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LESSONS FROM ABROAD: BUILDING BLOCKS
FOR NATIONAL E-HEALTH SYSTEMS
James Brennan BBS ACMA MICS MSc (Health informatics)
Department of Computer Science and Information SystemsUniversity of Limerick
Background to Research
Involved in e-Health projects for 20 years
Hospitals, Specialist Clinics, Disability Sector
Primary Care & Acute SectorPublic and Private Sectors
2010 - MSc in Health Informatics2011 - PhD candidate (Health
Informatics)
Literature Review on National e-Health Systems
NO TYPE NUMBER1 Journal Articles 3432 Published Reports 643 Newspaper Articles 324 Textbooks 315 Pamphlets 116 Conference Proceedings 107 Websites 98 Academic Dissertations 7
TOTAL 507
Adoption of EHRs & e-Prescribing in Primary Care
Country EHR % E-Prescribing %Finland 99 100
Denmark 99 95Sweden 99 70Norway 98 95
The Netherlands 98 85United Kingdom 95 90
New Zealand 92 78Australia 79 81Ireland 60 34
Germany 42 59United States 29 20
Canada 20 11Japan 10 0
National e-Health & e-Prescribing – the Leaders
DenmarkSwedenFinlandNorway
The NetherlandsThe UK
New ZealandEstonia
National e-Health & e-Prescribing – The Leaders
How ?
National e-Health Systems – The AORTA Approach
National e-Health Systems – The AORTA Approach
A
•ADAPTATION
OF:
O
•ORGANISATION
FACTORS
R
•REGULATION
FACTORS
T
•TECHNOLOGICAL
FACTORS
A
•=>
ADOPTION of E-HEALTH
Organisation Factors
1. National integrated health service2. National unifying organisation for e-
Health3. National e-Health leadership4. National e-Health strategy5. National governance model6. National communication channels7. National education & training in e-Health8. Method to consult with national software
industry
Regulatory Factors
1. Legal regulation of data privacy 2. Clear consent rules for e-Health use3. Unique ID system for patients,
professionals, providers & institutions4. Legally secure systems (e.g. Digital
signatures, transaction logging, legal penalties)
5. Regulation of e-record in the medical domain
6. Certification of e-health software
Technological Factors
1. Agreed national technical standards for data exchange (EDIFACT, XML, HL7)
2. Agreed national semantic data structures (SNOMED CT, ATC codes)
3. Secure national e-health networks4. Secure national e-registries with online
access5. Availability of nation-specific EHR software6. Availability of Interoperability products &
expertise
How does Ireland Compare?
Behind the leaders in all 20 areasBut going in the right direction ....
HSE & HIQA & DOH&C – moving towards an integrated universal health system
Proposed health information bill since 2008Proposed new system of unique health identifiersProposed ICT strategy (HSE)GPIT Group - certify software since 2007 & IT
training Healthlink – moving towards a national networkHIQA – 12 GP messaging standards/HL7 2.4 in 2010HIQA – beginning debate on national EHR
THANK YOU - QUESTIONS?
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