2. Medication records and e-Prescriptions Denmark MedCom Danish Centre for Health Telematics Ib Johansen, MI www.medcom.dk

3. e-Prescriptions – Medication records Denmark MedCom Danish Health Sector Danish Health Care data Network e-Prescribing –ETP –Support systems Medication Record

4. Copenhagen

5. MedCom The Danish Health Care Data Network FynCom The Funen Health Care Data Network International Projects CoCo, Primacom, Wise, Picnic, Prestige, OpenECG, Baltic-eHealth... http://www.openecg.net

6. Danish Health Sector 63 (41)Public hospitals – 21000 Beds >10 private hospitals- < 150 Beds 3400 GPs (2000 clinics) 804 Private specialists + 245 Part time 331 Pharmacies 2700 Dentists (1650 clinics) 1793 Physiotherapist (550 clinics) 225 Chiropractors 546 Psychologists 15 Counties/Kbh/Frberg/Bornholm 271 Municipalities 1 private Health Insurance

7. 2006/07 Danish Health Sector 63 (41)Public hospitals – 21000 Beds >10 private hospitals- < 150 Beds 3400 GPs (2000 clinics) 804 Private specialists + 245 Part time 331 Pharmacies 2700 Dentists (1650 clinics) 1793 Physiotherapist (550 clinics) 225 Chiropractors 546 Psychologists 5 Regions 98 Municipalities 1 Private Health Insurance

8. VANS All using national MedCom EDI / XML-standards

9. Why making Prescriptions electronic ?

10. Readable No retyping No misuse Medicine ready when patient show up Accessible from all Pharmacies Reuse of data from GP to Pharmacy Reuse data for Medicine profile / medication record Health Telematics Danish Centre for MedCom ijo ©

11. Prescriptions 1039105 = 73% Prescriptions 1289023 = 87% Disch. Letters 682923 = 85 % Disch. Letters 1054314 = 88 % Lab.reports 543040 = 82 % Lab.reports 844528 = 98 % Referrals 115597 = 60 % Referrals Reimbursement 21049 = 92 % GP´swithEDI : 2150 = 98 % SpecialistswithEDI: 639 = 80 % HospitalswithEDI : 63 = 100% Pharmacies withEDI: 331 = 100 % Doctors onCall: 15 = 100 % Health Insurance: 17 = 100 % 79messages/min Lab Requests 44385 = 15 %

12. VANS e-Prescriptions Denmark

13. E-Prescriptions Supporting systems-Patient

14. E-Prescriptions Supporting systems-Patient

15. E-Prescriptions Supporting systems-Patient

16. E-Prescriptions Supporting systems, GP X

17. E-Prescriptions Supporting systems, GP Common Data Foundation (CDF) Updated electronically every 2nd week Drug ID –Content generic, –Strength, –Package: size, price, –Form(i.e. tabl, liq) –Substitution –ATC code –Dosage and indication –Warnings, traffic –Dosage text –Indication text –And more

18. E-Prescriptions Supporting systems, GP Patient Electronic Medicine profile (PEM) (Medication Record)

19. e-Prescriptions Denmark E-Prescription server VANS

20. E-Prescriptions Supporting systems, Pharmacy, Common Data Foundation

21. E-Prescriptions Supporting systems, Pharmacy, Common Data Foundation CTR National Medicine Account database <75 €, 75-200 €, 200-500 €

22. E-Prescriptions Supporting systems, Pharmacy, Common Data Foundation CTR National Medical Account database

23. E-Prescriptions Supporting systems, Pharmacy, Common Data Foundation CTR National Medical Account database Reimbursement County (1/month)

24. E-Prescriptions Supporting systems, Pharmacy, Common Data Foundation CTR National Medical Account database Reimbursement County (1/month) Private Health Insurance (1/day)

25. E-Prescriptions Supporting systems, Pharmacy, Common Data Foundation CTR National Medical Account database Reimbursement County (1/month) Private Health Insurance (1/day) PEM

26. GP-Clinic Prescription /orders Patient

27. From Hospitals

28. Cave

29. Interactions

31. Medicine Prescribed / not prescribed.

32. CTR Account 100 % refunded

35. Generics

36. Compliance

37. 2.nd fase Medication record –On the way to a National Medication database –Accessible using national certificate through Health Portal –For Health professionals and citizens –Reuse data, based on e-Prescriptions E-Prescriptions Medication database