Focus on ...

eHealth as a Key Enabler:

eHealth as a Key Enabler:

Our first contributor is Dr. Peter Brosch, Head of Unit in the Austrian Federal Ministry of Health, Family and Youth. He describes the current success and future applications concerning the Austrian e-card, which was introduced in 2005.

For more than two years the e-card is THE key to the Austrian health system. For the card holder the e-card is more than a health insurance card: with the citizen card functionality it can also be used as a key to e-Government services.

Since the introduction of the e-card in 2005, its growth has been impressive. Currently more than 8.3 million e-cards are in use. About 11,000 physicians and health centres owned by the social insurance institutions are connected to the system. More than 240 million transactions have been processed and about 20,000 people have activated the citizen card function on their e-cards.

“In addition, applications have been continually added, bringing advantages to patients and health service providers,” says Dr. Brosch. “For instance the “Medication Approval Service” can quickly and securely process requests for medications that have to be approved by the insurance institutions. More than 75% of all requests are already operated via the e-card system.”

Well-accepted by citizens

The acceptance of the system has been tested in a public opinion poll and the results are overwhelmingly positive. Most of the insured citizens even requested additional applications to be added to the e-card system.

For example, they not only desired the connection of hospitals to the system (90%) but also an upgrade of the system to include an electronic prescription service (73%), electronic referrals (83%) and the possibility for health institutions to request medical findings via the e-card in order to avoid multiple examinations (77%).

Already in use in pharmacies and hospitals

In February 2007 a pilot project, the so-called "Medication Safety-Belt" – an e-medication programme using the e-card infrastructure – started in about 70 pharmacies in Salzburg. The project is a partial process of the planned e-medication application and uses a database designed for pharmacists which automatically checks all medications individually for interactions, double medication and compliance.

“The key for this service is the e-card of the insured person,” says Dr. Brosch. “This service can be used on a voluntary basis in all 70 pharmacies participating in the pilot project. The pharmacies are connected via the secure and closed Health Information Network.”

The integration of hospitals into the e-card system is an important factor and has already started. Some hospitals can now read the identification data from the public range of the e-card and process secure patient data for their IT systems. Since March 2007 hospitals can also use the so-called VDAS (Insured Data Query Service), the first e-card connected online service for hospitals. Using this service hospitals get online information about a patient's insurance status. This facilitates hospital administrators’ work and increases quality and availability of data.

Further integration with healthcare service providers

According to Dr. Brosch: “The e-card infrastructure and the secure Health Information Network provide the basis for versatile eHealth services, where identification, authentication and network security are crucial for processing any sort of application”.

The next steps in the development of the Austrian e-card system are the integration of further health service providers, electronic referrals and transfer of findings, e-prescription and e-medication, employer's quick dispatch (insurance registration and deregistration process), temporary disability reports and disease management by using the e-card for authentication and identification.

Dr. Peter Brosch is Head of Unit in the Austrian Federal Ministry of Health, Family and Youth. He is responsible for the continuous development of the Austrian Diagnoses Related Groups (DRG) System (“Leistungsorientierte Krankenanstaltenfinanzierung, LKF“), the elaboration of a documentation system for all areas of ambulatory care, measures to establish integrated health services and the development of eHealth on the European level. He is Austrian delegate to the EU-i2010/eHealth group and is on the Editorial Board of the EU-Health Portal.

WHO/European eHealth consumer trends

Our second contributor is Tove Sørensen from the Norwegian Centre for Telemedicine. She is Project Manager for a WHO/European survey investigating consumer trends in eHealth. Here she describes the objectives, initial results and next steps of the survey.

There is little knowledge on how eHealth will influence healthcare delivery. The potential of using the Internet and other electronic media in health promotion and healthcare seems promising, given the large group of people that can be reached, quickly and at low cost. However, there are important issues to take into consideration when this technology is adopted in health. This is the focus of the project WHO/European eHealth Consumer Trends, a study on eHealth use and uptake in seven European countries.

The project focuses on ‘new patients’ or consumers and the digital divide in Europe, as the Internet is becoming an increasing source of health information.

“The focus on patients and health consumers gives an opportunity to monitor to what degree eHealth practices are becoming important in the everyday lives of European citizens,” says Tove Sørensen.

Methods

The three-year project started on 1 June 2005. Seven countries participate in the project: Denmark, Germany, Greece, Latvia, Norway, Poland and Portugal, led by the Norwegian Centre for Telemedicine. The project is co-funded by the Programme of Community action in the field of Public Health eHealth (2003-2008) of the Health and Consumer Protection Directorate General, Directorate C, EC.

A representative stratified randomised sample was made in each country. The telephone survey was conducted twice in each country, late 2005 and spring 2007. The questionnaire with 21 questions was developed jointly.

Results ¹

A total of 7,934 interviews were conducted by telephone in 2005, and 7,022 interviews in 2007. In the total sample the number of Internet health users increased from 44% in 2005 to 54% in 2007 (from 71% to 83% of Internet users). The growth in the use of Internet for health purposes is found in all seven countries participating in the survey. The largest relative growth of Internet health users is found in eastern and southern Europe.

The Internet seems to be becoming a more important channel for health information. “eHealth and Internet-based health information are seen as a supplement rather than a substitute for other healthcare services,” says Tove Sørensen. “More users feel reassured than worried after having visited health information sites.”

Implications for eHealth policies

For eHealth, the picture is undergoing rapid changes which should be reflected in policy making and research programmes:

• How can we ensure that eHealth services are implemented with care, in order not to consolidate or create new inequalities in healthcare?
• How can we ensure that eHealth services support citizens and patients and thus contribute to better health outcomes for individual patients?
• How can we prevent eHealth services from fuelling unnecessary demand for health services?

Next steps

“It is our expectation that the survey will be conducted on a regular basis in all European countries forming a Forum for eHealth citizens,” adds Tove Sørensen. “Our aim is to develop a platform for eHealth trends research focusing on citizens’ use of the Internet for health purposes and its implications. The empowerment of patients, the digital divide within Europe and within population groups and confidentiality are some areas of interest for future research.”

Further information: www.telemed.no/eHealthtrends

Tove Sørensen is the Project Manager of the WHO/European eHealth Consumer Trends Project (‘eHealth Trends’). She is the head of the WHO Collaborating Centre for Telemedicine and eHealth, at the Norwegian Centre for Telemedicine in Tromsø, Norway. She has been working with international projects in telemedicine since 1997, conducting feasibility studies in a number of countries and organising workshops and training seminars. Her special interest is in 'low cost - high impact' information technologies for people, especially targeting traditionally disadvantaged groups.

 

¹ Please refer to www.telemed.no/ehealthtrends for an updated list of publications

World of Health IT 2008 Conference & Exhibition

Deadline for proposals: Monday, 11 February at 17.00 CET

11 February is the deadline to submit your paper for the World of Health Conference & Exhibition 2008 which will take place in Copenhagen, Denmark, 4-6 November.

How to submit your proposal:

1. Log on to the Call for Papers website
   Logging in your name, valid email address, and a password will ensure that only you have access to your online proposal. You will be able to come back to the site to finish or edit your proposal at any time up until the 11 February deadline.
2. Complete all fields on the 2-page online proposal form
   For your records, first prepare your proposal in a Word Document. If you wish, you may copy and paste your information from the Word document. You may return to edit an incomplete proposal as many times as needed, but the proposal must be completed before the proposal submission deadline.
3. Save your proposal # and password
   A proposal # and password will be included in the email confirmation you will receive when you submit a new proposal. Save this information. If you forget your proposal # and password, it may take up to 24 hours for a reply with your proposal # and password in order for you to access the accept/decline site in mid-April.
4. You will be notified of your proposal's status in mid-April
   Use your proposal # and password to access the "accept/decline site" in April. Your proposal will be reviewed by a panel of peer reviewers whose recommendations will be submitted to the Advisory Board, then to the Organising Committee for final selection and their decisions will be posted on the "accept/decline" site.

“Why have a Project Management Methodology in healthcare?”

There are many challenges facing healthcare IT. On the one hand are the numerous projects that could be implemented (Electronic Health Records, imaging systems, construction, RHIOs, infrastructure upgrades, new technologies etc.). On the other hand, financial resources as well as IT resources (people, process, technology) are limited.

Improving the quality, safety and efficiency of healthcare delivery is an over-riding challenge; a challenge which is exacerbated by issues unique to healthcare such as physician adoption and integration, CPOE implementation, clinical documentation and nursing shortages. In such an environment, communications and integration become complex when project team members are focused on other priorities, such as patient care.

Organisations have long-term risk and consequences for project delays or failure. In this respect, a deliverable of the HIMSS Project Management Task Force could prove extremely helpful. Entitled “Why have a Project Management Methodology in healthcare?” it puts healthcare projects into context and lists some of the key reasons for project failure.

The recommendation is a Project Management Methodology to describe every step in the project life cycle in depth and to provide:

• A formal framework to deliver more positive outcomes
• Reduced risk of project failure
• Increased efficiency/productivity
• Improved quality
• Improved communications
• Consistent results
• Standardisation of process
• Reduction of variability in process
• Increased chance of delivery to time, scope and budget
• Return on investment.

The deliverable details the many benefits achievable through such a methodology, as well as the common elements to successful projects. It can be downloaded here.

Questions anyone?
Challenge us to help you with your (healthcare ICT related) questions. Send your input to emea@himss.org (subject line: question time) and we will research and publish your questions and our answers in forthcoming issues of the eMessenger.

The HIMSS Mission

The Healthcare Information and Management Systems Society (HIMSS) is the premier professional member organisation exclusively focused on providing leadership for the optimal use of healthcare information technology.

The HIMSS mission is to lead change in the healthcare information and management systems field through knowledge sharing, advocacy, collaboration, innovation and community affiliations. HIMSS EMEA brings this mission to Europe, Middle East and Africa.

HIMSS EMEA

HIMSS in Europe, the Middle East and Africa (EMEA) is dedicated to bringing together all the major players in the Health ICT community to transcend borders and languages and engender a truly regional dialogue. As members of HIMSS EMEA, individual professionals (managers, administrators, clinicians, technology experts and users), vendor companies and IT providers meet, interact and learn from one another.

With the opening of its EMEA office in Brussels, HIMSS is now positioned to provide activities, programmes and education specifically designed for the EMEA Health ICT community. Guided by a Governing Council of members from within the EMEA region, HIMSS EMEA focuses on the needs of individual and corporate members to ensure dedicated services and membership value.

To learn more about HIMSS EMEA take a look at our website: www.himss.org/emea