Lars Hulbæk's presentation on "Building af national infrastructure for telemedicine" at the Healthcare DENMARK session, HIMSS 2015 in Chicago.

1. Lars Hulbæk
Lars Hulbæk
CEO
LHF@medcom.dk
”Building af national infrastructure
for telemedicine”
The vision:
• Simple and easy connectivity between home monitoring systems
and the national eHealth infrastructure - and existing EPR systems
in all parts of the Danish health care sector
• Support of a multi-supplier strategy and the market of home
monitoring systems
1. National action plan for Telemedicine
2. National infrastructure and standards for homem onitorering
3. The long and winding road to national dissemination

2. Lars Hulbæk
What is MedCom?
MedCom is a partnership of authorities, organisations and private enterprise associated
with the Danish health sector. In the 1999 financial agreement between the counties and
the government, it was decided to make MedCom permanent, with the following aims:
“MedCom shall contribute to the development, testing, dissemination and quality
assurance of electronic communication and information in the health sector with a view to
supporting good practice in patient care.”
MedCom is financed by:
• The Ministry of Health
• The Danish Regions
• Local Government Denmark
Lars Hulbæk, LHF@medcom.dk

3. New hospital plan
• 20 acute hospitals - 5
new
• Elective chirurgic in
specialised hospitals
• Chronic care in
primary sector
• 98 municipalities
• 2200 GPs
Lars Hulbæk, LHF@medcom.dk

4. Lars Hulbæk
National action plan for dissemination
of telemedicine (August 2012)
A common plan for the Public Health Sector
• Danish Government
• Danish Regions
• Local Government Denmark
Dissemination of mature telemedicine concepts
80 million DKK (10.7 million Euros) from the Danish Government
and a significant contribution from regions and municipalities
A part of the National eHealth Strategy 2013-2017
Lars Hulbæk, LHF@medcom.dk

5. Lars Hulbæk
Lars Hulbæk, LHF@medcom.dk
National action plan for dissemination
of telemedicine (August 2012)

6. Lars Hulbæk
Lars Hulbæk, LHF@medcom.dk
Reference Architecture for collecting Health
Data from Citizens
National Board of eHealth, June 2013

7. The national projects: Technical status
• Clinically Home Monitoring
• Home Monitoring for COPD patients
Lars Hulbæk, LHF@medcom.dk
• Open Tele platform published as open source, incl. Continua and HL7 profiles
• National database/repository version 1.0, accessible at the National Health Net
• Interface for data collection from different home monitoring systems (incl. Open Tele)
• Interface for data sharing with EPR / health portal
• Interfaces based on MedCom HL7/PHMR standards (Personal Health Monitoring Report)
• ”Data on demand” via XDS and the National Service Platform succesfully tested
• Access to data for patients at the national eHealth Portal sundhed.dk
Status February , 2015
• 1.103 uniqe patients in the national database
• 278.288 specific home monitoring results in the national repository

8. Building national infrastructure for telemedicine
Lars Hulbæk, LHF@medcom.dk
Short term
• Support from all 5 regions to the common standards, national
reference architecture and ”Open Tele”:
• Continua Health Alliance
• HL7
• IHE/XDS
• Maturing ”Open Tele” and the national Home Monitorering Repository
for operation:
• In clinical use in 3 out of 5 regions
• Ready for collecting and sharing data with municipalities and GPs
• Test and certification support to IT vendors (EPR-systems and
telemedicine applications) in MedCom
Longer term
• Regional vision statement about a distributed, regional XDS
infrastructure (Regional eHealth Cooperation, Januar 2015)

9. Three steps to cross sector dissemination
1) National consensus
• Standards and infrastructure: To ensure a multi-supplier strategy
• National business case and project plan: To ensure the marked for
eCollaboration
2) Pilot projects : Testing in daily use
--------- National infrastructure for Home Monitoring, version 1.0, Spring 2015 ---------
--------- Recalculation of the National Businesscase, Summer 2015 -----------
3) National Program for dissemination of telemedicine for COPD patients ?
• Implementation af standards in all relevant IT systems
• All relevant patients
• Hospitals
• Municipalities
• GPs
Lars Hulbæk, LHF@medcom.dk

10. Challenges and Requirements
- Cross sector large scale dissemination
Implies huge investments
• Healthcare organisations
• IT vendors
Requires strong leadership
• Courage: Selecting priority areas within telemedicine
• Persistence: Ongoing support - all the way
• Patience: The long and winding road to full dissemination…
1993 2013
MedCom eMessages
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Lars Hulbæk
CEO
LHF@medcom.dk
Thank you for your
attention!