1. STRATEGY, ACCREDITATION, SECURITY AND CLINICAL GUIDES DEFINITION: Clinical guides creation and broadcast. NHS Security Strategy. Centres and units accreditation. STRATEGIES AND EQUITY ON HEALTH MATTERS: Health strategies (Mental Health, Neoplasms, Palliative Care, Diabetes, EPOC, Rare Illnesses). Gender and health equity strategies. Woman’s Health Observatory. INFORMATION AND KNOWLEDGE MANAGEMENT: 110 NHS Key Indicators / Statistic Portal. National Health System Observatory. NHS Information Systems full development. NHS Virtual Library. ELECTRONICAL CASE HISTORY AND DIGITAL PRESCRIPTION: Digital Health Record in the NHS development: Personal Health Card Database. Central node, NHS intranet. A.C. and Scientific Societies consensus. Electronic Prescription development. HCD European Project. STRATEGY QUALITY AND INNOVATION NHS EQUITY, QUALITY AND INNOVATION ON THE NATIONAL HEALTH SYSTEM

2. HEALTHCARE STRATEGIES Expert Panel Regions Present situation Prioritization methods Strategy NHS-IB Implementation Multidisciplinary involvement Evidence - Ischemic heart disease - Diabetes - Mental health - Cancer - Palliative care - Etc.

3. e-HEALTH: ELECTRONIC HEALTH RECORD IN SPAIN JOINING EFFORTS TO REACH THE FUTURE - Digital health records - Personal health card - Electronic prescription

4. INFORMATION CIRCULATES

5. Healthc are Intranet SNS Healthcare Regional Intranet Regional Node Federal: No Central Data Base but Exchange Data System Central node

6. ANDALUCIA ARAGÓN 803410 803411 With an unique identifier for each person Developed in collaboration with the 17 regions Integrated with all the EHR of the Country Universal coverage (45 million users) BUILD AN UNIFIED PERSONAL HEALTH CARD DATABASE

7. Scope: To provide professionals and citizens with access to any clinical datasets that are relevant for healthcare (including diagnostic imaging) Electronic documents: AGREED SCOPE AND CONTENT

8. Professional Consensus (37 Professional Citizens and Technical Associations) Agreement on the contents of the e-documents Work Groups: Group 1 Group 2 Group 3 Group 4 Group 5 Group 6 Group 7 Summarised Medical Record Primary Health Care Report C. Discharge Report Consultation Report Emergency Room Report ARS Nursing Care Report Lab Tests Report Imaging Tests Report Imaging Attributes HOW?

9. Presential Telephone Users CEIS eMail Web Data Warehouse Others channels Back Office Centralized appointment B D U 60 Million Centralized Appointments in 2007 (data from one region of 8 million inhabitants)

10. Provides users with access to pharmaceutical facilities thus making it unnecessary for patients in poor health to go in person Simplifies and speeds up authorization of prescriptions. Increases time devoted to patients. 22% LESS OF UNNECESARY VISITS….22% MORE OF AVAILABLE TIME OF GPs Entire treatment prescribed by specialists Possibility of better support for correct prescription Significant promotion of Pharmaceutical Assistance Reduction of management expenses and billing of prescriptions. Improved follow-up and control of rational use of drugs (RUD) Correct assignment of responsibility in RUD among levels Greater control in alerts and pharmacovigilance programs OUTCOME: Improve effectiveness in primary care