EHR Systems Quality Labelling and Certification Danish Case Morten BRUUN-RASMUSSEN MEDIQ Belgrade. 22 nd November, 2011

AGENDA 1.The Danish Health Care Sector 2.Certification 3.EuroRec Seal 4.Messaging 5.General Practitioner EHR systems 6.Shared Medication Record MEDIQ

The Danish Health Care Sector MEDIQ

Denmark  Parliamentary democracy and constitutional monarchy  5,5 mill. inhabitants 90,1% Danish 9,9 % other  5 Regions  98 Municipalities  Equal and free access to healthcare MEDIQ

Health Care System: Administrative levels Ministry of Interior and Health National Regional Local 5 Regions 98 Municipalities MEDIQ

Health Care Providers – 3 sectors Primary Care Responsible for: General health problems including prevention and chronic diseases Hospitals Responsible for: Specialised treatment and intensive care Municipalities Responsible for: Prevention, rehabilitation and social care MEDIQ

Certificatation MEDIQ

Business Model and Costs 2/12/10 Low Costs High Costs Third Party Certification Self assessment MEDIQ

Interoperability (ALT model) MEDIQ Communication Application level Logical level Technical level Semantic interoperability Technical interoperability presentation clinical content model format & storage transmission terminology functionality Clinical Interoperability Continuity and quality presentation clinical content model format & storage transmission terminology functionality Organisational level FUNCTIONAL TECHNICAL

EuroRec Seal MEDIQ

EuroRec Seal - Guideline Test environment Test scenarios Test data Conformance criteria's Schedule for testing Test log Delivery document MEDIQ Functional testing/certificaion

EuroRec Seal MEDIQ

Messaging MEDIQ

Cross sector communication  National health care network (1992  ) Frequent messages in large volumes Discharge letters, prescriptions, lab. request and results, referrals, consultation notes....  More than 100 profiles (2011)  Vendor systems are tested by MedCom MEDIQ Technical testing/certification Functional testing/certification +

5.5 mill. messages per month MEDIQ

Test results are published MEDIQ

GP systems and ICPC - 2 MEDIQ

ICPC  International Classification of Primary Care Has become a standard all over the world  The ICPC contains 17 chapters A General and unspecified B Blood, blood forming organs, lymphatics, spleen D Digestive F Eye H Ear K Circulatory L Musculoskeletal N Neurological P Psychological R Respiratory S Skin T Endocrine, metabolic and nutritional U Urology W Pregnancy, childbirth, family planning X Female genital system and breast Y Male genital system Z Social problems  ICPC 2 is an extended terminology  A Danish ICPC 2 code chart can be downloaded, printed and used by the GP to find an the ICPC code for a symptom/diagnose MEDIQ

GP systems in Denmark (June 2011) MEDIQ 16 vendor of GP systems

ICPC 2 - requirements MEDIQ  Enable coding of diagnosis in GP systems  A national specification for the implementation of ICPC 2  Agreed with the vendors  Systems must by certified Functional testing/certificaion

Conformance levels MEDIQ Test Group TestsTypeConformance level Baisic functionality28O1100% Core functionality21O280% Extented functionality26O340% Advanced functionality26A0%

ICPC test results are published MEDIQ Percent of tests passed

Shared Medication Record (SMR) MEDIQ

SMR: Paradigm shift FROM sending TO sharing MEDIQ

What is SMR? Central SMR service Secure Health- care network Service- platform Local EMR/EHR A Service provider of online medication data to share and update - Transport - Security, - Connection Local service consumer that uses online data via a distributed service platform MEDIQ

SMR and EHR in Hospitals  Five years work Specification Development Discussions  Mandatory to use Primary care Secondary care All other  Health professionals can be fined if they do not update the SMR  Fully implemented by end 2012 MEDIQ Technical testing/certification Functional testing/certification +

SMR on mobile devices MEDIQ

Thank you.. MEDIQ Morten BRUUN-RASMUSSEN