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EHR S ystems U se and Q uality in Romania

EHR S ystems U se and Q uality in Romania. George Mihalas , past CEO of National Center for Health Statistics and Informatics Ministry of Health. Basic facts about: the country Population : 21,504,442 (2002) Life expectancy at birth: 73.4 y (WHO 2009)

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EHR S ystems U se and Q uality in Romania

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  1. EHR Systems Useand Qualityin Romania George Mihalas, past CEO of National Center for Health Statistics and Informatics Ministry of Health EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

  2. Basic facts about:the country • Population: 21,504,442 (2002) • Life expectancy at birth: 73.4 y (WHO 2009) • Basic facts about:the health care system • HC expenditure: 5.5% of GDP (WHO 2008) • Public sector hc expenditure as % of total hc expenditure: 81.7% (OECD 2007) • Organization: central / district auth./ local units • Ministry of Health (MoH) / 41 District Health Authorities • National Health Insurance House (NHIH) / 41 District HIH Country context (i) EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

  3. Basic facts about:General IT status/setup/developments within the health sector • Availability of IT in healthcare in Romania: • Computers (GP and hospitals): almost 100% (2010) • Internet connection: 31% (2007) • Professional IT support: <10% (2007) • Broadband connection: <5% (2007) • Link between e-health system and health system: • Most present implementation = result of national hc strategy • NHIH imposed “SIUI” = Integrated Unique Information System • Several hospitals – HIS from private companies Country context (ii) EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

  4. - Market penetration - (% of use in primary care and in secundary care (hospitals) • Simplified version (SIUI) = 100% (mandatory)in both primary care and hospitals • Extended version: • primary care ~ 50% (from small companies) • hospitals ~90% large hospitals, ~30% small hospitals EHR systems: market (i) EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

  5. Number of applications on the marketfor the different market segments (approx.) • Primary care: ~20, but only ~10 have acceptable quality • Hospitals: 5 better known applications • Pharmacies: ~6 • Dentistry: 2-3 EHR systems: market (ii) EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

  6. Market segmentation • Primary care: several providers, no visible leading group • (C-Med in West Romania ~10%) • Hospitals: • InfoWorld, Romanian Soft Co. (>50%), Total Soft, etc • Number of suppliers • In Romania a developper is usually the supplier • Evolution • Constant, but slow increase EHR systems: market (iii) EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

  7. Any legislation / regulation: Yes [1] • about the use of EHR systems? Not explicit (incl.in[1]) • aboutfunctionalities of the systems • related to functional system requirements? No • related to data-exchange and/or interoperability? No (*) • (*) Note: it does exist only related to protection of personal data [2] • [1] Ministry of Health: Strategic Plan of the Ministry of Public Health for 2008-2010 • [2] Law no 677 on the Protection of individuals with regard to Processing of Personal Data and onthe Free movement of such Data, November 2001 EHR systems:legal/regulatory context EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

  8. Any current actions • regarding quality assessing the EHR systems? • regarding requiring the use of quality assessed EHR systems? Yes: Developpers need accreditation from NHIH for compatibility of their soft with “SIUI” • Any incentive for using quality assessed / certified EHR systems? No EHR systems: quality assessment EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

  9. List and present the public initiatives / projects, if any • To promote / enforce the use of EHR systems • To assurequality of the systems • To improveinteroperability • To recognise quality labelling and certification • ProRec Romania <www.prorec.ro> • Participated in both Q-REC and EHR-QTN • Several Workshops for dissemination and promotion of EHR certification • Bucharest 2007, 2009 & Timisoara 2010, 2011 • ProRec Romania site: • List of all developpers • Eurorec Seal online support • Forms for application and self evaluation • Complete information package • etc EHR systems: initiatives, plans EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

  10. Present anyother: • ideas, proposals • message to the audience, authorities… • Need of “pressure” for accepting the necessity of EHR certification • Create incentives for the use of EHR certified systems • Present state: lack of “motivation” for developpers Ideas, proposals EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

  11. Contact data: • Prof Dr George Mihalas, University of Medicine and Pharmacy, Timisoara and ProRec Romania • Lect Dr MirceaFocsa, University of Medicine and Pharmacy, Timisoara and ProRec Romania • Web and e-mail addresses: • mihalas@umft.ro • focsam@prorec.ro • www.prorec.ro Closingslide EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

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