EHR Systems Quality Labelling and Certification

Danish Case

Morten BRUUN-RASMUSSENmbr@mediq.dk

MEDIQBelgrade. 22nd November, 2011

AGENDA

1. The Danish Health Care Sector

2. Certification

3. EuroRec Seal

4. Messaging

5. General Practitioner EHR systems

6. Shared Medication RecordMEDIQ

The Danish Health Care Sector

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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

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Health Care System: Administrative levels

Ministry of Interior andHealth

National

Regional

Local

5 Regions

98 Municipalities

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Health Care Providers – 3 sectors

Primary Care

Responsible for:

Generalhealth problems

including prevention and

chronic diseases

Hospitals

Responsible for:

Specialised treatment

andintensive care

Municipalities

Responsible for:

Prevention,rehabilitation

and social care

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Certificatation

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Business Model and Costs

2/12/10

Low Costs

High Costs

Third PartyCertification

Self assessment

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Interoperability (ALT model)

MEDIQCommunication

Applicationlevel

Logicallevel

Technicallevel

Semantic interoperability

Technical interoperability

presentation

clinical content

model

format & storage

transmission

terminology

functionalityClinical

Interoperability

Continuity and quality

presentation

clinical content

model

format & storage

transmission

terminology

functionality

Organisationallevel

FUNCTIONAL

TECHNICAL

EuroRec Seal

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EuroRec Seal - Guideline

Test environment Test scenarios Test data Conformance criteria's Schedule for testing Test log Delivery document

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Functional testing/certificaion

EuroRec Seal

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Start

VendorSelf evaluation

Week 1 Week 2 Week 3 Week 4 Week 5

Validation

Week 6

Vendorfix errors

Validation

Testlog

Testlog

Deliverydocument

Testlog

Deliverydocument

Messaging

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Cross sector communication 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

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Technical testing/certification

Functional testing/certification

+

5.5 mill. messages per month

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Test results are published

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GP systems and ICPC - 2

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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

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GP systems in Denmark (June 2011)

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16 vendor of GP systems

ICPC 2 - requirements

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Enable coding of diagnosis in

GP systems

A national specification for the

implementation of ICPC 2

Agreed with the vendors

Systems must by certified

Functional testing/certificaion

Conformance levels

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TestGroup

Tests Type Conformancelevel

Baisic functionality 28 O1 100%

Core functionality 21 O2 80%

Extented functionality 26 O3 40%

Advanced functionality 26 A 0%

ICPC test results are published

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Percent of tests passed

Shared Medication Record (SMR)

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SMR: Paradigm shift

FROM sending TO sharing

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What is SMR?

Central SMR service

Secure Health-care network

Service-platform

Local EMR/EHR

A Service provider of online medication data to

share and update

- Transport- Security,

- Connection

Local service consumer

that uses online data via a distributed service

platform

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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

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Technical testing/certification

Functional testing/certification

+

SMR on mobile devices

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Thank you..

MEDIQ

Morten BRUUN-RASMUSSENmbr@mediq.dk