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This presentation discusses the Danish healthcare sector's approach to EHR systems, focusing on quality labelling and certification. It highlights the significance of the EuroRec Seal for interoperability and clinical content, discusses messaging standards, the role of General Practitioner EHR systems, and the development of a Shared Medication Record (SMR). The Danish healthcare model prioritizes equal access to care and emphasizes clinical interoperability, ensuring that healthcare providers can efficiently share patient data. The findings present practical implications for EHR implementation and certification processes.
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EHR Systems Quality Labelling and CertificationDanish Case Morten BRUUN-RASMUSSEN mbr@mediq.dk MEDIQ Belgrade. 22nd November, 2011
AGENDA • The Danish Health Care Sector • Certification • EuroRec Seal • Messaging • General Practitioner EHR systems • Shared Medication Record MEDIQ
1 The Danish Health Care Sector MEDIQ
Denmark • Parliamentary democracy and constitutional monarchy • 5,5 mill. inhabitants • 90,1% Danish • 9,9 % other • 5 Regions • 98 Municipalities • Equal and free access to healthcare MEDIQ
Health Care System: Administrative levels National Ministry of Interior and Health Regional 5 Regions Local 98 Municipalities MEDIQ
Health Care Providers – 3 sectors Primary Care Responsible for: General health problems including prevention and chronic diseases Hospitals Responsible for: Specialised treatment and intensive care Municipalities Responsible for: Prevention, rehabilitation and social care MEDIQ
2 Certificatation MEDIQ
Business Model and Costs High Costs Low Costs Self assessment Third Party Certification MEDIQ
presentation Clinical Interoperability functionality clinical content terminology Semantic interoperability model format & storage transmission Technical interoperability Communication Interoperability (ALT model) Continuity and quality Organisational level FUNCTIONAL Application level presentation Logical level TECHNICAL functionality clinical content terminology Technical level model MEDIQ format & storage transmission
3 EuroRec Seal MEDIQ
EuroRec Seal - Guideline Functional testing/certificaion • Test environment • Test scenarios • Test data • Conformance criteria's • Schedule for testing • Test log • Delivery document MEDIQ
EuroRec Seal MEDIQ
4 Messaging MEDIQ
Cross sector communication Technical testing/certification + Functional testing/certification • National health care network (1992 ) • Frequent messages in large volumes • Discharge letters, prescriptions, lab. request and results, referrals, consultation notes.... • More than 100 profiles (2011) • Vendor systems are tested by MedCom • www.medcom.dk MEDIQ
5 GP systems and ICPC - 2 MEDIQ
ICPC • International Classification of Primary Care • Has become a standard all over the world • The ICPC contains 17 chapters • A General and unspecified • B Blood, blood forming organs, lymphatics, spleen • D Digestive • F Eye • H Ear • K Circulatory • L Musculoskeletal • N Neurological • P Psychological • R Respiratory • S Skin • T Endocrine, metabolic and nutritional • U Urology • W Pregnancy, childbirth, family planning • X Female genital system and breast • Y Male genital system • Z Social problems • ICPC 2 is an extended terminology • A Danish ICPC 2 code chart can be downloaded, printed and used by the GP to find an the ICPC code for a symptom/diagnose MEDIQ
GP systems in Denmark (June 2011) 16 vendor of GP systems MEDIQ
ICPC 2 - requirements Functional testing/certificaion Enable coding of diagnosis in GP systems A national specification for the implementation of ICPC 2 Agreed with the vendors Systems must by certified MEDIQ
Conformance levels MEDIQ
ICPC test results are published Percent of tests passed MEDIQ
6 Shared Medication Record (SMR) MEDIQ
SMR: Paradigm shift FROM sending TO sharing MEDIQ
What is SMR? A Service provider of online medication data to share and update Central SMR service Secure Health-care network - Transport- Security,- Connection Service-platform Local EMR/EHR Local service consumerthat uses online data via a distributed service platform MEDIQ
SMR and EHR in Hospitals • Five years work • Specification • Development • Discussions • Mandatory to use • Primary care • Secondary care • All other • Health professionals can be fined if they do not update the SMR • Fully implemented by end 2012 Technical testing/certification + Functional testing/certification MEDIQ
SMR on mobile devices MEDIQ
Thank you.. • Morten BRUUN-RASMUSSEN • mbr@mediq.dk MEDIQ