establishing the business case for sharing personal health
TRANSCRIPT
Establishing the business case for sharing personal health data across borders: the VALUeHEALTH project results
Dipak Kalra, EuroRec
on behalf of the VALUeHEALTH Consortium
© HIMSS Europe GmbH
EHEALTH DSI
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Core services:
• e-Identification
• e-Signature
• e-Delivery
• e-Invoicing
• Cyber security
• eHealth services
• OpenNCP platform
• national interfaces
• country B portal
• security services
• semantic services
Generic services:
• national connectors to the
core services
• portals
• terminology translations
National/local
services:
• eHealth systems and
services that
• create and export
conformant data
• import and use
received data
• manage patient and
user identification
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European Commission
EC pump priming
= CEF investment
National health and care
systems
National eHealth
investments
National
pump priming
investments
eHealth DSI
Need to be sustained and extended
beyond 2020 to support
cross-border planned and unplanned care
Need to be sustained and extended
beyond 2020 to support
national health care needs
Need to be sustained and extended
beyond 2020 to support
cross-border planned and unplanned care
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WHAT HAVE WE SOUGHT TO ACHIEVE ?
In relation to cross-border care:
▪ Support use cases for first CEF call (shared patient summary and e-
prescriptions) ➢ Improved quality and safety of care
▪ Support for planned activity ➢ Improved continuity of care
▪ Impact on national infrastructures to enable cross-border use cases
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USE CASE SELECTION CRITERIA
• Impact on patient care
–Potential positive impact on individual patients
–Potential positive impact on number of individuals (patients, family, carers)
–Potential impact on health professionals
• Impact on health systems and services
–Improved health outcomes
–Improved health system productivity
–Reduced healthcare costs
–Improved access (to services)
• Policy alignment
–Applicability across all 28 countries
–Legal achievability
–Political acceptance
• Informatics and health ICT alignment
–Technical & semantic feasibility
–Capital costs avoided/contained
–Market stimulation
–Existing experience
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REFERENCE (BUSINESS USE) CASE
eHealth DSI
"Safe Prescribing"
(illustrating the need and value of interoperability for optimising
the safe prescribing of the appropriate medication to the
right patient, at the right dose, at the right time, including in
complex cases of co-morbidity and polypharmacy)
"Integrated Care"
(illustrating the need and value of interoperability for optimising
local care coordination, home monitoring, cross-border
unplanned care, cross-border specialty referral for
interventions)
"Integrated Specialty Care" (ERN)
(illustrating the need and value of interoperability for optimising
cross-border specialty referral for complex diagnosis and
treatment)
Optimal and Efficient Management of DIABETES with Interoperable Solutions
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DIABETES SHARED CARE SCENARIOS
• Unplanned care: a person with diabetes needs unplanned treatment/medication while visiting country B. His/her health record data are located in country A.
• Planned care: a person with diabetes needs planned care in country B. His/her cumulative health record data are located in country A.
• Transfer of care (or cross-border specialist referral): a person with diabetes is moving home to country B. His/her data recorded were previously located in country A.
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IRIA: A PT DIABETIC TYPE 1 PATIENT, NEEDS EMERGENCY CARE
IN LONDON
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OCC Real time monitoring
Alerts
NI- PS, ePr
OCC: Operational co-ordination center
NI: National Infrastructure
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EVOLUTION – FINANCING
FOCUSING ON GENERATING SUSTAINABLE GROWTH
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Uniform Rules
• Core and generic services
• Co-financing EC and MS
CEF
Post CEF
Source: eSENS Project Long Term Governance Model, 2017
© HIMSS Europe GmbH 9
VALUE PROPOSITIONS
(drivers for interoperability)
Incentivise care services for
• timely diagnosis, safe prescribing, and seamless
care
• improving patients’ health outcomes, patient safety
and population health
• increasing the efficiency of health systems (resource
optimisation)
Accelerate the development and use of interoperable digital
eHealth and mHealth solutions
Scale up population level research (e.g. big health data,
biomarkers, rare diseases)
Facilitate MS co-operation on the eHealth agenda and
support the provision of cross-border healthcare
(unplanned care, planned care)
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OPTIMISING MULTI-STAKEHOLDER VALUE CHAINS
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EHEALTH CAPABILITY REFERENCE MODEL
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Technical
Information
Legal and Regulatory
Policy Market development,
new business
models,
and incentives
Privacy, quality and
safety policies
Legislative and
regulatory
framework
Financing,
Resource allocation,
reimbursement
models
eHealth leadership,
policy and strategy
EU & National Stake-
holder collaboration
Fostering standards
adoption Monitoring,
evaluation
Mobile and fixed
Electronic
Communication
Infrastructures
ICT processing
and storage
services
Access to ICT
Networks,
equipment and
facilities
Patient identification
and patient data
discovery
Data structures and
value sets for EHR,
EMR, PHR, other
Clinical terminologies
and classifications
and codifications
Data and
knowledge
management tools
Data
interoperability
and accessibility
Data bases and
Registries
HCP Authorisation,
authentication and rights
management
Consent management
and access control
ICT Professional
and technical
support; Training
Compliance
Applications Health care
management
Individual EHR
Health service
delivery
Health
information
Diagnostics
Acute / primary
Public health
Emergency Workforce
Pharmacy Finance, HR Planning
Hosting Directory services
Governance
© HIMSS Europe GmbH
EHEALTH CAPABILITY REFERENCE MODEL
Market development,
new business
models,
and incentives
Privacy, quality
and safety policies
Legislative and
regulatory
framework
Financing,
Resource allocation,
reimbursement
models
eHealth leadership,
policy and strategy
EU & National Stake-
holder collaboration
Fostering standards
adoption Monitoring,
evaluation
Mobile and
fixed Electronic
Communication
Infrastructures
ICT processing
and storage
services
Access to ICT
Networks,
equipment and
facilities
Patient identification
and patient data
discovery
Data structures and
value sets
EHR, EMR, PHR,
other
Clinical
terminologies and
classifications and
codifications
Data and
knowledge
management tools
Data interoperability
and accessibility
Data bases
and Registries
HCP Authorisation,
authentication and
rights management
Consent management
and access control
ICT Professional
and technical
support; Training
Compliance
Health care
management
Individual EHR
Health service
delivery
Health
information
Diagnostics
Care plans
Public health
Emergency Workforce
Pharmacy Finance, HR Planning
Hosting Directory services
Governance
Intended
Outcomes:
quality of
care,
continuity of
care
New capability
Capability already in
place
Enhanced capability
Technical
Information
Applications
Legal and Regulatory
Policy
© HIMSS Europe GmbH
EHEALTH CAPABILITY REFERENCE MODEL
Technical
Information
Market development,
new business
models,
and incentives
Privacy, quality
and safety policies
Legislative and
regulatory
framework
Financing,
Resource allocation,
reimbursement
models
eHealth leadership,
policy and strategy
EU & National Stake-
holder collaboration
Fostering standards
adoption Monitoring,
evaluation
Mobile and
fixed Electronic
Communication
Infrastructures
ICT processing
and storage
services
Access to ICT
Networks,
equipment and
facilities
Patient identification
and patient data
discovery
Data structures and
value sets
EHR, EMR, PHR,
other
Clinical
terminologies and
classifications and
codifications
Data and
knowledge
management tools
Data interoperability
and accessibility
Data bases
and Registries
HCP Authorisation,
authentication and
rights management
Consent management
and access control
ICT Professional
and technical
support; Training
Compliance
Applications Health care
management
Individual EHR
Health service
delivery
Health
information
Diagnostics
Care Plans
Public health
Emergency Workforce
Pharmacy Finance, HR Planning
Hosting Directory services
Governance New capability
Capablity already in
place
Enhanced capability
Legal and Regulatory
Policy
Intended
Outcomes:
quality of
care,
continuity of
care
© HIMSS Europe GmbH
VALUEHEALTH PROPOSALS FOR THE SUSTAINABILITY OF EHDSI
SERVICES
1. Legally establish a stand-alone entity, or eHealth business unit within a
nominated entity, within the ambit of the EC and the Member States.
2. Provision its operational mandate, at minimum to maintain the existing
eHealth DSI. This will include updating semantic assets and other services
(including knowledge services such as ontology, cross-mappings, algorithms
and rules) as needed on a regular basis.
3. Ensure this entity has sufficient start-up financial underpinning and access to
growth capital to enable it to reach self sustainability through the following
proposed enhanced services.
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© HIMSS Europe GmbH
VALUEHEALTH PROPOSALS FOR THE SUSTAINABILITY OF EHDSI
SERVICES
4. Increase the number of patients for whom the services provide benefit, by extending
the patient summary to include supplementary long-term condition summaries for the
(~10) most prevalent conditions and by developing additional services (such as the
healthcare encounter report service).
5. Increase the number of care scenarios for which the services provide benefit by
further extending the structural and semantic content of patient summaries so as to
provide for cross-specialist consultations within European Reference Networks.
6. Generate value and stimulate the health ICT market by enabling third-party access to
eHealth DSI services, through standardised secure APIs, with the purpose of enabling
the growth of apps and services to professionals, patients and other stakeholders.
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© HIMSS Europe GmbH
VALUEHEALTH PROPOSALS FOR THE SUSTAINABILITY OF EHDSI
SERVICES
7. Generate value through brokering secure query access services that derive
authorised aggregated statistics across multiple nationally-held repositories of
patient summary data, to approved research organisations such as
pharmaceutical firms and the medical device industry.
8. Add further value to Member States and international public organisations by
developing public health and benchmarking dashboards derived from multiple
nationally-held repositories of patient summary data.
9. Collect cost and benefit information from Member States, especially about the
enhanced services.
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http://www.valuehealth.eu
Thank you! Dipak Kalra
on behalf of the VALUeHEALTH Consortium