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					     eHealth Marketplace
- From point-to-point pilots to a pan-European
             eHealth Marketplace
                 Henning Voss
       Danish Centre for Health Telematics


                        TTeC
                 12-14 June 2006 Tromsø
Partners
           Facts:
           • Ten partners
           • Five countries
           • Start: 2004
           • End: 2007
           • Budget: 2 M€
The idea…
   Introduction of
eHealth in Rural areas


                  Better access to
               specialized healthcare

  Healthcare and           Less out migration
    migration?              from rural areas
Healthcare and migration?
Factors having great importance for choice of current settlement, % (n=1988)
            Av: 39
75
                                           48                            69
                                            60                   61
                            53
      49
50                                                     45
                                      46                                          33
     48        30
25
Rural healthcare under pressure:
0 • Ageing population
                               3 out of 4 doctors
                               position cannot be
      JOB




                EDUCATION




                            NETWORK




                                            HOUSING




                                                      SERVICE




                                                                HEALTH




                                                                         NATURE




                                                                                  CULTURE
  • Lack of specialists
                                                       PUBLIC



                               permanently filled                CARE
The idea…
   Introduction of
eHealth in Rural areas


                  Better access to
               specialized healthcare


                           Less out migration
                            from rural areas
Literature study (subset)
Radiology as a part of a comprehensive telemedicine and eHealth network in Northern Finland, Reponen J., Int J
    Circumpolar Health., 2004 Dec;63(4):429-35.

Remote working: survey of attitudes to eHealth of doctors and nurses in rural general practices in the United
   Kingdom. Richards H, King G, Reid M, Selvaraj S, McNicol I, Brebner E, Godden D. Fam Pract. 2005
   Feb;22(1):2-7.

Information Technology in the Rural Setting: Challenges and More Challenges. Frisse ME, Metzger J., J Am Med
     Inform Assoc. 2004 Oct 18;

Information technologies in Florida's rural hospitals: does system affiliation matter? Menachemi N, Burke D,
     Clawson A, Brooks RG., J Rural Health. 2005 Summer;21(3):263-8.

High-tech rural clinics and hospitals in Japan: a comparison to the Japanese average. Matsumoto M, Okayama M,
    Inoue K, Kajii E., Aust J Rural Health. 2004 Oct;12(5):215-9.

Cancer information needs in rural areas. Engelman KK, Perpich DL, Peterson SL, Hall MA, Ellerbeck EF, Stanton
    AL., J Health Commun. 2005 Apr-May;10(3):199-208

Patient safety-related information technology utilization in urban and rural hospitals. Brooks RG, Menachemi N,
     Burke D, Clawson A. J Med Syst. 2005 Apr;29(2):103-9

The promise of e-health--a Canadian perspective. Alvarez RC., World Hosp Health Serv. 2004;40(4):31-5.
The idea…
   Introduction of
eHealth in Rural areas

  Aim:
 Provide          Better access to
               specialized healthcare
  tools to
make use
of eHealth                 Less out migration
   easier                   from rural areas
Results

• Tools that facilitate use of eHealth:
   Cross border eHealth infrastructure
   Guidelines on how to overcome
    barriers for eHealth
   Best practise examples
Results: eHealth Infrastructure

              Tallinn            Denmark
                              ???
    Vilnius




Norway

                        BHN
                                           Sweden
Results: Guidelines on how
to overcome barriers for eHealth

• Legal (finalized)
• Reimbursement (pending)
• Organisational (pending)
• Cultural / linguistic (pending)
 => Contract template…
Results: eUltrasound pilot

• Classical Second opinion approach:
  • Mid-wives and doctors in Västerbotten
  • The Norwegian Centre for Fetal Medicine
• First step – off-line consultation
• Second step – on-line consultation
Results: eRadiology pilot

• Lack of Radiologists in Funen hospital
   Waiting lists and traveling to other hospitals.

• Solution:
   • Images are taken in Funen
   • Reports are made in Vilnius and Tallinn

• Start with conventional radiology
• Multi-lingual standardized reporting schemes
• Goal: From pilot to production (incl. business model)
Structured Reporting Tool
Interesting finding: Acceptance
of cross border remote reporting
A:   If I can get a faster treatment in Denmark, it is all
     right if a doctor in a foreign country does the
     reading of my X-rays

B:   ”I do not feel comfortable with having a doctor in a
     foreign country read my X-rays”

72 % agreed in statement A => high acceptance
(n = 1988, Danish telephone survey, oct. 2005)
Follow up

Today                    Future
• Basic infrastructure   • eHealth marketplace
• Point-to-point         • Many-to-many
• Guidelines on paper    • Guidelines integrated
• BSR                    • Europe
Thank you for your attention !

      Henning Voss (hvo@cfst.dk)
       www.Baltic-eHealth.org

 Baltic eHealth and eHealth for Regions joint final
         conference: 21-22 May in Stockholm


            Baltic eHealth is co-financed by the
                BSR Interreg III B programme

				
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