1. eHealth Strategy for Romania
Dr. Andrei KOZMA
Minister of Health’s Adviser
Sep 2010

2. Integrated Health Information System (IHIS)
Ministerul Sanatatii
Integrated Health Information System (IHIS)
eHealth vision
Electronic Data Management
Future expectations

3. Ministerul Sanatatii eHealth vision Medical practice evolution:
From the treatment of acute illness, to the prevention of disease;
From considering each patient as an isolated entity, to perceiving the patient as a member of a population;
From a focus on the individual, to the broader perspective of public health
From paper documentation to an electronic, paperless environment

4. Ministerul Sanatatii eHealth vision IHIS
In order to obtain optimal results, a National Health Information Strategy is required:
Interoperability
Security
Data confidentiality
Cost-effectiveness
Standardisation 4
4/6/2017

5. Ministerul Sanatatii eHealth vision IHIS
The eHealth system should be designed in a manner that would offer the best possible results for its main beneficiaries: the patients
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6. Electronic Data Management
Ministerul Sanatatii
IHIS
Electronic Data Management
Patient related medical data, gathered in a consistent and uniform manner, nationwide, constitutes the Electronic Patient File (EPF), sometimes referred to as Electronic Medical Record (EMR)
EPF is generated at birth, is updated throughout the patient’s life and is stored in the system for an undetermined period of time.
EPFs must be interoperable, secure, consistent, safe and must ensure data confidentiality.
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7. Electronic Data Management
Ministerul Sanatatii
IHIS
Electronic Data Management
The medical data stored in the EPF can be accessed by the authorised clinicians at any time and from any location.
All medical service providers must contribute in the EPF in a standardized format.
This does not mean all medical service providers must use the same Health Information System, but the Ministry of Health should enforce the use of a minimum set of standards, in order to ensure interoperability.
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8. eHealth objectives (1/2):
Ministerul Sanatatii
IHIS
Future expectations
eHealth objectives (1/2):
Improved quality, safety and efficiency of the clinical processes
Timely access to patient electronic medical data whenever and wherever they are needed
Patient access to their own medical records and to relevant health information
Communication and information exchange between multi-disciplinary medical teams
Intrucat fiecare tip de populatie, natiune etc. prezinta anumite caracteristici din punctul de vedere medical, adesea se impune crearea de programe specializate pentru controlul si ameliorarea unor fenomene. Aceste programe de nivel regional, national sau chiar transfrontalier pot fi conduse gratie existentei informatiilor mentionate.
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9. eHealth objectives (2/2):
Ministerul Sanatatii
IHIS
Future expectations
eHealth objectives (2/2):
Extensive use of international best practice guides and procedures
Unified national healthcare and health insurance data collection, both in the public and private health system
High level of security, confidentiality and control in relation to information management
Continuous health system improvement by ensuring a transparent and optimized reporting process
Implementation of a better informed health strategy
Intrucat fiecare tip de populatie, natiune etc. prezinta anumite caracteristici din punctul de vedere medical, adesea se impune crearea de programe specializate pentru controlul si ameliorarea unor fenomene. Aceste programe de nivel regional, national sau chiar transfrontalier pot fi conduse gratie existentei informatiilor mentionate.
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10. Chronic Disease Management
IHIS
Future expectations
Chronic Disease Management
Chronic diseases:
are long term conditions (over 6 months)
are not contagious
produce certain disfunctionalities or handicaps
in most cases, do not improve over time
are rarely healed completely
Chronic diseases are the main cause of death and morbidity, e.g. Europe (87% of all deaths, in high income countries, according to WHO – World Health Organisation)
Intrucat fiecare tip de populatie, natiune etc. prezinta anumite caracteristici din punctul de vedere medical, adesea se impune crearea de programe specializate pentru controlul si ameliorarea unor fenomene. Aceste programe de nivel regional, national sau chiar transfrontalier pot fi conduse gratie existentei informatiilor mentionate.
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11. Chronic Disease Management
Ministerul Sanatatii
IHIS
Future expectations
Chronic Disease Management
CDM represents a systematic approach to improving the quality of the medical services provided for the chronic disease patients.
Instrument: an efficient system for the remote monitoring of chronic disease patients and the prevention of related medical complications
Intrucat fiecare tip de populatie, natiune etc. prezinta anumite caracteristici din punctul de vedere medical, adesea se impune crearea de programe specializate pentru controlul si ameliorarea unor fenomene. Aceste programe de nivel regional, national sau chiar transfrontalier pot fi conduse gratie existentei informatiilor mentionate.
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12. Future expectations Ministerul Sanatatii IHIS Telemedicine
Remote medical monitoring
enables medical professionals to monitor a patient remotely using various technological devices
Improves the quality of life for chronic disease patients, by reducing the number of hospital admissions
e.g. Electrocardiogram by phone
Intrucat fiecare tip de populatie, natiune etc. prezinta anumite caracteristici din punctul de vedere medical, adesea se impune crearea de programe specializate pentru controlul si ameliorarea unor fenomene. Aceste programe de nivel regional, national sau chiar transfrontalier pot fi conduse gratie existentei informatiilor mentionate.
Interactive telemedicine services
Teleradiology and teleconsultations: shorter waiting lists, optimized use of resources
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13. Future expectations Ministerul Sanatatii IHIS Telemedicine
Homecare devices and applications
Glycaemia measurement devices
Blood pressure measurement devices
Devices for the recording of vital signs and other clinical indicators
Intrucat fiecare tip de populatie, natiune etc. prezinta anumite caracteristici din punctul de vedere medical, adesea se impune crearea de programe specializate pentru controlul si ameliorarea unor fenomene. Aceste programe de nivel regional, national sau chiar transfrontalier pot fi conduse gratie existentei informatiilor mentionate.
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14. IHIS Major Components Ministerul Sanatatii Health Cards e-Prescribing
Electronic Health Record
CDM – Chronic Disease Management
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15. Health Cards Ministerul Sanatatii IHIS Major Components
Only after interoperability and infrastructure availability are ensured can we talk about a viable Electronic Health Card system implementation.
Intrucat fiecare tip de populatie, natiune etc. prezinta anumite caracteristici din punctul de vedere medical, adesea se impune crearea de programe specializate pentru controlul si ameliorarea unor fenomene. Aceste programe de nivel regional, national sau chiar transfrontalier pot fi conduse gratie existentei informatiilor mentionate.
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16. Health Cards Ministerul Sanatatii IHIS Major Components
The experience of other EU states regarding Health Cards indicates that, whenever an implementation was successful, the cards were used as identification devices, rather than data storage.
[ In Germany, the efforts made over the last 8 years to implement a National Health Card System have not materialized yet.]
Even so, we consider that the introduction of a Romanian Health Card could have beneficial effects if proper approach and goals are adopted.
Intrucat fiecare tip de populatie, natiune etc. prezinta anumite caracteristici din punctul de vedere medical, adesea se impune crearea de programe specializate pentru controlul si ameliorarea unor fenomene. Aceste programe de nivel regional, national sau chiar transfrontalier pot fi conduse gratie existentei informatiilor mentionate.
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17. Health Cards Ministerul Sanatatii IHIS Major Components
Health Card Functions
Stores administrative information regarding health insurance.
Confirms the right of the patient to have access to medical treatment.
Intrucat fiecare tip de populatie, natiune etc. prezinta anumite caracteristici din punctul de vedere medical, adesea se impune crearea de programe specializate pentru controlul si ameliorarea unor fenomene. Aceste programe de nivel regional, national sau chiar transfrontalier pot fi conduse gratie existentei informatiilor mentionate.
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18. e-Prescribing Ministerul Sanatatii IHIS Major Components Introduction
The existance of a well structured EPF system offers the basis for the implementation of a national ePrescribing system
Requirements:
new forms
new types of printers
reliable Internet connection
Intrucat fiecare tip de populatie, natiune etc. prezinta anumite caracteristici din punctul de vedere medical, adesea se impune crearea de programe specializate pentru controlul si ameliorarea unor fenomene. Aceste programe de nivel regional, national sau chiar transfrontalier pot fi conduse gratie existentei informatiilor mentionate.
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19. e-Prescribing Ministerul Sanatatii IHIS Major Components Introduction
Advantages of an electronic prescribing system:
clear prescription text
minimization of human errors, through the implementation of a prescription validation expert system
limitation of fraud risks to the system
facilitates efficient resource management
automatic reporting process
Intrucat fiecare tip de populatie, natiune etc. prezinta anumite caracteristici din punctul de vedere medical, adesea se impune crearea de programe specializate pentru controlul si ameliorarea unor fenomene. Aceste programe de nivel regional, national sau chiar transfrontalier pot fi conduse gratie existentei informatiilor mentionate.
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20. e-Prescribing Ministerul Sanatatii IHIS Major Components
Prescription example (standard form)
Unique identifier
Patient related data
Medication details
2D Barcode – contains details about the medication and the patient
1D Barcode – contains form number and doctor’s ID number
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21. Electronic Health Record
Ministerul Sanatatii
IHIS Major Components
Electronic Health Record
Pre-requirements:
Standardized, complete and correct electronic medical data collection
Existence of IT tools for data analysis and statistical reports generation
Action: National EHR (Electronic Health Record) implementation
Objective: resource allocation and management according to national or even EU-level policies
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22. EHR – Electronic Health Record
Ministerul Sanatatii
IHIS Major Components
Electronic Health Record
EHR – Electronic Health Record
EHR is a complex system (comprising of hardware, software, people, policies and processes) which:
Gathers data from multiple sources
Is used by clinicians as a primary information source at the point of care
Offers decision support in evidence based healthcare.
The term describes the highest level of functionality in medical data computerized management
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23. eHealth system structure
Ministerul Sanatatii
IHIS Major Components
eHealth system structure
Decision
makers
Electronic Health Record
Decision level
Medical data
Economic data
Decisions
Medical
service providers
Information systems
Electronic Patient File
Primary level
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24. Ministerul Sanatatii
Conclusion
eHealth Strategy
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25. eHealth Strategy Ministerul Sanatatii Conclusions
This presentation, too brief - considering the importance of the issues in hand, aims to mark the importance of:
a coherent and stable (at least – for mid-term) eHealth strategy
proper definition of the roadmap and milestones
appropriate funding for each of the steps to be taken
Intrucat fiecare tip de populatie, natiune etc. prezinta anumite caracteristici din punctul de vedere medical, adesea se impune crearea de programe specializate pentru controlul si ameliorarea unor fenomene. Aceste programe de nivel regional, national sau chiar transfrontalier pot fi conduse gratie existentei informatiilor mentionate.
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26. eHealth Strategy Ministerul Sanatatii Conclusions Benefits:
Deployment at a national level of an integrated eHealth system, part of a national eHealth Vision
Reuse of solutions and experience from similar countries
Use of the state of the art technologies
Unique patient health record
Infrastructure and information to support the long term health strategies
Improved health services and quality of life
Intrucat fiecare tip de populatie, natiune etc. prezinta anumite caracteristici din punctul de vedere medical, adesea se impune crearea de programe specializate pentru controlul si ameliorarea unor fenomene. Aceste programe de nivel regional, national sau chiar transfrontalier pot fi conduse gratie existentei informatiilor mentionate.
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27. Thank you for your attention!
Ministerul Sanatatii
eHealth Strategy for Romania
Thank you for your attention!
Dr. Andrei KOZMA
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