Conclusions from e-Health by hcj

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									       Conclusions from e-Health

   National Projects
           NPfIT - NHS (UK 2002)
           Estonia: Electronic Health Record System
            (2008 - )
   International projects
           EpSOS Cross Border eHealth (2008 – 2013)
           Baltic eHealth Project (2005 - 2007)




                     Kristian & Søren Duus Østergaard
                            Duus.Communications ApS
   NpfIT – Health – 2002 – 2011
    > 15 Bn €
    All hospitals, GP's medical staff in UK
    Centrally stored Summary Card
    Severe and critical audit remarks:
          Lack of overall Architecture
          Lack of citizen and staff trust in central solution
          Lack of basic principles for security/privacy
          Numerous examples of security breaches
    Development stopped in 2011
    Back to decentral organisation



                   Kristian & Søren Duus Østergaard
                          Duus.Communications ApS
    Estonia e-Health System - 2008-
   Builds on a national overall ICT strategy (from 2001)
   Clear principles and service-oriented architecture
   National Identity solution common to all sectors
   X-Road – principle connecting sub-domains
   Stepwise implementation:
           Digital patient Record (decentralised DB's)
           Digital booking/reservation
           Digital Prescription
   Well accepted and take-up steadily increases



                       Kristian & Søren Duus Østergaard
                              Duus.Communications ApS
Estonian eHealth System




       Kristian & Søren Duus Østergaard
              Duus.Communications ApS
Baltic eHealth Project - 2005-2007

   Connecting national Health networks for
    specialists – Radiology + Ultrasound
   Supplementing national staff – Rural areas
   Central hub + defined set of standards
   Infrastructure based on Danish MEDCOM
   Secure connection between hospitals
   Successful and continued as R-Bay (eTen)



                   Kristian & Søren Duus Østergaard
                          Duus.Communications ApS
              EpSOS – 2008 – 2013
            (Smart Open Services for European Patients)

   Enable patients to receive medicine and allow
    transfer of health summary record across broders
   Establish trusted network between National Contact Points
   Read-Only access allowed to practitioner
   No data stored locally (abroad)
   Interoperability addressed through:
            Clinical Document accepted architecture
            A master Value Set Catalogue
            Master translation/transcoding catalogue
            An epSOS ontology (linguistic reference system)




                          Kristian & Søren Duus Østergaard
                                 Duus.Communications ApS
           Recommendations 1
General principles for eHealth across EU:

   Common Baseline for security of eHealth Data
   Framework for x-national acceptance of eID
   Baseline set of standards for access control
   Common standards for 'secondary use'
    (like de-identification for health data used for
    statistics, research etc.)




                    Kristian & Søren Duus Østergaard
                           Duus.Communications ApS
              Recommendations 2
    International/x-border eHealth solutions
   Decision Phase:
    Define baseline standards for the data contained in the
    proposed solution and ensure maintaince of these
   Design Phase
    Establish National Control Point/Gateway and a set of
    x-national rules, audit, logging, access rights

    Secure Interoperability between users in each country

    Robust definition of network security between NCP's


                        Kristian & Søren Duus Østergaard
                               Duus.Communications ApS
             Recommendations 3
International/x-border eHealth solutions
   Operational Phase:
    Establish common body to ensure audit, monitor and
    resolve differences between countries
    Ensure compliance with changes in EU regulations

    Not only Data Protection skills, but also health authorities
    (Patient Security + privacy)

    Updating the common set of ethical and legal standards
   Decommisioning Phase
    Migration of vital data to new system(s)

                       Kristian & Søren Duus Østergaard
                              Duus.Communications ApS
Back up slides




Kristian & Søren Duus Østergaard
       Duus.Communications ApS
NHS – NPfIT - Structure




       Kristian & Søren Duus Østergaard
              Duus.Communications ApS
Baltic eHealth




  Kristian & Søren Duus Østergaard
         Duus.Communications ApS
EpSOS - Interoperability




       Kristian & Søren Duus Østergaard
              Duus.Communications ApS
EpSOS Structure




    Kristian & Søren Duus Østergaard
           Duus.Communications ApS

								
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