GOALS AND PERSPECTIVES GOALS AND PERSPECTIVES OF THE BILATERAL PROGRAMME ON OF THE BILATERAL PROGRAMME ON CNR – ITBA - Epidemiology and Medical Informatics Unit, Milan Templar Partnership Company, Budapest 1 INTEGRATION OF DATA AND SYSTEMS BETWEEN MEDICAL STRUCTURES IN HUNGARY AND ITALY Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999. Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999. PROJECT COORDINATORS: THE INTEGRATION OF DATA AND SYSTEMS BETWEEN MEDICAL STRUCTURES IN HUNGARY AND ITALY Dr. Pál Simon Dr. Pál Simon, Dr. Franceso Sicurello Dr. Franceso Sicurello, C.N.R I.T.B. ISTITUTO DI TECNOLOGIE BIOMEDICHE SEGRATE (MILANO)

 The The objectives objectives and the the health professional ideas that founded the Italian – Hungarian bilateral programme The chapters chapters of the presentation The short history and the the results of the Italian – Hungarian bilateral programme About the further plans: plans: aproposed common system-model variant CNR – ITBA - Epidemiology and Medical Informatics Unit, Milan Templar Partnership Company, Budapest Conclusions and perspectives 2 [from the references are linked: 1, 2, 3, 5] [from the references are linked: 4, 6, 7, 9] 8, 10 [from the references are linked: 8, 10] INTEGRATION OF DATA AND SYSTEMS BETWEEN MEDICAL STRUCTURES IN HUNGARY AND ITALY Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999. Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/ Pál Simon M.D. Ph. Sc., László D. Molnár M.D., Béla Juhász: Portable Electronic Patient Record with special database functions (PATREC): preparation of the health card system application. Health Cards ’99 Congress, Milan, 5-7 october 1999, Proceedings: pp Pál Simon: Multifunctional Smart Doctor Card MSDC. Smart Card Italia – IV Conference-Exhibition on Smart Cards: technologies and Applictions. December 12, 2000, University Bicocca, Milan. 3 Pál Simon M.D. Ph. Sc., Dénes Kellner, László Békési M.D., István Loványi, István Schiszler M.D.: Portable Patient Record Model (PPRM) for the introducing of smart card system and preparation of the interactive database network. MEDINFO 2001 London, September Poster, proceedings 252 – 8. 5 SMART CARDS AND THE BACKGRUOND SYSTEMS. Conference on the tasks defined by the eEurope and eEurope + initiatives. June 28 – Budapest. Proceedings, Senior editor: Dr. Pál Simon. 4 B. Righetti (Scientific Attaché Italian Embassy, Budapest): Cooperation programs in health informatics between Italy and 2001 Conference, September, 2001 Palermo. 6 Advanced Course on medical Informatics, Bio-Informatics and Statistical Software. Course CNR LITA Palace Milano, May Course Coordinator: Francesco Sicurello, Faculty: Pál Simon professor and researhcer Templar Partnership Company. 9 Towards Telemedicine and Health Informatics Cooperating Network between Italy, Hungary and Central-East European Countries. Workshop in the frame of MIE 2002 Budapest (Congress Centre University of Sciences, Room G, August 28). Chairmen: Benito Righetti ( Scientific Attaché of Italian Embassy in Budapest ) 7 Smart cards access technology to secure information systems and (interactive) services. Workshop May 2002 Budapest, IST Co-ordination Point of the Ministry of Education, Research and Development Division, Templar Partnership Company. 8 Dr. Francesco Sicurello, Dr. Pál Simon, Dr. Patrizia Magretti (Ms), Ágota Medgyesi (Ms): The Goals and the Perspectives on the common research and development work about the Italian – Hungarian bilatreal programme. MIE 2002 G Surjan at all (eds) IOS Press 2002, Proceedings: pp. 10 The theme market for young health informatics professionals. Coordinators: Dr. Pál Simon and Dr. Francesco Sicurello. Workshop7 in the framework of the XVII th Medical Informatics Europe. MIE 2002 Budapest

The The objectives objectives and the the health professional ideas ideas that founded the Italian – Hungarian bilateral programme To collect the medical data bank networks from different services for common interactive use; CNR – ITBA - Epidemiology and Medical Informatics Unit, Milan Templar Partnership Company, Budapest 3 The modern health information system has to provide information about the care-needs of the population and the patients, the immaterial and material conditions of health care, the functioning of the health care process and has to analyse the outcome of care, to evaluate the efficiency of care and to compare original needs and changing demands. To collect the problem-oriented portable medical record structures for the analysing of quality control and controlling on individual and on population level; To prepare the realisation of the high-speed networks and databases, the multifunctional smart card systems. INTEGRATION OF DATA AND SYSTEMS BETWEEN MEDICAL STRUCTURES IN HUNGARY AND ITALY Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999. Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999.

The main milestones milestones of the Italian – Hungarian bilateral programme The organization and the realisation of the Smart Cards and the Background Systems a conference in Budapest on June, 2001 CNR – ITBA - Epidemiology and Medical Informatics Unit, Milan Templar Partnership Company, Budapest 4 Conference in Palermo on September, 2001: the survey of the Italian and Hungarian projects on telemedicine, patient record structures and health cards systems The collaboration in the organisation of the eSmart Card info day in Budapest on May, 2002 with IST Hungarian Co-ordination Point The organisation of the workshops ‘The theme – market for young health informatics professionals’ ‘Telemedicine Copertaing Network between Itlay, Hungary CEE Countries’, ‘NEUROWEB’ in the framework of MIE 2002 INTEGRATION OF DATA AND SYSTEMS BETWEEN MEDICAL STRUCTURES IN HUNGARY AND ITALY Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999. Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999.

About the further plans: aproposed common system-model system-model variant CNR – ITBA - Epidemiology and Medical Informatics Unit, Milan Templar Partnership Company, Budapest 5 provides the individual on-line patient follow-up in an interactive way - patient-oriented organising concept The goal is to develop the prototype of a model system which supports medical activities and their evaluation - quality-oriented organising concept offers real-time services to the management of the department and the institute - management-oriented organising concept on the GOVERNMENTAL LEVEL REGIONAL LEVEL MEDICAL WORKING PLACE INTEGRATION OF DATA AND SYSTEMS BETWEEN MEDICAL STRUCTURES IN HUNGARY AND ITALY Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999. Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999.

Health Insurance Competence CENTRAL REVENUE OFFICE CONTRIBUTION REGISTER SYSTEM SERVICES: INDIVIDUAL INFORMATION FOR THE PATIENTS INDIVIDUAL INFORMATION FOR THE PATIENTS (COMPETENCE SERVICES, CONTRIBUTION – EMPLOYMENT BALANCE) SYSTEMATIC DECISION MAKING INFORMATION FOR THE MANAGEMENT SYSTEMATIC DECISION MAKING INFORMATION FOR THE MANAGEMENT (THE HEALTH INSTITUTES, HEALTH INSURANCE, GOVERNMENTAL ORGANS) Competence controlling, separating of deficient competence, contribution Set of portable patient records CNR – ITBA - Epidemiology and Medical Informatics Unit, Milan Templar Partnership Company, Budapest 6 GOVERNMENTAL LEVEL INTEGRATION OF DATA AND SYSTEMS BETWEEN MEDICAL STRUCTURES IN HUNGARY AND ITALY Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999. Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999.

PATIENT CARD CARD P HEALTH CARE – MEDICAL - ACTIVITIES ANAMNESIS, STATUS, INVESTIGATIONS, DIAGNOSIS, THERAPY, QUALITY CONTROL, CONTROLLING COMPARISON BETWEEN ORIGINAL CARE AND MEDICAL PROTOCOLS: QUALITY CONTROL DIRECT AND INDIRECT COSTS OF CARE: CONTROLLING INDIVIDUAL FOLLOWING INFORMATION ABOUT THE HEALTH CARE ACTIVITIES PORTABLE PROBLEMORIENTED RECORD POSTERMINAL ADTINPUT P Health insurance competence control activating preliminary health status Qualification of health care and health status Certifying of health care results, quality control and controlling SYSTEM SERVICES: MANAGEMENT-ORIENTED AND PATIENT-ORIENTED INFORMATION (FROM PORTABLE RECORDS TO PROBLEM-ORIENTED PORTABLE RECORDS) Certifying of health care and health insurance competence CNR – ITBA - Epidemiology and Medical Informatics Unit, Milan Templar Partnership Company, Budapest REGIONAL LEVEL ADTOUTPUT PATIENT CARD CARD DOCTOR DOCTOR 7 INTEGRATION OF DATA AND SYSTEMS BETWEEN MEDICAL STRUCTURES IN HUNGARY AND ITALY Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999. Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999.

PATIENT RECORD FIELDS ADMINISTRATIVE IDENTIFICATION PERSONAL IDENTIFICATION, ADDITIONAL INSURANCE, SPECIAL INSTRUCTIONS RISC FACTORS RISK CATEGORIES, QUALIFICATION OF RISC EMERGENCY DATA BLOOD GROUP, CONGENITAL DISEASES, ACQUIRED DISEASES, ALLERGY, PERMANENT DRUGS, IMMUNISATION, RADIATION THERAPY HEALTH CARE LEVEL ID NUMBER OF CARE, IDENTIFICATION OF CLINICS, IDENTIFICATION OF WARD DOCTOR HEALTH CARE ACTIVITY DIAGNOSIS, DIAGNOSTICS, SURGERY, SURGEON, THERAPY QUALITY CONTROL, CONTROLLING FINAL DIAGNOSIS OF PATIENT, CLASSIFICATION OF THE OUTCOME OF DISEASES, QUALIFICATION OF THE PATIENT’S STATUS, QUALIFICATION OF THE PATIENT BY NEEDS OF PERMANENT CARE, TOTAL PATIENT’S BILL (detailed and total), CHARGE OF CARE FROM HEALTH INSURANCE (pay by DRG) PATIENT RECORD FIELDS ADMINISTRATIVE IDENTIFICATION PERSONAL IDENTIFICATION, ADDITIONAL INSURANCE, SPECIAL INSTRUCTIONS RISC FACTORS RISK CATEGORIES, QUALIFICATION OF RISC EMERGENCY DATA BLOOD GROUP, CONGENITAL DISEASES, ACQUIRED DISEASES, ALLERGY, PERMANENT DRUGS, IMMUNISATION, RADIATION THERAPY HEALTH CARE LEVEL ID NUMBER OF CARE, IDENTIFICATION OF CLINICS, IDENTIFICATION OF WARD DOCTOR HEALTH CARE ACTIVITY DIAGNOSIS, DIAGNOSTICS, SURGERY, SURGEON, THERAPY QUALITY CONTROL, CONTROLLING FINAL DIAGNOSIS OF PATIENT, CLASSIFICATION OF THE OUTCOME OF DISEASES, QUALIFICATION OF THE PATIENT’S STATUS, QUALIFICATION OF THE PATIENT BY NEEDS OF PERMANENT CARE, TOTAL PATIENT’S BILL (detailed and total), CHARGE OF CARE FROM HEALTH INSURANCE (pay by DRG) DATA OF THE HEALTH CARE EPISODES IN THE PATIENT RECORDS THE SEPARATION AND RECLASSIFICATION OF THE DATA ON HEALTH CARE PROCESS DATA BASE CONSTRUCTION ON A WORKSTATION OF MEDICAL WORKING PLACE DIAGNOSTICS DATA, CHANGING OF DIAGNOSIS CLASSIFICATIO N OF MEDICAL INDICATION DATA ABOUT THE OUTCOME OF CARE DATA OF DIRECT COST OF CARE DIAGNOSTICS DATA, CHANGING OF DIAGNOSIS CLASSIFICATION OF MEDICAL INDICATION DATA ABOUT THE OUTCOME OF CARE DATA OF DIRECT COST OF CARE DIAGNOSTICS DATA, CHANGING OF DIAGNOSIS CLASSIFICATION OF MEDICAL INDICATION DATA OF DIRECT AND INDIRECT COST OF CARE DATA ABOUT THE OUTCOME OF CARE Portable Patient Record QUALITY CONTROL OF HEALTH CARE, QUALIFICATION OF HEALTH STATUS Portable Patient Record CONTROLLING, COST BENEFIT OF HEALTH CARE PROBLEM-ORIENTED PORTABLE RECORDS ON A WORKSTATION OF MEDICAL WORKING PLACE PATIENT RECORD FIELDS ADMINISTRATIVE IDENTIFICATION PERSONAL IDENTIFICATION, ADDITIONAL INSURANCE, SPECIAL INSTRUCTIONS RISK FACTORS RISK CATEGORIES, QUALIFICATION OF RISK EMERGENCY DATA BLOOD GROUP, CONGENITAL DISEASES, ACQUIRED DISEASES, ALLERGY, PERMANENT DRUGS, IMMUNISATION, RADIATION THERAPY HEALTH CARE LEVEL ID NUMBER OF CARE, IDENTIFICATION OF CLINICS, IDENTIFICATION OF WARD DOCTOR HEALTH CARE ACTIVITY DIAGNOSIS, DIAGNOSTICS, SURGERY, SURGEON, THERAPY QUALITY CONTROL, CONTROLLING FINAL DIAGNOSIS OF PATIENT, CLASSIFICATION OF THE OUTCOME OF DISEASES, QUALIFICATION OF THE PATIENT’S STATUS, QUALIFICATION OF THE PATIENT BY NEEDS OF PERMANENT CARE, TOTAL PATIENT’S BILL (detailed and total), CHARGE OF CARE FROM HEALTH INSURANCE (pay by DRG) Problem-oriented record types QUALITY CONTROL OF HEALTH CARE, QUALIFICATION OF HEALTH STATUS Problem-oriented record types CONTROLLING, COST BENEFIT OF HEALTH CARE CNR – ITBA - Epidemiology and Medical Informatics Unit, Milan Templar Partnership Company, Budapest 8 INTEGRATION OF DATA AND SYSTEMS BETWEEN MEDICAL STRUCTURES IN HUNGARY AND ITALY Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999. Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999. MEDICAL WORKING PLACE

Conclusions and perspectives CNR – ITBA - Epidemiology and Medical Informatics Unit, Milan Templar Partnership Company, Budapest 9 Circumstances influence the realisation of this common common model: the differences in the material and immaterial conditions of the health care network; the differences in the health insurance systems ; the status of the information and communication technology ; the situation of the education and the scientific-research activities in health informatics; the economic situation. The perspectives are: are: to continue the realisation realisation of the similar similar health informatics model model in the medical working place place level of health care system in the framework of the further bilateral cooperation INTEGRATION OF DATA AND SYSTEMS BETWEEN MEDICAL STRUCTURES IN HUNGARY AND ITALY Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999. Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999.

CNR – ITBA - Epidemiology and Medical Informatics Unit, Milan Templar Partnership Company, Budapest 10 INTEGRATION OF DATA AND SYSTEMS BETWEEN MEDICAL STRUCTURES IN HUNGARY AND ITALY Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999. Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/ Pál Simon M.D. Ph. Sc., László D. Molnár M.D., Béla Juhász: Portable Electronic Patient Record with special database functions (PATREC): preparation of the health card system application. Health Cards ’99 Congress, Milan, 5-7 october 1999, Proceedings: pp Pál Simon: Multifunctional Smart Doctor Card MSDC. Smart Card Italia – IV Conference-Exhibition on Smart Cards: technologies and Applictions. December 12, 2000, University Bicocca, Milan. 3 3 Pál Simon M.D. Ph. Sc., Dénes Kellner, László Békési M.D., István Loványi, István Schiszler M.D.: Portable Patient Record Model (PPRM) for the introducing of smart card system and preparation of the interactive database network. MEDINFO 2001 London, September Poster, proceedings 252 – B. Righetti (Scientific Attaché Italian Embassy, Budapest): Cooperation programs in health informatics between Italy and 2001 Conference, September, 2001 Palermo. 5 5 SMART CARDS AND THE BACKGRUOND SYSTEMS. Conference on the tasks defined by the eEurope and eEurope + initiatives. June 28 – Budapest. Proceedings, Senior editor: Dr. Pál Simon. 6 6 Advanced Course on medical Informatics, Bio-Informatics and Statistical Software. Course CNR LITA Palace Milano, May Course Coordinator: Francesco Sicurello, Faculty: Pál Simon professor and researhcer Templar Partnership Company. 7 7 Smart cards access technology to secure information systems and (interactive) services. Workshop May 2002 Budapest, IST Co-ordination Point of the Ministry of Education, Research and Development Division, Templar Partnership Company. 8 8 Dr. Francesco Sicurello, Dr. Pál Simon, Dr. Patrizia Magretti (Ms), Ágota Medgyesi (Ms): The Goals and the Perspectives on the common research and development work about the Italian – Hungarian bilatreal programme. MIE 2002 G Surjan at all (eds) IOS Press 2002, Proceedings: pp. 9 9 Towards Telemedicine and Health Informatics Cooperating Network between Italy, Hungary and Central-East European Countries. Workshop in the frame of MIE 2002 Budapest (Congress Centre University of Sciences, Room G, August 28). Chairmen: Benito Righetti ( Scientific Attaché of Italian Embassy in Budapest ) The theme market for young health informatics professionals. Coordinators: Dr. Pál Simon and Dr. Francesco Sicurello. Workshop7 in the framework of the XVII th Medical Informatics Europe. MIE 2002 Budapest Bibilography (selection):

Thank you for your attention ! CNR – ITBA - Epidemiology and Medical Informatics Unit, Milan Templar Partnership Company, Budapest 11 INTEGRATION OF DATA AND SYSTEMS BETWEEN MEDICAL STRUCTURES IN HUNGARY AND ITALY Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999. Italian – Hungarian bilateral project on health informatics 2000 – 2003, Registration Number: I-7/1999. Together Together for the not beyond beyond far-away far-away future!