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EHR Systems Quality Labelling and Certification
Danish Case
Morten [email protected]
MEDIQBelgrade. 22nd November, 2011
AGENDA
1. The Danish Health Care Sector
2. Certification
3. EuroRec Seal
4. Messaging
5. General Practitioner EHR systems
6. Shared Medication RecordMEDIQ
The Danish Health Care Sector
MEDIQ
Denmark Parliamentary democracy and
constitutional monarchy 5,5 mill. inhabitants
90,1% Danish 9,9 % other
5 Regions 98 Municipalities Equal and free access to healthcare
MEDIQ
Health Care System: Administrative levels
Ministry of Interior andHealth
National
Regional
Local
5 Regions
98 Municipalities
MEDIQ
Health Care Providers – 3 sectors
Primary Care
Responsible for:
Generalhealth problems
including prevention and
chronic diseases
Hospitals
Responsible for:
Specialised treatment
andintensive care
Municipalities
Responsible for:
Prevention,rehabilitation
and social care
MEDIQ
Certificatation
MEDIQ
Business Model and Costs
2/12/10
Low Costs
High Costs
Third PartyCertification
Self assessment
MEDIQ
Interoperability (ALT model)
MEDIQCommunication
Applicationlevel
Logicallevel
Technicallevel
Semantic interoperability
Technical interoperability
presentation
clinical content
model
format & storage
transmission
terminology
functionalityClinical
Interoperability
Continuity and quality
presentation
clinical content
model
format & storage
transmission
terminology
functionality
Organisationallevel
FUNCTIONAL
TECHNICAL
EuroRec Seal
MEDIQ
EuroRec Seal - Guideline
Test environment Test scenarios Test data Conformance criteria's Schedule for testing Test log Delivery document
MEDIQ
Functional testing/certificaion
EuroRec Seal
MEDIQ
Start
VendorSelf evaluation
Week 1 Week 2 Week 3 Week 4 Week 5
Validation
Week 6
Vendorfix errors
Validation
Testlog
Testlog
Deliverydocument
Testlog
Deliverydocument
Messaging
MEDIQ
Cross sector communication National health care network (1992 )
Frequent messages in large volumes Discharge letters, prescriptions, lab. request
and results, referrals, consultation notes.... More than 100 profiles (2011) Vendor systems are tested by MedCom
www.medcom.dk
MEDIQ
Technical testing/certification
Functional testing/certification
+
5.5 mill. messages per month
MEDIQ
Test results are published
MEDIQ
GP systems and ICPC - 2
MEDIQ
ICPC International Classification of Primary Care
Has become a standard all over the world The ICPC contains 17 chapters
A General and unspecified B Blood, blood forming organs, lymphatics, spleen D Digestive F Eye H Ear K Circulatory L Musculoskeletal N Neurological P Psychological R Respiratory S Skin T Endocrine, metabolic and nutritional U Urology W Pregnancy, childbirth, family planning X Female genital system and breast Y Male genital system Z Social problems
ICPC 2 is an extended terminology
A Danish ICPC 2 code chart can be downloaded, printed and used by the GP to find an the ICPC code for a symptom/diagnose
MEDIQ
GP systems in Denmark (June 2011)
MEDIQ
16 vendor of GP systems
ICPC 2 - requirements
MEDIQ
Enable coding of diagnosis in
GP systems
A national specification for the
implementation of ICPC 2
Agreed with the vendors
Systems must by certified
Functional testing/certificaion
Conformance levels
MEDIQ
TestGroup
Tests Type Conformancelevel
Baisic functionality 28 O1 100%
Core functionality 21 O2 80%
Extented functionality 26 O3 40%
Advanced functionality 26 A 0%
ICPC test results are published
MEDIQ
Percent of tests passed
Shared Medication Record (SMR)
MEDIQ
SMR: Paradigm shift
FROM sending TO sharing
MEDIQ
What is SMR?
Central SMR service
Secure Health-care network
Service-platform
Local EMR/EHR
A Service provider of online medication data to
share and update
- Transport- Security,
- Connection
Local service consumer
that uses online data via a distributed service
platform
MEDIQ
SMR and EHR in Hospitals
Five years work Specification Development Discussions
Mandatory to use Primary care Secondary care All other
Health professionals can be fined if they do not update the SMR
Fully implemented by end 2012
MEDIQ
Technical testing/certification
Functional testing/certification
+
SMR on mobile devices
MEDIQ
