1. EHR Systems Use and Quality in Romania EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

2. Country context (i) Basic facts about: the country Basic facts about: the country ◦Population ◦Population: 21,504,442 (2002) ◦Life expectancy ◦Life expectancy at birth: 73.4 y (WHO 2009) Basic facts about: the health care system Basic facts about: the health care system ◦HC expenditure ◦HC expenditure: 5.5% of GDP (WHO 2008) ◦Public sector ◦Public sector hc expenditure as % of total hc expenditure: 81.7% (OECD 2007) ◦Organization ◦Organization: central / district auth./ local units  Ministry of Health (MoH) / 41 District Health Authorities  National Health Insurance House (NHIH) / 41 District HIH EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

3. Country context (ii) Basic facts about: General IT status/setup/ developments within the health sector Basic facts about: General IT status/setup/ developments within the health sector ◦Availability of IT in healthcare in Romania ◦Availability of IT in healthcare in Romania:  Computers (GP and hospitals): almost 100% (2010)  Internet connection: 31% (2007)  Professional IT support: <10% (2007)  Broadband connection: <5% (2007) ◦Link between e-health system and health system ◦Link between e-health system and health system:  Most present implementation = result of national hc strategy  NHIH imposed “SIUI” = Integrated Unique Information System  Several hospitals – HIS from private companies EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

4. EHR systems: market (i) - Market penetration - (% of use in primary care and in secundary care (hospitals) - Market penetration - (% of use in primary care and in secundary care (hospitals) Simplified version (SIUI) = 100% (mandatory) in both primary care and hospitals Extended version: ◦primary care ~ 50% (from small companies) ◦hospitals ~90% large hospitals, ~30% small hospitals EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

5. EHR systems: market (ii) Number of applications on the market Number of applications on the market for the different market segments (approx.) Primary care Primary care: ~20, but only ~10 have acceptable quality Hospitals Hospitals: 5 better known applications Pharmacies Pharmacies: ~6 Dentistry Dentistry: 2-3 EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

6. EHR systems: market (iii) Market segmentation Market segmentation Primary care Primary care: several providers, no visible leading group ◦(C-Med in West Romania ~10%) Hospitals Hospitals: ◦InfoWorld, Romanian Soft Co. (>50%), Total Soft, etc Number of suppliers Number of suppliers In Romania a developper is usually the supplier Evolution Evolution Constant, but slow increase EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

7. EHR systems : legal/regulatory context Any legislation / regulation: Yes [1] ◦about the use of EHR systems? Not explicit (incl.in[1]) ◦about functionalities of the systems  related to functional system requirements? No  related to data-exchange and/or interoperability? No (*)  (*) Note: it does exist only related to protection of personal data [2] Strategic Plan  [1] Ministry of Health: Strategic Plan of the Ministry of Public Health for 2008-2010 Protection of individuals  [2] Law no 677 on the Protection of individuals with regard to Processing of Personal Data and onthe Free movement of such Data, November 2001 EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

8. EHR systems: quality assessment Any current actions ◦regarding quality assessing the EHR systems? ◦regarding requiring the use of quality assessed EHR systems? Yes: Developpers need accreditation from NHIH for compatibility of their soft with “SIUI” Any incentive for using quality assessed / certified EHR systems? No EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

9. EHR systems: initiatives, plans List and present the public initiatives / projects, if any ◦To promote / enforce the use of EHR systems ◦To assure quality of the systems ◦To improve interoperability ◦To recognise quality labelling and certification ProRec Romania ProRec Romania Q-RECEHR-Q TN ◦Participated in both Q-REC and EHR-Q TN Workshops ◦Several Workshops for dissemination and promotion of EHR certification  Bucharest 2007, 2009 & Timisoara 2010, 2011 ◦ProRec Rosite: ◦ProRec Romania site:  List of all developpers  Eurorec Seal online support ◦ Forms for application and self evaluation ◦ Complete information package  etc EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

10. Ideas, proposals Present any other: ◦ideas, proposals ◦message to the audience, authorities… Need of “pressure” for accepting the necessity of EHR certification Create incentives for the use of EHR certified systems Present state: lack of “motivation” for developpers EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

11. Closing slide Closing slide Contact data: ◦Prof Dr George Mihalas ◦Prof Dr George Mihalas, University of Medicine and Pharmacy, Timisoara and ProRec Romania ◦Lect Dr Mircea Focsa ◦Lect Dr Mircea Focsa, University of Medicine and Pharmacy, Timisoara and ProRec Romania Web and e-mail addresses: ◦mihalas@umft.ro ◦focsam@prorec.ro ◦www.prorec.ro EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade