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Status and perspective of personal health informatics in Denmark

Status and perspective of personal health informatics in Denmark. Mads Ronald Dahl PhD, Assistant Professor Institute of Public Health Section for Health Informatics University of Aarhus Denmark MD@HI.AU.DK WWW.HI.AU.DK. Agenda. Introduction History and status Example on our research

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Status and perspective of personal health informatics in Denmark

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  1. Status and perspective of personal health informatics in Denmark Mads Ronald Dahl PhD, Assistant Professor Institute of Public Health Section for Health Informatics University of Aarhus Denmark MD@HI.AU.DK WWW.HI.AU.DK

  2. Agenda • Introduction • History and status • Example on our research • IEEE workshop input

  3. Denmark (2006) 14 counties 270 local governments 5.430.000 people 43.560 km2 No. 7

  4. Danish EHR History • 1967 System: Control data 3300 • “in a few years there will be no paper journals…..the data will be digital and assembled in a fraction of a second” • First national strategy 1996-2000 • 13 regional projects and 1 EHR observatory • Denmark wants a EHR • A lot of technical, system, bits and byte talk • Politics

  5. Danish EHR History • Second national strategy 2000-2002 • Focus of EHR in the hospital sector • Focus on data standard • What did we see and hear then?

  6. www.epj.dk Crete, October 11, 2002

  7. www.epj.dk Crete, October 11, 2002

  8. Concepts / terminology(20) B-EHRsystems(1,2) Integration Platform(8) NQR QI Pilot DGMA B-EHR pilots(3-6) IQR(17) Classifications(22,23) NHCR(14) NPI (15) Pilot NHCR(14) Legal-safetyclarification (7) ”New-DRG” Basic EHRstandard ConvertionNew -> Old (14) XML-EPJmessages(25) HealthCare-portal(18) Old-DRGaccounting Medication-messagesin XML (4) SDN oninternet(26) Primary EHR(21) PKI forHealth professionals (24) GP-systems Medicatio-profile (16) User-management Initiatives of the strategy How did we communicate and evaluate?

  9. Danish EHR History • Third national strategy 2003-2007 • Focus on EHR in the primary health sector • and continuous and interconnected healthcare system • “.. seamless data exchange among parties in • the health care service is of vital importance”.

  10. Strategy 2003-2007 vision • “The pivotal point is the patient’s influence on his own treatment and his involvement in self-care. “ “.. citizen must be able to receive and to give relevant and personally customized information.” http://www.sst.dk/publ/Publ2004/National_IT_strategy.pdf pp 17

  11. Concepts / terminology(20) B-EHRsystems(1,2) Integration Platform(8) NQR QI Pilot DGMA B-EHR pilots(3-6) IQR(17) Classifications(22,23) NHCR(14) NPI (15) Pilot NHCR(14) Legal-safetyclarification (7) ”New-DRG” Basic EHRstandard ConvertionNew -> Old (14) XML-EPJmessages(25) HealthCare-portal(18) Old-DRGaccounting Medication-messagesin XML (4) SDN oninternet(26) Primary EHR(21) PKI forHealth professionals (24) GP-systems Medicatio-profile (16) User-management Initiatives of the strategy

  12. Political vision • Relevant and personally customized information. • All Danes have an E-box • Digital signature • 720.000 issued since 2003 • Valid 2 years • I have 3 • 20% of Danes (maybe only 5 – 10 %) • Maybe 1-2% use for HI

  13. Structured EHR Structured EHR with SUP Structured EHR with LHR GEPJ GEPJ compatible GEPJ-light GEPJ-ultra....? Extended Green system Mulitsectional EHR Cross-sectional EHR Multisectional with health codes EHR with SUP EHR with instructions EHR with ...... Danish EHR 2005-2006 • More than 28% of ”Hospital beds” • 50 % of the hospitals has a EHR system • (EHR evaluation report 2005) • 99 % of general practitioner use IT

  14. The regional reform in Denmark 1.1.2007 From 14 counties to 5 regions From 270 to 98 local governments http://www.kl.dk/372656/

  15. Full stop • The Danish health minister (Lars Løkke Rasmussen) make a full stop. • He wants a central control of the EHR implementation • One EHR solution for the healthcare sector • High ambitions • Bad result • Who is to blame?

  16. Danish focus • Diabetes patients • Dermatology • Wound healing topics • E-mail consultation with general practitioner • Medicine profile (sundhed.dk) • Pharmacists • Donor register • One EHR solution

  17. IEEE 2407 vision • Healthcare Information for all by 2015 • Provide a standard of • Consumer tools to stay healthy • Consumer tools to improve health • Improve healthcare information in developing countries

  18. Scientific questions • What do we mean by “All”? • How do we stay healthy? • What improves our health? • How do we communicate with potential consumers of health informatics?

  19. Who do we mean by “All”? • Above 60 years old • Vast population • ~1.2 mill (21%). 1 • Heterogeneous • Income, health, social, mobility. 2 • Gets ill • 42% of all admissions. 3 1: Population statistics January 2006 2: Audun-Olsen, 2001:47 3: Danish statistics, SYG1A and UD1 2004-2006

  20. Our research The study • cross-sectional survey • 2000 Danes over 60 years of age • Postal questionnaire made for the purpose. • 54% responded

  21. Do the elderly use the internet for information about health and disease? • ~45% used the internet • ~20% searched for health information • ~3% searched for health information before consultation with a doctor • Age is a factor • Gender is not a factor • Attitude towards technology is a factor • Economy? • Education level? • State of health?

  22. ICT in developing country's

  23. No smoking 3 days 12 hours 27 minutes Informatics to the test

  24. Literacy level Who can we give tools of health informatics? Example: information on diabetes (thought experiment)

  25. IEEE 2407 working group • Should discuss and define: • Potential and relevant consumers • Level of information complexity • Personalized informatics • Right information • to the right person • at the right time • Usability of distribution technology • Enactment theory

  26. System (code) Communication (language) Professor Balthazar

  27. Status and perspective of personal health informatics in Denmark Mads Ronald Dahl M.Sc, PhD, Assistant Professor Institute of Public Health Section for Health Informatics University of Aarhus Denmark MD@HI.AU.DK WWW.HI.AU.DK

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