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https://www.tervisepank.ee
Tervisepank®
e-solution for primary careMadis Tiik, MD
CEO, Estonian Society of Family Doctors
06.04.2006
Estonian primary careKey facts
787 patient lists
1.251.385 insured patients
FDs: private entrepreneurs
100% funded by Estonian Health Insurance Fund
Total annual budget: ca EUR 40M
Monthly IT budget: ca EUR 75 per doctor
Computer literacy and use of internet in primary care
In 2003 there were 2.369 workers in the primary care units (doctors and nurses)
1920 were using computers daily (81%), from those1872 were using computers with internet connection (97%)
all together 1207 computers, from those1147 computers with internet connection
1350 doctors work in the primary care units1242 use computers daily (92%), from those
1237 use computers with internet connection (99%)
Digitalization in Estonian primary care
1994 – 1998: First software solutions for FDsPurely structured, mainly text fails
1998: EHIF financial support for FDsSoftware oriented to the needs of EHIF
First FD’s started using digital patient records only
Since 2001: All claims’ data sent to EHIF digitally3 – 4 local software companies
Software architecture: only local installations
Financial aspect: expensive license fees + monthly service fees
Flaws arising from existing architecture
Data not available in time-critical situations;Most data exchanged and stored on paper;Medical decisions often based only on data received from patients;Patients tied to their FD: mobile patient loses health record history;Collected data not comparable and exchangeable;Software not corresponding to the requirements of processing delicate personal information;Expensive maintenance and updating of softwareFDs expected to be IT power-users
Key requirements to the new solution
Functionality;Customer-friendly interfaces;Easily and independently learnable (ca 20 - 30 min);Central management, updating and archiving;Automatic claiming, reporting and statistics;Low requirements to the hardware;Easily scalable;Compliance with Data Protection Act.
Tervisepank – first PPP project in Estonian healthcare
Customer: Estonian Society of Family DoctorsDevelopment of functionality and logic
Financing: local private investors
Design and technology: local IT companies
Business model: operational lease of softwareNo upfront fees;
Everything (maintenance, archiving, updates, growth in functionality) included in fixed monthly price (ca EUR 40 per professional user).
Further joint development:Ideas from FDs;
Implementation by Tervisepank.
Time and costs
Business process mapping – 2003;
Design & programming, license from Data Protection Agency – 2004;
Real-time launch – 29.12.2004;
Real-time users – Q3 2005.
Direct investments > 300.000 EUR
Tervisepank – centralized IT system
Modern, web-based solution for primary care, but not limited to that;
All users use the resources on same servers;
Access through standard web browser and internet connection
All encrypted patient data kept in one database;
All updates are in force immediately to all system users;
Key functionality
Fully functional daily work environment driven by doctors’ needsKey functionality:
Practice administration and e-registry;Digital health record database;Patient management, disease curing and prevention;Medical decision making support;Documents, certificates etc;Claiming, reporting and statistics;Information exchange with third parties (laboratories, pharmacies etc).
Technical highlights
Estonian ID card based encryption model
Valid ID card
Valid ID PIN code
Technology: Microsoft .net 1.1.
MS SQL Server 2000
Highly scalable
Key security features
Unauthorized users are unable to connect personal data with medical records;FD can delegate his/her access rights to patients’ health records;System administrators do not have access to patients’ medical records;All activities are logged and saved;Approved by DPA
Win-win solution for doctors and patients
Professional users:Full digital, real time and constantly updating health record database on every patient;Accessible from everywhere, 24/7; More information = better care;Medical decision making support;Extensive savings in time = better care;Automatic reporting; No initial investment required, usage results in significant savings;Only system licensed by DPA.
Patients:All medical data in one secure place;Access to personal health records;Access to FD’s e-registry;Chance for alternative diagnosis;FD has more time for patient = better care;Report on persons viewing personal medical data.
Tervisepank – a virtual hospital of tomorrow
E-consultation;
Specialist doctors;
Hospitals;
Ambulance / emergency care;
Laboratories;
School healthcare;
Drug / genetic research.
Thank you !
For further information, please contact:
Mr. Loit Linnupõld
partner
Tervisepank
Ph: +372 502 4152
https://www.tervisepank.ee
Mr. Madis Tiik
CEO
Estonian Society of Family Doctors
Ph: +372 510 9143