ICT Solutions for Management of health sector resources


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ICT Solutions for Management of health sector resources

  1. 1. ICT Solutions for Management of Health sector resources Chisinau – 19.05.2011 ©2008 SIVECO Romania. All Rights Reserved.
  2. 2. Alexandru Dan DonciulescuSIVECO RomaniaDeputy Director of the e-Health Department of SIVECO Romania, the largest software house of Romania. He is a Doctor Engineer in Applied Informatics at the Politechnica University of Bucharest. He is specialised in Decision Support Systems for Operational Control. He was for a long time with the National Institute for Research & Development in Informatics and lectured as a Professor at different Universities in Romania. In SIVECO Romania his application fields are in e-Health, especially health insurances, and is a 2 Project Manager of the SIUI System, the Information System of the National Health Insurance House in Romania. 5/25/2011
  3. 3. Summary:1. Integrated Health Information System (IHIS)2. IHIS Major Components3. Conclusion 3 5/25/2011
  4. 4. 1. IHIS - Integrated Health Information System e-Health vision 4 5/25/2011
  5. 5. 1. IHIS e-Health vision Medical practice evolution:  From the treatment of acute illness, to the prevention of disease;  From considering each patient as an isolated entity, to perceiving the patient as a member of a population;  From a focus on the individual, to the broader perspective of public health  From paper documentation to an electronic, paperless 5 environment 5/25/2011
  6. 6. 1. IHIS e-Health vision In order to obtain optimal results, a National Health Information Strategy is required:  Interoperability  Security  Data confidentiality  Standardisation  Cost-effectiveness 6 5/25/2011
  7. 7. 1. IHIS e-Health vision The eHealth system should be designed in a manner that would offer the best possible results for its main beneficiaries: the patients 7 5/25/2011
  8. 8. 2. IHIS Major Components HIIS – Health Insurance Information Systems Health Cards e-Prescribing Electronic Health Record Future expectations 8 5/25/2011
  9. 9. 2. IHIS Major Components Health Insurance Information System Management of the Health Insurance Fund(s) Recommended integration between Health Insurance and Health Care systems Any service has to be paid. Payment data are reported together with the service Payments from insurance funds are restricted by rules a HIIS covers all flows from the medical services contracts with the providers, to the reporting, validation and payment 9 of the services HIIS is the 1st step in building a medical complex system May 25, 2011
  10. 10. SIUI of the NHIH Health Insurance Information SystemNHIH and 42 CHIHSIUI main objectives management of the National Health Insurance Fund management of the Insurances Register management of the medical services providers contracts management services validation and payment access using qualified certificate Business Intelligence analyses for managers26 (SIUI) + 9 (ERP) modules 10
  11. 11. SIUI of the NHIH Health Insurance Information System service provider SIUI Main Flow authentication SIUI insurance service service category pre-validation claim at each service monthly contracts serviceother services validation NHIH norms payment ERP System Bank approval and ordering 11
  12. 12. SIUI of the NHIH Health Insurance Information SystemOther functions: management of prescriptions management of the medical leaves management of the insurance categories – links withpartner organizations management of independent contributors ERP (9 modules: Financial Accounting, Payroll, HumanResources, Inventories, Procurement, Investments, FixedAssets & Inventory Objects, Maintenance, BI) Reporting to SIUI applications for 15 types of medicalservices providers 12
  13. 13. 2. IHIS Major Components Health Cards Electronic Health Card – implementation in connection with other e-Health systems. Prerequisites: Interoperability and infrastructure availability. 13 May 25, 2011
  14. 14. 2. IHIS Major Components Health Cards Stores administrative information regarding health insurance The experience of other EU states regarding Health Cards – cards optimal use as identification devices, rather than data storage Confirms the right of the 14 patient to have access to medical treatment May 25, 2011
  15. 15. 2. IHIS Major Components e-PrescribingIntroduction Recommended: integration with another e-Health system  Requirements:  new forms  new types of printers  reliable Internet connection 15 May 25, 2011
  16. 16. 2. IHIS Major Components e-Prescribing Advantages of an electronic prescribing system:  clear prescription text  minimization of human errors, through the implementation of a prescription validation expert system  limitation of fraud risks  facilitates efficient resource management 16  automatic reporting process May 25, 2011
  17. 17. 2. IHIS Major Components Electronic Health RecordPre-requirements:  Standardized, complete and correct electronic medical data collection  Existence of IT tools for data analysis and statistical reports generationAction: National EHR (Electronic Health Record)implementationObjective: resource allocation and management according to 17national or even EU-level policies May 25, 2011
  18. 18. 2. IHIS Major Components Electronic Health RecordEHR – Electronic Health Record EHR is a complex system (comprising of hardware, software, people, policies and processes) which:  Gathers data from multiple sources  Is used by clinicians as a primary information source at the point of care  Offers decision support in evidence based healthcare. The term describes the highest level of functionality in 18 medical data computerized management May 25, 2011
  19. 19. 2. IHIS Major Components Electronic Patient File Patient related medical data, gathered in a consistent and uniform manner, nationwide, constitutes the Electronic Patient File (EPF), sometimes referred to as Electronic Medical Record (EMR) EPF is generated at birth, is updated throughout the patient’s life and is stored in the system for an undetermined period of time. EPFs must be interoperable, secure, consistent, safe and 19 must ensure data confidentiality. 5/25/2011
  20. 20. 2. IHIS Major Components Electronic Patient File The medical data stored in the EPF can be accessed by the authorised clinicians at any time and from any location. Connection with systems for health insurance management All medical service providers must contribute in the EPF in a standardized format. This does not mean all medical service providers must use the same Health Information System, but the Ministry of 20 Health should enforce the use of a minimum set of standards, in order to ensure interoperability. May 25, 2011
  21. 21. 2. IHIS Major Components eHealth system structureDecisionlevel Health Decision Electronic Insurance makers Health Record Medical data Decisions Economic dataPrimary 21level Medical Electronic Electronic Electronic service providers Prescriptions Card Patient File May 25, 2011
  22. 22. Future expectationse-Health objectives (1/2): Timely access to patient electronic medical data whenever and wherever they are needed Patient access to their own medical records and to relevant health information Unified national healthcare and health insurance data collection, both in the public and private health system Communication and information exchange between multi- 22 disciplinary medical teams May 25, 2011
  23. 23. Future expectationse-Health objectives (2/2): Extensive use of international best practice guides and procedures Improved quality, safety and efficiency of the clinical processes High level of security, confidentiality and control in relation to information management Continuous health system improvement by ensuring a 23 transparent and optimized reporting process Implementation of a better informed health strategy May 25, 2011
  24. 24. Future expectationsChronic Disease Management Chronic diseases:  are long term conditions (over 6 months)  are not contagious  produce certain disfunctionalities or handicaps  in most cases, do not improve over time  are rarely healed completely Chronic diseases are the main cause of death and morbidity 24 (e.g. in Europe 87% of all deaths, in high income countries, according to WHO – World Health Organization) May 25, 2011
  25. 25. Future expectationsChronic Disease Management CDM represents a systematic approach to improving the quality of the medical services provided for the chronic disease patients. Instrument: an efficient system for the remote monitoring of chronic disease patients and the prevention of related medical complications 25 May 25, 2011
  26. 26. Future expectationsTelemedicine Remote medical monitoring  enables medical professionals to monitor a patient remotely using various technological devices  Improves the quality of life for chronic disease patients, by reducing the number of hospital admissions  e.g. Electrocardiogram by phone Interactive telemedicine services  Tele-radiology and tele-consultations: 26 shorter waiting lists, optimized use of resources May 25, 2011
  27. 27. Future expectationsTelemedicineHomecare devices and applications Glycemia measurement devices Blood pressure measurement devices Devices for the recording of vital signs and other clinical indicators 27 May 25, 2011
  28. 28. 3. Conclusion eHealth Strategy 28 5/25/2011
  29. 29. 3. Conclusions eHealth StrategyRecommended approach: a coherent and stable e-Health strategy proper definition of the roadmap and milestones appropriate funding for each of the 29 steps May 25, 2011
  30. 30. 3. Conclusions eHealth Strategy Benefits:  Deployment at a national level of an integrated eHealth system, part of a national eHealth Vision  Reuse of solutions and experience from similar countries  Use of the state of the art technologies  Unique patient health record  Infrastructure and information to support the long term health strategies 30  Improved health services and quality of life May 25, 2011
  31. 31. 3. Conclusions A Road MapInitiative Year 1 Year 2 Year 3 Year 3 Year 5I. Initiatives concerning legal matters1 Creating the legislative framework2 Determining the standardisation framework3 Ensuring legislation coherenceII. Development and implementation of the IHIS4 EMR – Electronic Medical Record5 HIIS – Health Insurance Information System6 eID – Health Cards for Citizens7 ePrescription – Electronic Prescription System8 National Health Portal9 Hospital information Systems 31III. Training10 IT training for health professionals May 25, 2011
  32. 32. eHealthThank you for your attention! 32 5/25/2011