1. Using IT as a Strategic Tool to Achieve better Health How to Gain National Equality in Health IT Solutions Peder Jest, Exec. Director, CMO, Odense University Hospital, DK

2. EMR Adoption Model Scores, Means per Bed Size Segment Denmark 1 (24) Small (1 – 199 beds) (2) Medium (200 – 499 beds) (9) Large (>500 beds) (13) Source: HIMSS Europe Database, 07/25/2014 EMRAM Score (Means) Equality in health IT implementation

3. One strategy as means to insuring similar standards Strong partnerships Making it easy for the citizen Making most of the ressources Stable service Making it easy for health employes Coherent patient cycle Ensuring coherent, effective and similar digitizaion

4. Goal 1 Goal 2 Goal 3 Goal 4 Goal 5 Goal 6 (Telepsych.) (Logistics) (Service & Quality) ( Benchmark) (Internet psych.) (pharmacy system)

5. Standards for IT architecture are crucial

6. 3 LEVELS OF GOVERNANCE Cross-regional Portfolio and Project Governance Regional Project Governance Local Project Governance

7. Health record available online for all

8. Advantages of MAST Described in Kidholm et al. (2012) Based on EUnetHTA and healthcare decision makers' need for information Focused on the need for maturation of telemedicine interventions Examples of relevant outcomes and outcomes measures: –Accessibility –Technical reliability –Patient acceptance –Business case –… Improving the scientific level of data collection and reporting:

9. MAST: The most widely used framework in the EU

10. On-going work on MAST Publication of results from studies of telemedicine applications: Sorknaes et al. (2013): Telemedicine for COPD patients Thorbjørnsen et al. (2014): Telemedicine for diabetes patients Holmen et al. (2014): Telemedicine for diabetes patients Minet et al. (2015): Telerehabilitation Cano et al. (2015): Integrated care MAST courses: Berlin 2012 Treviso 2013 Paris 2014 Bilbao 2014 Odense 2014 … Implementation of the mini-MAST checklist in Danish Regions Extension of MAST’s scope to cover Integrated care (underway) Mental Health (underway)

11. DesignD2: Safety D3: Clinical D4: Patient Perception D5: Economics D6: Organisation Baby Briefcase Pilot COPD Briefcase RCT Telemedicine for Diabetic Foot Ulcer ptts RCT Tele- rehabilitation Cohort Tele- interpretation Pilot Tele-dischargePilot Results from 6 MAST assessments of new services

12. Players in the Region Southern Denmark – Telemedicine OUH Uptake Region SD Regional Development department Regional Development department Regional Health Direction SDSI CoLab OUH CIMT Odense Municipalit y Odense Municipalit y 9 Municipalities Public Authorities Smaller companies/SM Es Private Players Big Companies International Companies Sydenergi Trefor Local energy companies Local energy companies Other Players Welfare Tech Patient@home MedCom Science Park Institute of Technology Institute of Technology Patient organizations

13. Developing indicators: Levels of demand Level of detail Political level Local level: Administrative and clinical tool Regional level: administrative tool The more frequent reporting, the greater demands on available data

14. Developing indicators – a framework StructureProcess Result Professional quality Organisational quality Patient-perceived quality AvailabilityUsage Effect

16. Driving clinical value from political aims Ensuring certainty of quality in health IT solutions Creating equal opportunity for all social groups across Denmark! Develope indicators for measurement of new health IT solutions, ex. Mobile health IT Purpose of Indicator Project

17. Peder Jest, Exec. Director, CMO Peder.jest@rsyd.dk

18. Thank you!