The Use of the eID for Health Professionals within the Nationwide Infrastructure in The Netherlands

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The Use of the eID for Health Professionals within the Nationwide Infrastructure in The Netherlands. Sprenger M. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

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The Use of the eID for Health Professionals within the Nationwide Infrastructure in The Netherlands

  1. 1. The use of e-ID in the national infrastructure of the Netherlands Michiel Sprenger, PhD Senior Adviser IT & Innovation National Institute for IT in Healthcare
  2. 2. e-ID for health care professionals and providers
  3. 3. Agenda • Introduction to eHealth in the Netherlands • e-ID in the Netherlands • Some application areas • Questions
  4. 4. Agenda • Introduction to eHealth in the Netherlands • e-ID in the Netherlands • Some application areas • Questions
  5. 5. The Netherlands in EU Area: #22/27 Pop: #8/27
  6. 6. IT proliferation • Hospitals: • HIS 100% • PACS 100% • Clinical overview: 80% • Order management (CPOE): 30% • General Practitioners: 100% • Pharmacies: 100% • Nursing homes: 10%
  7. 7. Interconnection cross- enterprise - current • Many local and regional initiatives • NO regions in Health system, only in collaboration (+IT) • Dominant: Edifact messaging: • >100M messages / year • Prescriptions • Lab-results • Discharge letters • Patient summaries • Islands, not interconnected • Security doubtful • Need for national standards
  8. 8. Healthcare in the Netherlands • Multi-enterprise business model: • 100 hospitals, 4500 GP practices, 1800 pharmacies, 100 locum tenency services for GP’s, each responsable for own finance, medical policies, investments, and IT • Thus: interoperability problems are large on all levels •  Urge for standards •  Much debate (“polder”-model)
  9. 9. Upfront Choice for health IT • Leave information at the source • Responsibility • Unambiguousness • Security • Fits to business situation •  Connectivity, not “system” building
  10. 10. Nationwide electronic patientrecord (“the EPD”) • It is not a record, nor a system • It is an infrastructure • Leaving information at the source • In the (electronic) working environment of the Health Care Professional or Provider (HCP) • Under the responsibility of the source HCP • Enabling selective and safe information exchange between HCP’s and between HCP’s and patients
  11. 11. Standards • HL7v3 for messaging (www.hl7.org) • SNOMED-CT for “language” unification Systematitized Nomenclature of Medicine – Clinical Terms (www.ihtsdo.org) • IHE for implementation guidelines Integrating the Healthcare Enterprise (www.ihe.net) • Many others
  12. 12. Infrastructure • Standardised communication • Safe communication • Logging • Identification: patients, HCP’s • Patient consent registration & handling • Index function: search, find, transfer
  13. 13. Agenda • Introduction to eHealth in the Netherlands • e-ID in the Netherlands • Some application areas • Questions
  14. 14. HCP register - UZI • National register of: • Health care professionals (persons) • Health care providers (institutions) • UZI register (Unique HCP Identification) • UZI card
  15. 15. Health care professionals • General Practitioners (8.000) • Pharmacists (1.800) • Nurses (140.000) • Medical specialists • Dentists • Etc • Total >200.000 • Role codes: 70
  16. 16. Health care providers • GP practices (4.500) • Pharmacies (1.800) • Hospitals (100) • Etc • Total >8000
  17. 17. UZI-certificates • Authenticity (person + institution) • Confidentiality (person + institution) • Non-repudiation (person) – “signature”
  18. 18. Authorisation • Identification • Authentication • Role code • Authorisation scheme for application • Patient consent • Treatment relation • Logging of transactions
  19. 19. Agenda • Introduction to eHealth in the Netherlands • e-ID in the Netherlands • Some application areas • Questions
  20. 20. Diabetes - program • Driver: Quality • Exchange of all data relevant to diabetes between the (many) healthcare professionals involved • Self-management • Reports 20
  21. 21. Diabetes HCP’s involved • General Practitioner (often also the manager) • Diabetes nurse • Podotherapist • Physical therapist • Dietician • Internal medicine specialist • Ophthalmologist • Neurologist • ..... 21
  22. 22. Diabetes - status • Care standard - ready • Information model – ready • Architecture – ready • Implementation guidelines (44 HL7v3 messages) – ready • 2 pilots running 22
  23. 23. Questions ? sprenger@nictiz.nl

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