ict solutions for management of health sector resources
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- 1. ICT Solutions for Managementof Health sector resourcesChisinau 19.05.20112008 SIVECO Romania.All Rights Reserved.
2. Alexandru Dan DonciulescuSIVECO RomaniaDeputy Director of the e-Health Department of SIVECO Romania, the largest software house of Romania. He is a Doctor Engineer in Applied Informatics at the Politechnica University of Bucharest. He is specialised in Decision Support Systems for Operational Control. He was for a long time with the National Institute for Research & Development in Informatics and lectured as a Professor at different Universities in Romania. In SIVECO Romania his application fields are in e-Health, especially health insurances, and is a 2 Project Manager of the SIUI System, the Information System of the National Health Insurance House in Romania. 5/25/2011 3. Summary:1. Integrated Health Information System (IHIS)2. IHIS Major Components3. Conclusion 3 5/25/2011 4. 1. IHIS - Integrated Health Information System e-Health vision45/25/2011 5. 1. IHIS e-Health vision Medical practice evolution: From the treatment of acute illness, to the prevention of disease; From considering each patient as an isolated entity, to perceiving the patient as a member of a population; From a focus on the individual, to the broader perspective of public health From paper documentation to an electronic, paperless 5 environment5/25/2011 6. 1. IHISe-Health vision In order to obtain optimal results, a National HealthInformation Strategy is required: Interoperability Security Data confidentiality Standardisation Cost-effectiveness65/25/2011 7. 1. IHISe-Health vision The eHealth system should be designed in a manner thatwould offer the best possible results for its mainbeneficiaries: the patients 7 5/25/2011 8. 2. IHIS Major ComponentsHIIS Health Insurance Information SystemsHealth Cardse-PrescribingElectronic Health RecordFuture expectations 8 5/25/2011 9. 2. IHIS Major ComponentsHealth Insurance Information System Management of the Health Insurance Fund(s) Recommended integration between Health Insurance andHealth Care systems Any service has to be paid. Payment data are reportedtogether with the service Payments from insurance funds are restricted by rules a HIIS covers all flows from the medical services contractswith the providers, to the reporting, validation and payment 9of the services HIIS is the 1st step in building a medical complex systemMay 25, 2011 10. SIUI of the NHIH Health Insurance Information SystemNHIH and 42 CHIHSIUI main objectives management of the National Health Insurance Fund management of the Insurances Register management of the medical services providers contracts management services validation and payment access using qualified certificate Business Intelligence analyses for managers26 (SIUI) + 9 (ERP) modules 10 11. SIUI of the NHIH Health Insurance Information Systemservice providerSIUI Main Flowauthentication SIUI insurance serviceservicecategorypre-validation claimat each service monthlycontracts serviceother servicesvalidationNHIH normspaymentERP SystemBankapproval andordering11 12. SIUI of the NHIH Health Insurance Information SystemOther functions: management of prescriptions management of the medical leaves management of the insurance categories links withpartner organizations management of independent contributors ERP (9 modules: Financial Accounting, Payroll, HumanResources, Inventories, Procurement, Investments, FixedAssets & Inventory Objects, Maintenance, BI) Reporting to SIUI applications for 15 types of medicalservices providers 12 13. 2. IHIS Major ComponentsHealth Cards Electronic Health Card implementation in connection withother e-Health systems.Prerequisites: Interoperability andinfrastructure availability. 13May 25, 2011 14. 2. IHIS Major Components Health Cards Stores administrativeinformation regarding healthinsurance The experience of other EUstates regarding Health Cards cards optimal use asidentification devices, ratherthan data storage Confirms the right of the 14patient to have access tomedical treatment May 25, 2011 15. 2. IHIS Major Components e-PrescribingIntroduction Recommended: integration with another e-Health system Requirements: new forms new types of printers reliable Internet connection 15 May 25, 2011 16. 2. IHIS Major Components e-Prescribing Advantages of an electronic prescribing system: clear prescription text minimization of human errors, through the implementation of a prescription validation expert system limitation of fraud risks facilitates efficient resource management16 automatic reporting process May 25, 2011 17. 2. IHIS Major Components Electronic Health RecordPre-requirements: Standardized, complete and correct electronic medical data collection Existence of IT tools for data analysis and statistical reports generationAction: National EHR (Electronic Health Record)implementationObjective: resource allocation and management according to 17national or even EU-level policiesMay 25, 2011 18. 2. IHIS Major ComponentsElectronic Health RecordEHR Electronic Health Record EHR is a complex system (comprising of hardware, software,people, policies and processes) which: Gathers data from multiple sources Is used by clinicians as a primary information source at the point of care Offers decision support in evidence based healthcare. The term describes the highest level of functionality in 18medical data computerized managementMay 25, 2011 19. 2. IHIS Major Components Electronic Patient File Patient related medical data, gathered in a consistent anduniform manner, nationwide, constitutes the ElectronicPatient File (EPF), sometimes referred to as ElectronicMedical Record (EMR) EPF is generated at birth, is updated throughout the patientslife and is stored in the system for an undetermined period oftime. EPFs must be interoperable, secure, consistent, safe and 19must ensure data confidentiality.5/25/2011 20. 2. IHIS Major Components Electronic Patient File The medical data stored in the EPF canbe accessed by the authorised cliniciansat any time and from any location. Connection with systems for healthinsurance management All medical service providers must contribute in the EPF in astandardized format. This does not mean all medical service providers must usethe same Health Information System, but the Ministry of 20Health should enforce the use of a minimum set ofstandards, in order to ensure interoperability. May 25, 2011 21. 2. IHIS Major Components eHealth system structureDecisionlevelHealthDecision Electronic Insurance makersHealth Record Medical dataDecisions Economic dataPrimary 21level Medical ElectronicElectronic Electronic service providers Prescriptions CardPatient File May 25, 2011 22. Future expectationse-Health objectives (1/2): Timely access to patient electronic medical data wheneverand wherever they are needed Patient access to their own medical records and to relevanthealth information Unified national healthcare and health insurance datacollection, both in the public and private health system Communication and information exchange between multi- 22disciplinary medical teams May 25, 2011 23. Future expectationse-Health objectives (2/2): Extensive use of international best practice guides andprocedures Improved quality, safety and efficiency of the clinicalprocesses High level of security, confidentiality and control in relationto information management Continuous health system improvement by ensuring a23transparent and optimized reporting process Implementation of a better informed health strategy May 25, 2011 24. Future expectationsChronic Disease Management Chronic diseases: are long term conditions (over 6 months) are not contagious produce certain disfunctionalities or handicaps in most cases, do not improve over time are rarely healed completely Chronic diseases are the main cause of death and morbidity24(e.g. in Europe 87% of all deaths, in high income countries,according to WHO World Health Organization) May 25, 2011 25. Future expectationsChronic Disease Management CDM represents a systematic approach to improving thequality of the medical services provided for the chronicdisease patients. Instrument: an efficient system forthe remote monitoring of chronicdisease patients and theprevention of related medicalcomplications 25 May 25, 2011 26. Future expectationsTelemedicine Remote medical monitoring enables medical professionals to monitor a patient remotely using various technological devices Improves the quality of life for chronic disease patients, by reducing the number of hospital admissions e.g. Electrocardiogram by phone Interactive telemedicine services Tele-radiology and tele-consultations:26shorter waiting lists, optimized use ofresources May 25, 2011 27. Future expectationsTelemedicineHomecare devices and applications Glycemia measurement devices Blood pressure measurement devices Devices for the recording of vital signs and other clinicalindicators 27May 25, 2011 28. 3. Conclusion eHealth Strategy285/25/2011 29. 3. ConclusionseHealth StrategyRecommended approach: a coherent and stable e-Healthstrategy proper definition of the roadmapand milestones appropriate funding for each of the 29stepsMay 25, 2011 30. 3. Conclusions eHealth Strategy Benefits: Deployment at a national level of an integrated eHealth system, part of a national eHealth Vision Reuse of solutions and experience from similar countries Use of the state of the art technologies Unique patient health record Infrastructure and information to support the long term health strategies 30 Improved health services and quality of lifeMay 25, 2011 31. 3. Conclusions A Road MapInitiativeYear 1 Year 2 Year 3 Year 3 Year 5I. Initiatives concerning legal matters1Creating the legislative framework2Determining the standardisation framework3Ensuring legislation coherenceII.Development and implementation of