eHealth Marketplace -From point-to-point pilots to a pan-European eHealth Marketplace Henning Voss Danish Centre for Health Telematics TTeC June 2006 Tromsø

Partners Facts: Ten partners Five countries Start: 2004 End: 2007 Budget: 2 M€

The idea… Introduction of eHealth in Rural areas Better access to specialized healthcare Less out migration from rural areas Healthcare and migration?

Factors having great importance for choice of current settlement, % (n=1988) Rural healthcare under pressure: Av: 39 Ageing population Lack of specialists 3 out of 4 doctors position cannot be permanently filled

The idea… Introduction of eHealth in Rural areas Better access to specialized healthcare Less out migration from rural areas

Radiology as a part of a comprehensive telemedicine and eHealth network in Northern Finland, Reponen J., Int J Circumpolar Health., 2004 Dec;63(4): Remote working: survey of attitudes to eHealth of doctors and nurses in rural general practices in the United Kingdom. Richards H, King G, Reid M, Selvaraj S, McNicol I, Brebner E, Godden D. Fam Pract Feb;22(1):2-7. Information Technology in the Rural Setting: Challenges and More Challenges. Frisse ME, Metzger J., J Am Med Inform Assoc Oct 18; Information technologies in Florida's rural hospitals: does system affiliation matter? Menachemi N, Burke D, Clawson A, Brooks RG., J Rural Health Summer;21(3): High-tech rural clinics and hospitals in Japan: a comparison to the Japanese average. Matsumoto M, Okayama M, Inoue K, Kajii E., Aust J Rural Health Oct;12(5): Cancer information needs in rural areas. Engelman KK, Perpich DL, Peterson SL, Hall MA, Ellerbeck EF, Stanton AL., J Health Commun Apr-May;10(3): Patient safety-related information technology utilization in urban and rural hospitals. Brooks RG, Menachemi N, Burke D, Clawson A. J Med Syst Apr;29(2):103-9 The promise of e-health--a Canadian perspective. Alvarez RC., World Hosp Health Serv. 2004;40(4):31-5. Literature study (subset)

The idea… Introduction of eHealth in Rural areas Better access to specialized healthcare Less out migration from rural areas Aim: Provide tools to make use of eHealth easier

Results Tools that facilitate use of eHealth:  Cross border eHealth infrastructure  Guidelines on how to overcome barriers for eHealth  Best practise examples

Results: eHealth Infrastructure Norway Vilnius Tallinn Sweden BHN Denmark ???

Results: Guidelines on how to overcome barriers for eHealth Legal (finalized) Reimbursement (pending) Organisational (pending) Cultural / linguistic (pending) => Contract template…

Results: eUltrasound pilot Classical Second opinion approach: Mid-wives and doctors in Västerbotten The Norwegian Centre for Fetal Medicine First step – off-line consultation Second step – on-line consultation

Results: eRadiology pilot Lack of Radiologists in Funen hospital  Waiting lists and traveling to other hospitals. Solution: Images are taken in Funen Reports are made in Vilnius and Tallinn Start with conventional radiology Multi-lingual standardized reporting schemes Goal: From pilot to production (incl. business model)

Structured Reporting Tool

Interesting finding: Acceptance of cross border remote reporting A:If I can get a faster treatment in Denmark, it is all right if a doctor in a foreign country does the reading of my X-rays B: ”I do not feel comfortable with having a doctor in a foreign country read my X-rays” 72 % agreed in statement A => high acceptance (n = 1988, Danish telephone survey, oct. 2005)

Follow up Today Basic infrastructure Point-to-point Guidelines on paper BSR Future eHealth marketplace Many-to-many Guidelines integrated Europe

Thank you for your attention ! Henning Voss Baltic eHealth and eHealth for Regions joint final conference: May in Stockholm Baltic eHealth is co-financed by the BSR Interreg III B programme