Madis Tiik CEO Estonian E-Health Foundation
Architecture of Estonian healthcare IT STATE AGENCY OF MEDICINES - Handlers of medicines - Coding Centre HEALTH CARE BOARD - Health care providers - Health professionals - Dispensing chemists POPULATION REGISTER BUSINESS REGISTER HOSPITAL ( HIS) integration 2009 FAMILY DOCTORS 2009 PHARMACIS 2010 january SCHOOL NURSES 2011 september EMERGENCY MEDICAL SERVICE 2012 X-Roads, ID-card, State IS Service Register eHealth Foundation EHR SYSTEM 2009 Health Insurance INSURANCE REGISTER CLAIMS & REIMBURSMENT PRESCRIPTION CENTRE 2010 january PATIENT PORTAL 2009 HCP PORTAL 2011 XROADS GATEWAY SERVICE 2009 PHARMACIS AND FAMILY DOCTORS 2009
Situation in 01.05.2011 Availability of digital documents on the EHR Discharge letters (epicrises) 90% Out-patient consultation notes around 15% Other documents in the EHR Images raports immunization note Day surgery note Referrals Birth epicrises There are 4 886 891 ePrescriptions issued during 2010, it is more than 80% all prescriptions in 2010 100% of Radiological images (excl. dental) are digital and stored to the PACS More than 602 379 citizens have digital medical records in EHR – it is 47% of the population 29 105 citizens have viewed his/her data in EHR (Patient Portal)
Distribution of costs and benefits of Estonian e-Health platform (Digimpact study 2010) : Eesmärk: Miks on vaja toetada lõppkasutajaid- sest nemad ei ole otsesed kasu saajad, kuid peavad tegema olulise osa kuludest ja viima läbi muudatused. Kuna arstid on koolituselt konservatiivsed, siis on vastuseis ilmne Total cost of EHR system development (2005-2010) has been around 10M€ - it is 7.5€ per citizen http://eng.e-tervis.ee/digimpact-final.html
Estonian roadmap for eHealth Local EMRs Digital Claims & Reimbursement 1992 2010 2015 2020 Time Impact Simulation Environment Tracking Behaviour Tracking Online Intervention Lifestyle Value Added Shared care Personal Guidelines Care Paths Service Brokering Integrated Statistics Social Networking Decision Support Central EHR Health Portal Registries Integration Standardization Information Exchange Slaidi eesmärk oleks välja tuua etervise erinevad arenguetapid. Iga termin tahaks eraldi välja toomist ja enda jaoks spikrina kasutamiseks diskussiooni ajal
Healthcare transformation Patient data available to any clinician who needs to see it Legal reforms Access protocols Clinician engagement Payment for value and for care coordination Relationship between providers and payers Metrics of value Processes of coordination Preventive health maintenance centred on the patient Allocation of funding and staff Patient engagement E-Health is one thing that makes these transformations in healthcare possible, but it is not a substitute for the transformations! Põhiline sõnum peaks olema sellel slaidil- poliitika soovitused
e-Health=healthcare management e-Health ≠ICT project Thank you! e-Health=healthcare management e-Health ≠ICT project madis@etervis.ee wwww.etervis.ee