1. UNIVERSITY OF AARHUS DENMARK Frede Olesen, Res. Unit for GP, Univ. of Aarhus, Denmark

2. Fam. Med. and IT §The clinics are (nearly) without paper. §All fam. med. clinics are computerised l - lists of patients l - administration and billing systems l - records and prescription lists l - communication with hospitals referrals and discharge letters from lab. & diagnostic investigations, ambulatory care and hospital care §All clinics have acces to and use the Web

3. Fam. med. and IT - history §> 25 years ago standards from the College og GPs §The Fam. med. ass. would create one system – failed – went bankererupt §The college standards became national phrame of reference for 6-10 companies §Development driven by ’clinical added value’ and targeted time limited incentives §Now mandatory for GP’s with contract to health care §~15 years ago Medcom national state negotiated communication standards §~15 years ago standard for patients who change practice

4. Today’s developmental frontline §Communication to and from municipalities l social welfare and district nurses. §Quickly incentive driven raise in e-mail consultations §Decision support systems running and improved §ICPC coding with clinical advantages – probably incentives from 2009 §Data-capture to central database l reseach including pop up ad hoc registrations l chronic care databases – diabetes is implemented §IT hotel l prescriptions on a national server and database l referrals l ?? §Web based shared patient held part of records?? l pilot with pregnant women

5. Hospitals and IT §The ambition: to create a comprehensive system that can do everything. §National standards §Clinicians too far away in the proces l failed to be perceived as giving clinical added value §To many (>10) different systems §2007: a new beginning §Did the same mistakes as in GP in the beginning §Now: 5 – 10 years behind schedule

6. The vision and a good example l The x ray clinic in Vejle county hospital l 1: patient at a doc: you need an x-ray l 2: referral written and sent ’go to the hospital before 2 pm.’ – ’welcome, I have your referral. l 3: x-ray same day – max 1 (2) hour waiting l 4: voice-recognition and answer to GP in the afternoon l 5: next day: the result. l Productivity up more than x 5 at x-ray

7. Thank you for your attention…. Fo@alm.au.dk