eHealth Marketplace- From point-to-point pilots to a pan-European

eHealth Marketplace

Henning VossDanish Centre for Health Telematics

TTeC12-14 June 2006 Tromsø

Partners

Facts:• Ten partners

• Five countries

• Start: 2004

• End: 2007

• Budget: 2 M€

The idea…

Introduction of eHealth in Rural areas

Better access to specialized healthcare

Less out migration from rural areas

Healthcare and migration?

Healthcare and migration?

49

30

5360

69

33

61

45

0

25

50

75

JOB

EDUCATION

NETWORK

HOUSING

PUBLIC

SERVICE

HEALTH

CARE

NATURE

CULTURE

Factors having great importance for choice of current settlement, % (n=1988)

Rural healthcare under pressure:48

48

46

Av: 39

• Ageing population• Lack of specialists

3 out of 4 doctors position cannot be permanently filled

The idea…

Introduction of eHealth in Rural areas

Better access to specialized healthcare

Less out migration from rural areas

Radiology as a part of a comprehensive telemedicine and eHealth network in Northern Finland, Reponen J., Int J Circumpolar Health., 2004 Dec;63(4):429-35.

Remote working: survey of attitudes to eHealth of doctors and nurses in rural general practices in the United Kingdom. Richards H, King G, Reid M, Selvaraj S, McNicol I, Brebner E, Godden D. Fam Pract. 2005 Feb;22(1):2-7.

Information Technology in the Rural Setting: Challenges and More Challenges. Frisse ME, Metzger J., J Am Med Inform Assoc. 2004 Oct 18;

Information technologies in Florida's rural hospitals: does system affiliation matter? Menachemi N, Burke D, Clawson A, Brooks RG., J Rural Health. 2005 Summer;21(3):263-8.

High-tech rural clinics and hospitals in Japan: a comparison to the Japanese average. Matsumoto M, Okayama M, Inoue K, Kajii E., Aust J Rural Health. 2004 Oct;12(5):215-9.

Cancer information needs in rural areas. Engelman KK, Perpich DL, Peterson SL, Hall MA, Ellerbeck EF, Stanton AL., J Health Commun. 2005 Apr-May;10(3):199-208

Patient safety-related information technology utilization in urban and rural hospitals. Brooks RG, Menachemi N, Burke D, Clawson A. J Med Syst. 2005 Apr;29(2):103-9

The promise of e-health--a Canadian perspective. Alvarez RC., World Hosp Health Serv. 2004;40(4):31-5.

Literature study (subset)

The idea…

Introduction of eHealth in Rural areas

Better access to specialized healthcare

Less out migration from rural areas

Aim: Provide

tools to make use of eHealth

easier

Results

• Tools that facilitate use of eHealth:Cross border eHealth infrastructureGuidelines on how to overcome

barriers for eHealthBest practise examples

Results: eHealth Infrastructure

Norway

Vilnius

Tallinn

SwedenBHN

Denmark???

Results: Guidelines on how to overcome barriers for eHealth

• Legal (finalized)

• Reimbursement (pending)

• Organisational (pending)

• Cultural / linguistic (pending)

=> Contract template…

Results: eUltrasound pilot

• Classical Second opinion approach:

• Mid-wives and doctors in Västerbotten

• The Norwegian Centre for Fetal Medicine

• First step – off-line consultation

• Second step – on-line consultation

Results: eRadiology pilot

• Lack of Radiologists in Funen hospital

Waiting lists and traveling to other hospitals.

• Solution:

• Images are taken in Funen

• Reports are made in Vilnius and Tallinn

• Start with conventional radiology

• Multi-lingual standardized reporting schemes

• Goal: From pilot to production (incl. business model)

Structured Reporting Tool

Interesting finding: Acceptance of cross border remote reporting

A: If I can get a faster treatment in Denmark, it is all right if a doctor in a foreign country does the reading of my X-rays

B: ”I do not feel comfortable with having a doctor in a foreign country read my X-rays”

72 % agreed in statement A => high acceptance(n = 1988, Danish telephone survey, oct. 2005)

Follow up

Today

• Basic infrastructure

• Point-to-point

• Guidelines on paper

• BSR

Future

• eHealth marketplace

• Many-to-many

• Guidelines integrated

• Europe

Thank you for your attention !

Henning Voss (hvo@cfst.dk)

www.Baltic-eHealth.org

Baltic eHealth and eHealth for Regions joint final conference: 21-22 May in Stockholm

Baltic eHealth is co-financed by the BSR Interreg III B programme