1) Poland has implemented several e-health initiatives including the Medical Information System (SIM) consisting of the P1, P2, and P4 projects. P1 enabled digital prescription filling and other functionalities. P2 allowed sharing of medical records and registers. P4 involved supplementary domain systems.
2) Pilot telemedicine projects were launched in cardiology and geriatrics to provide teleconsultations, reduce wait times and unnecessary hospitalizations, and evaluate outcomes.
3) Upcoming amendments to the Act on the health information system will require compulsory electronic medical documentation from August 2017 and enable telemedicine services from pharmacists, doctors, and others. Coordination of regional and central e-health systems is
How Sweden improved patient self service with ehealthJohan Eltes
Since 2006, a national Health Advice Line – 1177 - has been Swedish residents first point of contact with healthcare. In 2006, a national patient portal was set up to facilitate form based, secure information exchange between patients and Swedish care providers. The next step was to introduce fully digitalized self-service e-services. These services offload health care personnel from manual registration tasks and improves the service to the patients. As an example, 1177 provides a national e-service for online appointment management with primary care providers across the country. Another e-service of the national patient portal provides online access to electronic health records from the majority of the EHR systems of Sweden’s 21 county councils and 300 municipalities. The appointment e-service has had a linear increase in patient transactions, starting at 25 000 per year with a current rate of 1,2 million per year. The current development is focused on tele medicine services (a national platform for remote treatment programs), the ability for the patient to share EHR data with apps and services and a national architecture for personal connected health (home monitoring). The presentation gives an overview of e-services offered to patients, their adoption and share some lessons learned.
How Sweden improved patient self service with ehealthJohan Eltes
Since 2006, a national Health Advice Line – 1177 - has been Swedish residents first point of contact with healthcare. In 2006, a national patient portal was set up to facilitate form based, secure information exchange between patients and Swedish care providers. The next step was to introduce fully digitalized self-service e-services. These services offload health care personnel from manual registration tasks and improves the service to the patients. As an example, 1177 provides a national e-service for online appointment management with primary care providers across the country. Another e-service of the national patient portal provides online access to electronic health records from the majority of the EHR systems of Sweden’s 21 county councils and 300 municipalities. The appointment e-service has had a linear increase in patient transactions, starting at 25 000 per year with a current rate of 1,2 million per year. The current development is focused on tele medicine services (a national platform for remote treatment programs), the ability for the patient to share EHR data with apps and services and a national architecture for personal connected health (home monitoring). The presentation gives an overview of e-services offered to patients, their adoption and share some lessons learned.
20151028 hd College van Geneesheren-Directeurs - Collège des directeurs médicauxJohan van Bussel
20151028 presentation project healthdata.be to College van Geneesheren-Directeurs - Collège des directeurs médicaux. More info available @ http://www.healthdata.be
Guest lecture Programme in the Methods of Health Economics (Abteilung für Ges...healthdata be
Guest lecture Programme in the Methods of Health Economics (Abteilung für Gesundheitsökonomie, Zentrum für Public Health an der Medizinische Universität Wien)
Monday, July 20, 2015
11:00 am - 12:00 pm
Learn more about the technical framework and implementation of sPRL and how your organization can leverage this powerful tool.
¿Sabías que la palabra de Dios es tu escudo y protección?
¿Has usado la palabra de Dios como tu escudo de protección?
¿Recuerdas alguna ocasión en que la palabra de Dios fue tu escudo y te protegió?
¿Tienes algún testimonio sobre esto?
20151028 hd College van Geneesheren-Directeurs - Collège des directeurs médicauxJohan van Bussel
20151028 presentation project healthdata.be to College van Geneesheren-Directeurs - Collège des directeurs médicaux. More info available @ http://www.healthdata.be
Guest lecture Programme in the Methods of Health Economics (Abteilung für Ges...healthdata be
Guest lecture Programme in the Methods of Health Economics (Abteilung für Gesundheitsökonomie, Zentrum für Public Health an der Medizinische Universität Wien)
Monday, July 20, 2015
11:00 am - 12:00 pm
Learn more about the technical framework and implementation of sPRL and how your organization can leverage this powerful tool.
¿Sabías que la palabra de Dios es tu escudo y protección?
¿Has usado la palabra de Dios como tu escudo de protección?
¿Recuerdas alguna ocasión en que la palabra de Dios fue tu escudo y te protegió?
¿Tienes algún testimonio sobre esto?
І під кінець року хочемо вас ознайомити з результатами опитування "Потреби місцевої громади ", до якого ви долучилися і за що вам величезне Дякуємо!
Чудова можливість завдяки Isar Ednannia та Київському Міжнародному Інституту Соціології. Дякуємо!
Leader in Alternative Investment Management.
ROEL is the group of partners representing a leading value-focused alternative investment manager. We specialise in buyouts and development of middle market companies.
Digital Health in Context - Insights from Denmark, USA, China, South Korea an...Till Winkler
Slides from the workshops on Digital Health in Context at Copenhagen Business School (CBS) June 28, and the Hamburg Center of Health Economics (CHE) July 4, 2018.
An eHealth suite for the support of Primary Health Care.
Athena Triantafyllidi, IT Director at IDIKA explains the developments behind the eGov organisation for Social Security and what led them to be considered one of the leading European examples in implementing a digital reference for all those living in Greece.
Twitter: @idikagr
Governmental and private eHealth and telemedicine initiatives in LithuaniaCARRE project
R. Kizlaitis, Governmental and private eHealth and telemedicine initiatives in Lithuania, East Europe eHealth Innovation Summit, Warsaw, 15 January 2015
Presentation at the National Capitalization conference of the Swiss-Ukrainian Mother and Child Health Programme (Kyiv, Ukraine, April 23, 2015)
http://motherandchild.org.ua/eng/event/768
How to move Forward the Implementation of the EU Interoperability Recommendation to Establish Trust and user Acceptance Part 1: Perspective of a Member State. Rossing N. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)
eHealth Summit: "Case Study: How Finland became a leader in eHealth adoption"...3GDR
Slides from National eHealth Summit, 30 Sept 2015 at Carton House, Kildare: Maritta Korhonen, head of development, Ministry of Social Affairs and Health, Finland.
#eHealthSummit15
http://www.ehealthsummit.ie
http://mhealthinsight.com/2015/09/25/mhealth-insights-from-the-ehealth-summit/
Kanta services for healthcare: Prescription service and Patient Data RepositoryTHL
Kanta services for healthcare: Prescription service and Patient Data Repository.Outi Lehtokari, Development Manager, Finnish Institute for Health and Welfare
Konstantin Hyppönen, Chief Architect for Kanta Services, Kela (Social Insurance Institution, Finland). Webinar on Kanta Services 30 October 2019
National Kanta Services Support Clinical Work in FinlandTHL
National Kanta Services Support Clinical Work in Finland. Vesa Jormanainen, Finnish Institute for Health and Welfare Webinar on Kanta Services
30 October 2019
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
1. 1
e-Health Initiatives in Poland
Edyta Rokicka
Departament of Infrastructure and
eHealth
Ministry of Health
2. 2
► currently 1 entitypayers
► 2.9 thousand entitiesadministration
► 11.7 thousand entitiespharmacies
► 85.5 thousand entitiesproviders of services
► 343.4 thousand peoplemedical personnel
► 38.1 million peoplerecipients
of services
3. 3
Medical
Information
System (SIM)
• P1
• P2
• P4
Domain
Systems
• SMZ
• SMK
• ZSMOPL
• RUM NFZ
• SSOZ
• SEZOZ
• SMSFE
• SMD
Medical
Registers
• Cancer
register
• inVitro
register
• other
Health Information System
4. 4
Project: Electronic Platform for Collection, Analysis and
Sharing of Digital Medical Records
Time frame: 29.11.2007 – 15.12.2015
Budget: 713 000 000 PLN
Medical Information System - P1
5. 5
Enabling digital
prescription filling
Enabling on-line
consultation bookings
Enabling electronic
invoice processing
Providing digital
resources on medical
records, ensuring uniform
and homogenous
standards
Providing fast access to
digital medical records
in urgent cases
Enabling up-to-date
analysis of medical
records
Facilitating digital
maintenance of
medical service
provision settlements
Facilitating electronic
handling of drug refunds
Enabling electronic sick
leave processing
Key functionalities of P1
7. 7
Project: Platform for sharing services and resources of
digital medical records with on-line business (P2)
Time frame: 18.12.2007 – 31.12.2012 Budget: 6 500 000 euro
SIM - Projekt P2
8. In the upcoming years on P2 it is planned to share next subjective
registers, as well as to develop records already available.
8
Registers integrated with P2
9. 9
Project: Domain systems supplementary to health
information system
Time frame: 30.09.2015
Budget: 25 000 000 mln PLN
SIM - Project P4
10. Statistics System in Health Care;
Risks Monitoring System;
Integrated Monitoring System of Medicinal Products Trading;
Medical Workers Training Monitoring System;
Health Resources Registration System.
10
Project P4
11. 11
Pilot projects – telemedicine in the area of
cardiovascular diseases and geriatrics
Scope of the projects:
Duration: one year
Call for proposal for healthcare providers organised by regional
branches of National Health Fund
GP teleconsultations with medical specialist in cardiovascular diseases
and geriatrics
Healthcare providers will be equipped with ICT equipment
12. 12
Expected results
Limiting of waiting lists
Facilitating access to the medical
specialists
Reducing unnecessary diagnostic
hospitalisation
Evaluation report for the Agency for Health
Technology Assessment and Pricing
13. 13
• Reimbursement Systems
• Integrated Patient Information (ZIP)
National Health
Fund (Payer)
• Telemonitoring, teleconsultation, digital
health records, e-registration for visits
Private sector
Telemedicine
• Regional eHealth PlatformsSelf Government
• Local IT SystemsHospitals, General
Practitioners
Other eHealth Projects in
Poland
14. According to the law (amendment to the Act on health information
system)- compulsory medical documentation only in electronic
on 1 August 2017.
The further amendments to the Act are being proceeded at the moment.
Planned changes with regard to electronic medical documentation:
14
Amendments to Act on health information
system
•e-prescription
1 of August 2016
•e-refferal
1 of March 2017
•Other EMD (only indiviual documentation)
1 of August 2017
15. 15
Enabling provision of health services through information and
communication systems by:
pharmacists
doctors
dentists
nurses and midwives
Provisions on telemedicine
16. 16
Co-ordination with regional initiatives
Cooperation
Communication
Integration
434 projects in the area of e-Healthy were identified with a total value of nearly 1
648 million PLN.
Part of regional projects duplicate functionalities of the central information
system.
Coodination is neccessary:
Guidelines
Technical specification
Standardisation of electronic health records
17. Adaptation of IT infrastructure
of healthcare providers
transition periods
European Union funds
17
•e-prescription
1 of August 2016
•e-refferal
1 of March 2017
•Other EMD (only indiviual documentation)
1 of August 2017
Although computers are used in the majority of health care units in Poland, usage in single-physician medical practices and middle-sized ambulatories is low.
Medical documentation is still maintained in paper form.
Several voivodeships have well-developed IT systems in large clinics and specialist hospitals, in which the administration is connected to the flow of medical data from hospital wards, hospital pharmacies and surgery management systems. However, the use of IT in secondary care still seems to be much less advanced than in western Europe.
The use of e-health in Poland is very low, but some initiatives in this area have been piloted. For example, although virtually all prescriptions are dispensed in printed form, prototype e-prescriptions were implemented in 16 pharmacies, 2 medical practices and 2 outpatient clinics in 2011 in Leszno. A prototype of internet patient accounts (with information on medical history) was introduced in 2011 in several diabetic medical centres in Kraków.
Registers contain records, list or other ordered collection of personal or individual medical data, i.e. all information necessary for provision of health services. Registers provide data for different purposes (statistical, scientific, medical records) . The system is built both on existing registers, as well as on completely new records. Some registers were merged into one (Register of Entities Providing Healthcare Services was built from separate registers).
Register of pharmacies;
Register of pharmaceutical wholesalers;
Register of coding systems;
Register of medicinal products;
Register of laboratory diagnosticians;
National Cancer Register;
National Register of Cardiac Surgery;
National Register of Acute Coronary Syndrome;
InVitro Register.
Domain systems – ICT systems supporting specific area of the health care system:
NHF Medical Services Registration System,
Healthcare Statistics System,
Healthcare Resources Registration System ,
Medical Emergency Support System,
Hazard Monitoring System,
Accessibility of Healthcare Services Monitoring System,
Treatment Costs and Financial Condition of Healthcare
entities Monitoring System,
Medical products Trading Integrated Monitoring System ,
Medical Workers Training Monitoring System.
Project P1 – „Electronic Platform for Collection, Analysis and Sharing of Digital Medical Records” : the implementation of the project has started since 2007, and is planned to be completed in 2015.
P1 is the largest project of ICT and the basis is for the entire program in Healthcare.
The platform will enable various interested parties to collect, analyse and share digital resources regarding medical events. As part of the project the necessary level of security of the data processed will be ensured. As regards the data processed, the system assumes that both data entry into the system and their processing will be performed with the full knowledge of the patient, ensuring the required security measures and confidentiality.
Key benefits of the Project:
access to patient medical data regardless of time and place,
faster access to case history,
more effective treatment owing to updating data in the patient's medical documentation,
better time management owing to on-line registration,
easy access to medical information through online portals,
secure storage of medical data,
e-Prescription – convenient, safe and practical form of purchasing drugs,
possibility of monitoring by a doctor if prescription was purchased,
easier self-control of health owing to access to examination results
. W celu realizacji tej wymiany zostały wybrane standardy komunikacji, które sprawią, że proces ten będzie mógł przebiegać w sposób zunifikowany.
P1 platform will be used for communication between service providers and will enable exchange of medical records in electronic form. Medical documentation will still be stored by the service provider (producer of the documentation). P1 Platform will store information on location of the documentation. Each service provider through the P1 Platform can access medical data of another provider, if this is necessary to diagnose or further treatment of the patient.
However, there are a few specific documents which will be stored and proces by the P1 Platform such as prescription, referral and an order for medical devices. Information about these documents will be sent to the P1 in complete form (all the information inherent in a document) – P1 will be the custodian of these documents . In order to implement this exchange communication standards will be implemented.
In the financial perspective for the years 2007-2013, within the 7th priority axis of the Innovative Economy Operational Program, a project has been implemented, entitled: Platform for sharing services and resources of digital medical records with on-line businesses (P2). Within the P2 project a platform for medical records was established and launched at the beginning of 2013. The Medical Records Platform is a universal IT tool used to keep registers and provide electronic services that ensure the optimal level of safety. During integration with the P2 platform the registers are rebuilt so that they are consistent with the reference architecture of a medical register. This allows them to communicate with the P2 platform by means of web services or to be entirely embedded on the P2 platform. In 2013 and in the first quarter of 2014 the following registers were integrated with the P2 platform:
Register of permits for running commonly available pharmacies, pharmacy points and register of permits for running hospital and company pharmacies as well as hospital pharmacy departments,
Register of permits for running pharmaceutical warehouses,
Coding Systems Register,
Register of Medically Assisted Procreation mentioned in the programme "Infertility treatment by in vitro fertilisation for the years 2013 – 2016",
Residency IT System (SIR) handling the process of residency contracts implementation,
Register of Medicinal Products Authorised for the Market on the territory of the Republic of Poland.
The National Centre for Health Information Systems (CSIOZ) based on a system and technical infrastructure independent from P2 holds the National Register of Blood Donors, the National Register of Cardiovascular Operations, the Central Register of Patients with Cerebral Palsy (CRCMPD), the Monitoring System of Consumer Accidents (SMWK) and the Healthcare Communication System (ZOZMAIL).
In addition, CSIOZ is currently working on the integration of other medical registers on the P2 platform in 2014, i.e. the Central List of Pharmacists and the List of Laboratory Diagnosticians.
The functionality of the Document Exchange Platform allows public administration entities and entrepreneurs to download the registered data, exchange electronic documents between entrepreneurs and registration bodies, track current request state, receive automatic confirmation of document delivery and mark electronic documents (e.g. with date and time or electronic signature).
The project implementation was connected with the functioning in Poland 30 subjective records kept by different administrators. These registers have not been able to exchange information with each other, for the most part also with the outside world, and were not able to provide e-services. Currently at Medical Registry Platform (http://www.rejestrymedyczne.csioz.gov.pl/) are available:
- Register of pharmacies;
- Register of pharmaceutical wholesalers;
- Register of coding systems;
- Register of medicinal products;
- Register of laboratory diagnosticians.
In the upcoming years on P2 it is planned to share next subjective registers, as well as to develop records already available. In the early phase of entering P2 platform, the quality of the data reported by individual administrators left much to be desired, but now thanks to the cooperation between National Centre for Healthcare Information Systems, and individual administrators quality of publicly available data is meeting high standards.
The project will improve business processes related with access to:
a) the statistical data as referred in the Public Statistics Research Programme (PBSSP)
b) information on preventing the adverse effects of events affecting the health and life of humans,
c) information on the turnover of medicinal products,
d) information on medical professionals resources including the age, specialization, placement, training courses,
e) information on the health care resources that will allow to assess the needs of the medical equipment necessary to ensure adequate protection of the health of patients across the country, planning funds for the implementation of such purchases, according to current needs, provide access to information collected by the system to the needs of contracting medical services.
Project P4 - "Domain systems supplementary to health information system" (in progress). As part of the project in 2015 ICT systems will be built and implemented in support of specific business areas, respectively:
- Statistics System in Health Care;
- Risks Monitoring System;
- Integrated Monitoring System of Medicinal Products Trading;
- Medical Workers Training Monitoring System;
- Health Resources Registration System.
The information system operated by the NFZ is mainly used for the purpose of contract settlement. Data on the provision of health services is electronically transmitted by health care providers to the payer (the NFZ), which uses it to draw up reports for the Ministry of Health on the provision of services financed from public means. The range of data submitted by service providers is defined by the 2004 Law on Health Care Services Financed from Public Sources and includes the amount (or number) of health services provided, the number of patients on the waiting lists, drug prescriptions and consumption of refunded pharmaceuticals, and payment of insurance contributions by the insured.
Some university clinics and specialist hospitals use telemedicine in areas such as cardiology and orthopedics. Electronic appointment booking is not widespread but there are encouraging examples of such practices (e.g. for online booking of specialist appointments in hospitals). Electronic patient registration is one of the tools foreseen in Project P1 of the Healthcare Computerization Programme, which was launched in 2009 and is 85% co-financed by the EU under the Innovative Economy Programme 2007–2013.
Legal framework concerning e-Health in Poland
The Act from 28th April 2011 about information system in health care, other “Law System” in accordance with Art. 58 came into force on 1st January 2012, with the exception of certain provisions whose entry into force was provided on 1st August 2014. This applies to art. 7 paragraph. 1 point. 3 and 4, Art. 11 and Art. 50 Section 1, which regulate the conduct by providers of electronic medical records, the exchange of data in electronic medical records and electronic documents between service providers.
System Act defines the organization and operation of information systems in health care, which process data necessary to carry out state health policy, improve the quality and accessibility of health care services. It is assumed that information systems in health care is structured datasets (registers and medical records) that are able to be shared across the system. According to the Law on the system, information system is operated by: Electronic Platform for Collection, Analysis and Sharing of digital Medical Records (P1) and On-line Platform for the Services and Resources related to Digital Medical Registries (P2).
In addition, last year, the Regulation of the Council of Ministers of April 12 2012, on the National Interoperability Framework, the minimum requirements for public registry and electronic information exchange as well as the minimum requirements for IT systems, which is an important step to structure the government's information infrastructure. The regulation defines, inter alia methods and guidelines for building IT systems of public administration, system architecture, language description and referral of state registers. It also contains a series of guidelines for IT security
In 2013 National Centre for Healthcare Information Systems conducted a questionnaire survey on the analysis investigating the status and the development directions of information projects implemented in different regions of the country in the e-Health. As part of the audit, 434 projects in the area of e-Healthy were identified with a total value of nearly 1 648 million PLN.
They included regional medical information systems, implementation of IT systems in health care units, and purchase of IT and communication technology infrastructure for health care units.
Part of regional projects duplicate functionalities of the central information system. Thus coordination mechanism is neccessary. Ministry of Health issues guidelines, technical specification and stanadrs of electronic health records
In order to proces the digital medical information investment in IT are neccessary.
Large hospitals are more likely to use IT infrastructure, for both administrative purposes and for medical record keeping. According to a survey there is a wide variation in terms of IT use, which seems to be correlated with hospital size. In general, 83% of the surveyed hospitals had access to the Internet – mostly in administrative departments.
Although computers are used in the majority of health care units in Poland, usage in single-physician medical practices and middle-sized ambulatories is low.
Medical documentation is still maintained in paper form.
Service providers in the field of primary care, who do not have their own systems, will be freely available on-line application: Application Service Providers and Pharmacies, which is part of the P1 platform and enables fulfillment law obligations: record medical events in the system, download the EDM of the patients, issue of e-presribtions, e-refferal.
Other therapeutic entities (hospitals, AOS) will comunicate with the P1 through local IT systems: His (hospital information system).
Support for these activities will be available in EU funds.
