ePrescription current approach within the eHealth strategy of Slovakia Ing. Peter Linhardt, PhD., NESS Slovakia eHealth competence center, July 2010
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Milestones of national eHealt project
National consensus in the eHealth matter Collection of stakeholders requirements Feasibility studies non-repayable financial contribution MF SR Call for Project by MoH Consortium of ITC companies Public procurement and 2 round process Win – win solution
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Definition of Slovakia solution cornerstones
Solution based on „The best of the bread“ from worldwide collection of experience and know how Comprehensive search and know- how analysis Precise costs, complexity, range, integration demand and scheduling estimation up to 2018 Establishing the cooperation and know - how transfer from z EU countries with leading position within eHealth – DK, Sweden, UK Support for MoH for costs breakdown for eHealth design and delivery, concept for its sustainability
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Slovak government resolution/support
The government of Slovak republic on special session at 2008 July 16th had approved the National eHealth program: Strategic goals of the eHealth as the key solution to improve the management quality and IT support for the health system of Slovakia Resources to ensure the strategic eHealth goals for period 2009 - 2013 in total volume of 253mil EUR Š 2010 Ness Technologies – Proprietary and Confidential
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Projects breakdown in few waves eSO1 – First wave of eHealth project - 4 main priorities according decision of Minister of health SR for period 2010 – 2011 in volume of 40mil EUR (including VAT) ►
National health portal – the only I/O to the eHealth for users
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Electronic patients folder – Personal health book and records
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ePrescription and eMedication
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eAlocatting, eScheduling, eVaccination, eAllergies, laboratory results
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HW, infrastructure, security of access and data, communication,
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Consent management
eSO XX – for period 2011 – 2013 ►
roll out of eSO1 pilots
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new domains, telemedicine, genomics
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incorporation of epSOS results,
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Key start base – list of stakeholder needs List of needs - collection of many interviews , open and published list on WEB of MoH SK. This activity enabled all stakeholders of health care processes to define, what they expect from the eHealth, what kind of support, outputs, functionality, what impact on health care processes, solutions of life situations for groups: ►
Citizens
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Foreigners
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Health professionals, care providers
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Health managements structures (MoH, regional government, Public health ..)
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Cooperative structures of the eGovernment
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Health insurances
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Milestones and schedule The eSO1 project for period 2010 – 2011 covers following milestones of development: ►
Prototypes
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Alfa version of the applications
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Beta version
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Field tests
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Handover the control to the provider
The milestone are high importance to present the delivered solution to the health professional and collect the feedback in order to eliminate bugs and misunderstanding of development teams and ensure positive confirmation of values by users The National health portal will be build stepwise and will serve to whole population, the applications roll out after pilots and integration with IS of care providers is assumed for the second wave of eHealth
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Prove of right approach of the roadmap ePrescription, eMedication, Health Portal and EHR/PHR are subject of focus of all eHealth solutions, built and utilized in national solutions within Europe, and RHO v Israel, USA, Brazil, Singapore, Australia The best result are achieved by method of small steps, no big bang is possible due the specific approach of physicians and whole segment, this is also the EC recommendation General consensus of stakeholders is essential The eHealth solution in the national measures is large scale and complex task, the successful implementation overrides the possibilities of any national or international company, operating in the country It is essential to avoid incorrect methods, approaches, accept the leanings from the analyze of fault s and errors and follow the accepted successful global and EU trends
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What is to be focused in preliminary phase
Selection of proper solution platform (HER, CHF, concept…) Selection of proper standards (CEN 13 606, archetypes…) Proper conceptual solution for interoperability and semantic interoperability on all levels (hospital, region, national, global) Wise re-use of EHR, primary for better care providing, but for statistical purposes, evidence based medicine, education, trends analyze… Direct involvement of patients in all eHealth processes, including the use and shaping of PHR Systematic engagement of the health professionals at all levels in design and functionality/user friendliness of solution Focus to the quality criteria of care providing and reporting processes – monitoring of EHR
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Efficient prescribing process
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Prescription eccuracy
Reduction of physicians and pharmacists administrative load
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Simplification of operation
Duplication of prescription
New features of e-prescription
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Improving the level of prescription
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Elimination of illegibility Elimination of prescription errors
Time – efficiency of prescription process
Restoring the validity Validity renewal Invalidation of the prescription www.ness.com
Electronic prescription high level process ■
ePRESCRIPTION
Electronic Prescription
Prescribing process
eMEDICATION Database of drugs
Database of interactions
Dispensing process
Medical history
Statistics and analysis © 2010 Ness Technologies – Proprietary and Confidential
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Basic concepts of ePrescription
Electronic prescribing: The physician has the possibility to prescribe medicines, using electronic prescriptions. In process created exact prescription includes all data required, the insurance – patient relationship, indication and prescribing restrictions are forced to be checked. Dispensation: Pharmacists has access to the process supporting services, in order to check the prescription, inquires about possible interactions of used drugs, and list of possible generic substitutes.
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Medication and medical information Patient medical history: All the products dispensed to patient on the basis of electronic prescription will be recorded in the medication history. Eligible persons to whom the patient has given access rights might get an overview of patient medical history. Information on medical products: Accurate and expert information concerning all medicinal products and drugs are available within the scope of the solution in the extend tailored for the patients and for medical professionals. Information on interactions, contraindications and warnings (Expert system): The process of drug prescribing by a physician and following dispensation by the pharmacist will be supported by expert system for automatic assessment the pre-defined risks of pharmacotherapy. Statistics and analysis of ePrescription: Prescription and medication data, collected within the application usage will support the evaluation of depersonificated data in the form of trends, and what-if analysis, to identify drugs utilization, distribution among groups of patients and to detect possible frauds. Š 2010 Ness Technologies – Proprietary and Confidential
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Rules within the ePrescription
Incorporation of prescribing and indicating restrictions
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Vetting
Feedback on the selection of prescribed drugs
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Patient compliance
■ Special cases
Long-term and multiple prescription
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Prescription recommendation
Possibility of printing of paper prescription
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Psychological effect
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Simple updates
Therapy control
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Health benefits by expert system
Pharmacodynamic risk minimization
Complete information about medication and medical history
The possibility to reduce the risk of automedication
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Adverse effects
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Secure sharing of patient information for all eligible health care providers
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The self-medication - OTC and dietetics
Interactions Contraindications Allergies
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Patient’s benefits
An enhanced awareness of the patient and improved conditions for the patient - health insurance communication concerning medication
Time saving in the process of hardly available drugs searching
Elimination of the risk by loosing and/or degradation of prescription
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Economic aspects
Automatic substitution control during dispensing prescription
Fraud detection and elimination
Elimination of duplicate prescription
Accurate information on pricing and promotion of generic substitution
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Q&A
Thank You for Your attention
Ing. Peter Linhardt, PhD., NESS Slovakia eHealth competence center
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