UNIVERSITY OF AARHUS DENMARK Frede Olesen, Res. Unit for GP, Univ. of Aarhus, Denmark

Fam. Med. and IT §The clinics are (nearly) without paper. §All fam. med. clinics are computerised l - lists of patients l - administration and billing systems l - records and prescription lists l - communication with hospitals referrals and discharge letters from lab. & diagnostic investigations, ambulatory care and hospital care §All clinics have acces to and use the Web

Fam. med. and IT - history §> 25 years ago standards from the College og GPs §The Fam. med. ass. would create one system – failed – went bankererupt §The college standards became national phrame of reference for 6-10 companies §Development driven by ’clinical added value’ and targeted time limited incentives §Now mandatory for GP’s with contract to health care §~15 years ago Medcom national state negotiated communication standards §~15 years ago standard for patients who change practice

Today’s developmental frontline §Communication to and from municipalities l social welfare and district nurses. §Quickly incentive driven raise in consultations §Decision support systems running and improved §ICPC coding with clinical advantages – probably incentives from 2009 §Data-capture to central database l reseach including pop up ad hoc registrations l chronic care databases – diabetes is implemented §IT hotel l prescriptions on a national server and database l referrals l ?? §Web based shared patient held part of records?? l pilot with pregnant women

Hospitals and IT §The ambition: to create a comprehensive system that can do everything. §National standards §Clinicians too far away in the proces l failed to be perceived as giving clinical added value §To many (>10) different systems §2007: a new beginning §Did the same mistakes as in GP in the beginning §Now: 5 – 10 years behind schedule

The vision and a good example l The x ray clinic in Vejle county hospital l 1: patient at a doc: you need an x-ray l 2: referral written and sent ’go to the hospital before 2 pm.’ – ’welcome, I have your referral. l 3: x-ray same day – max 1 (2) hour waiting l 4: voice-recognition and answer to GP in the afternoon l 5: next day: the result. l Productivity up more than x 5 at x-ray

Thank you for your attention….