Estonian Electronic Health Record System (EHR)

Report
Estonian Electronic Health Record
System (EHR)
MD.Madis Tiik
CEO
Estonian E-Health Foundation
HCP PORTAL
2011
PATIENT PORTAL
2009
XROADS GATEWAY
SERVICE
2009
PHARMACIS AND
FAMILY DOCTORS
2009
eHealth Foundation
EHR
SYSTEM
2009
2012
EMERGENCY MEDICAL SERVICE
2011 september
SCHOOL NURSES
2010 january
PHARMACIS
2009
FAMILY DOCTORS
2009
HOSPITAL ( HIS) integration
BUSINESS REGISTER
POPULATION REGISTER
- Health care providers
- Health professionals
- Dispensing chemists
HEALTH CARE BOARD
- Coding Centre
- Handlers of medicines
STATE AGENCY OF MEDICINES
Architecture of Estonian
healthcare IT
X-Roads, ID-card, State IS Service Register
Health Insurance
INSURANCE REGISTER
CLAIMS & REIMBURSMENT
PRESCRIPTION
CENTRE
2010 january
Situation in 01.05.2011
• Availability of digital documents on the EHR
– Discharge letters (epicrises)
– Out-patient consultation notes
90%
around 15%
• Other documents in the EHR
–
–
–
–
–
Images raports
immunization note
Day surgery note
Referrals
Birth epicrises
• There are 4 886 891 ePrescriptions issued during 2010, it is more than
80% all prescriptions in 2010
• 100% of Radiological images (excl. dental) are digital and stored to the
PACS
• More than 602 379 citizens have digital medical records in EHR – it is
47% of the population
• 29 105 citizens have viewed his/her data in EHR (Patient Portal)
Retrieval of medical documents by healthcare professionals
60,000
50,000
More than 95% of Estonian doctors
have used the EHR services
40,000
30,000
20,000
10,000
2009
2010
March
February
January
December
November
October
September
August
July
June
May
April
March
February
January
December
November
October
September
August
July
June
May
April
March
0
4
Distribution of costs and benefits of Estonian eHealth platform (Digimpact study 2010)
:
Total cost of EHR system development (2005-2010) has been
around 10M€ - it is 7.5€ per citizen
http://eng.e-tervis.ee/digimpact-final.html
Estonian roadmap for eHealth
Impact
Shared
care
Decision
Support
Information
Exchange
Simulation
Environment Tracking
Behaviour Tracking
Online Intervention
Lifestyle Value Added
Personal Guidelines
Care Paths
Service Brokering
Integrated Statistics
Social Networking
Central EHR
Health Portal
Registries Integration
Standardization
Local EMRs
Digital Claims & Reimbursement
1992
2010
Time
2015
2020
Healthcare transformation
• Patient data available to any clinician who needs to see it
• Legal reforms
• Access protocols
• Clinician engagement
• Payment for value and for care coordination
• Relationship between providers and payers
• Metrics of value
• Processes of coordination
• Preventive health maintenance centred on the patient
• Allocation of funding and staff
• Patient engagement
• Clinician engagement
E-Health is one thing that makes these transformations in healthcare possible,
but it is not a substitute for the transformations!
Thank you!
e-Health=healthcare management
e-Health ≠ICT project
[email protected]
wwww.etervis.ee

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