e-Prescription in Belgium
 Based on Trust and Free Basic IT Services
              JP Dercq, MD
Some basic IT functions can be developped and used
for a lot of e-health services, including e-prescription;
This allows:
...
E-health services

• E-prescription: drugs, labs, medical images,
  physiotherapy, care
• Messages ( reports, patient even...
Typical example is the
authenticated database of
professionnals

• One single permanent update; no copies
• Always availab...
Ehealth.fgov.be the Belgian technical
platform wich ensures basic services
Ehealth.fgov.be

• Authority: availability, scalability, safety,
  financial ( >1€/hab/year)
• Insurers
• Professionnals
•...
Basic services

•   Portail www.ehealth.fgov.be
•   User management
     •   Physician( e-id+ dbase of professionnals, sin...
Global architecture

   eHealth Access
      System :
    identification
   authentification                              ...
Insurer       On line
                     authorization



                      Access
     Prescription     Controlled ...
Drugs database
                   Software
                   homologation




Market                     Reimbursement


...
Conclusion

• Pilote Project end of 2010
• After, progressive enlargement to the whole
  Country
• Incentive: authorizatio...
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Building Consensus around EPrescription: the Belgian Roadmap

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Building Consensus around EPrescription: the Belgian Roadmap. Dercq JP. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

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Building Consensus around EPrescription: the Belgian Roadmap

  1. 1. e-Prescription in Belgium Based on Trust and Free Basic IT Services JP Dercq, MD
  2. 2. Some basic IT functions can be developped and used for a lot of e-health services, including e-prescription; This allows: • To limit the costs (you never pay the same thing twice) • enhancing performance (one single investment better investment) • by always using the same basic services, the professionnals becomes more familiar with these; • Basic services are developped by authority, and are free of charge for developpers of services with added value: creativity
  3. 3. E-health services • E-prescription: drugs, labs, medical images, physiotherapy, care • Messages ( reports, patient events..) • Administrative Processes (authorization, recognition) • Billing fee • Patient record, specific registers ( cancer, arthritis, orthopaedic, medical devices,….) • Decision support, EBM, journals, • E-monitoring • Data Storage
  4. 4. Typical example is the authenticated database of professionnals • One single permanent update; no copies • Always available (24/24 7/7) • Can be used to prove identity and quality • All e-health application need this basic services
  5. 5. Ehealth.fgov.be the Belgian technical platform wich ensures basic services
  6. 6. Ehealth.fgov.be • Authority: availability, scalability, safety, financial ( >1€/hab/year) • Insurers • Professionnals • Services, but no personnal health data • Personnal health data are handled under control of Professionnals
  7. 7. Basic services • Portail www.ehealth.fgov.be • User management • Physician( e-id+ dbase of professionnals, single sign on) restricted access/proven Id • Patient (e-id+dbase of patients), • Systems Certificates, PC • Loggings (track): who, what ,when • Message: encryption, structure and vocabulary (HL7, Kmehr), codification ( ICPC, ICD, ICF, ….) • Business processes coordination, especially for multi-business processes. • On line Storage ( safety, availability, scalability) • Authenticated dbases: Drugs, Professionnals, Patient, relationship P-P • Software homologation (local software or Software as a Service) • Data stamping (hashing as a proof of content at a time) • Tools for Anonymity (ex.longitudinal studies) • Free eBox for professionnals
  8. 8. Global architecture eHealth Access System : identification authentification Logging and Prescription Temporary Encrypted Encryption Public Key Time Autorisation Monitoring autorisation Audit Trail Data Storage End to End Infrastructure Stamping Policy Engine See 8 See 1 System See 7 See 2 See 3 See 4 See 6 See5 ESB Base de données des Prescribed Care services mis à Prescription Prescribers Web Portal for Providers Intermediary disposition par les ... Process Intermediary systems Patients systems mutualités Management See 15 Assurability check See 10 See 11 See 13 Other services See 9 INTERNET INTERNET Prescribed Care Prescribers Providers Integration Integration Archiving system Module Module See 16 See 12 See 14 Web Services Web Services Prescribed Care Prescribers Providers Software package Workstation Software package Other Doctor Doctor Patient Pharmacist Other Pharmacist Other
  9. 9. Insurer On line authorization Access Prescription Controlled by the profession E-Id Professionals ( physician/pharmacist) Patient -Properties Drugs - Price -authorization GP
  10. 10. Drugs database Software homologation Market Reimbursement Medical Independent Information
  11. 11. Conclusion • Pilote Project end of 2010 • After, progressive enlargement to the whole Country • Incentive: authorization • Incentive for the doctor • Incentive for the pharmacist • Incentive for the patient • Trust is created by bringing the prescription database/project under the control of Professionnals

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