An Overview on ehealth Co-operation in the Baltic States. Gediminas Cerniauskas Lithuania

Transcription

1 An Overview on ehealth Co-operation in the Baltic States Gediminas Cerniauskas Lithuania

2 ehealth co-operation in the Baltic States: overview Small countries Limited healthcare resources Fragmentary and locally implemented ehealth solutions Electronic patient visit reservation Electronic patient records Telemedicine Focus on National ehealth system development Co-financing by the EU

3 ehealth co-operation in the Baltic States: needs Improve access to more specialized healthcare Reduce the costs: move the data not the patient Avoid doctors emigration Apply experience on development of national ehealth system - avoid mistakes and non effective solutions

4 ehealth co-operation in the Baltic States: barriers Interoperability standards, terminology and semantics networks and security Reimbursement not settled Legal issues Linguistic differences

5 ehealth projects Litmed (eotorhinolaryngology and eophtalmology) Baltic Medweb (infrastructure and management system) Litmed 2 (telepathology) Baltic ehealth (eradiology and eultrasound) ehealth for Regions (ecardiology) RadiologyNet (eradiology) R-Bay (eradiology) HDN.EU (European health-data network)

6 Objectives of ehealth projects Promote ehealth solutions to decision makers Demonstrate cross-border mobility Establish legal base Brake linguistic barriers Create secure infrastructure to ensure interoperability Create a functional business model (healthcare services financing / reimbursement) Stimulate adaptability in national level

7 Litmed project The project is supported by the Swedish Government through the Baltic Sea IT-fund Duration of the project is from 2000/04 - to 2002/01

8 Litmed project. Objectives Construct telemedicine pilot workstations for training and demonstration purposes between the two countries eotorhinolaryngology - co-operation between Lund University Hospital and Kaunas Medical University Hospital Teleeducation and consultations on middle ear surgery. Consultations on laryngostroboscopic images. Support to rehabilitation of children with cochlea implants Distant programming of speech processors for cochlea implants. eophtalmology distance consultation of the Lithuanian patients by Swedish specialists possibility for distance education of Swedish students from Kaunas Eye Clinic trauma department and Lithuanian specialists from Swedish Eye Hospital by Swedish specialists

9 Baltic Medweb project Continuing Litmed The Baltic Medweb project started in the 1st quarter of 2001 and one of its main goal is to establish high quality image databases and clinical routines of storing images within 4 medical disciplines. Participants/Partners Sweden, Lithuania, Latvia

10 Participants : Denmark (coordinator and lead partner), Estonia, Lithuania, Norway and Sweden. Duration of the project is from 2004 to 2007 Part-financed by the EU within the BSR INTERREG III B Neighbourhood Programme. Baltic ehealth project

11 Baltic ehealth project. Objectives -1 Connect the national healthcare data networks in Denmark, Sweden and Norway and two regional networks in Estonia and Lithuania After the establishment of the Baltic Health Network (BHN), the five participating hospitals will test the infrastructure in two pilot projects within ehealth, eultrasound and eradiology

12 Baltic ehealth project. Objectives -2 eradiology Digital images of the hip and pelvis are taken in Denmark hospital Reports are made in Lithuania and Estonia (lack of radiologist in Denmark) Multi-lingual standardized reporting schemes (automatic translation from lithuanian or estonian to danish) Acting business model (from legal base to payment system)

13 ehealth for Regions project 17 partners from 7 countries : Denmark, Finland, Germany, Lithuania, Norway, Poland, Sweden Duration of the project is from 2004/06 - to 2007/06 This project is part-financed by the European Union within the BSR INTERREG III B NP programme

14 ehealth for Regions project. Objectives to enhance the attractiveness of the regions by using ehealth as an instrument for regional development, to improve the accessibility and quality of health care available to citizens in urban and rural areas ("pervasive healthcare on the basis of ehealth"), to share knowledge and resources through transnational transfer, standardisation and localisation of ehealth solutions, to promote the acceptance of patients, doctors and other actors in the health care sector with regard to ehealth services, to build a transnational, cross-sectoral network and develop a business model promoting co-operation in the field of ehealth in the Baltic Sea region, to experience the transnational network and to co-operate in the field of telecardiology and other fields.

15 ehealth for Regions project. ecardiology The pilot implementation in the field of ecardiology aims to home care and/or for monitoring high risk patients waiting for an invasive diagnostic or bypass operation. Either medical staff like home nurses or patients are equipped with ECG devices according to the partner region (see implementation status below). After recording an ECG the transmission of the ECG records is organised cross-border via telephone calls from medical staff or patients in different countries to a multilingual server located in Bad Segeberg, Germany. The ECGs and patient data is transferred via Internet to medical specialists in the different countries where the call came from to decide about appropriate treatment. The calls for medical staff and patients are via a toll free line. The project partners pay a monthly fee per ECG device including the server based services. The sharing of a server located in Germany and buying the related services cross-border avoid investments in the partner regions.

16 RadiologyNet project Cross-border Pilot project of Teleradiology Network Development among Hospitals in Latvia and Lithuania Duration of the project is from 2006/02 - to 2007/08 Overall Objective to ensure high life quality and life span in border areas, to overcome human resource problem in remote hospitals by developing innovative solution for provision of adequate health care services in border regions by using diagnostic opportunities provided by highly skilled medical specialists from large medical centres supported by teleradiology solutions. Financing from INTERREG IIIA Programme

17 RadiologyNet project. Partners Riga Preili (LV) hospital - coordinator Ludza district (LV) hospital Zarasai (LT) hospital Riga (LV) P.Stradins Medical University Hospital Kaunas (LT) Medical University Hospital Zarasai Preili Ludza Kaunas

18 RadiologyNet project. Specific Objectives - 1 To improve diagnostic abilities of remote hospitals in provision of high quality, round-the-clock radiology services, allowing faster, more precise, therefore more effective treatment for patients in border areas in Latvia and Lithuania Ludza, PreiĜi and Zarasai; To introduce teleradiology solutions in 5 hospitals in two countries, in order to test and elaborate generalised model of teleradiology solutions in border region and remote hospitals in Latvia and Lithuania makers of both countries; To test the proposed solution of teleradiology in border areas of two countries (where the human resource problem is most acute), to summarize improvements and hopefully demonstrate effectiveness of the proposed solution to health care policy makers and offer elaborated model for inclusion into state health care policy and subsequently in respective programs.

19 RadiologyNet project. Specific Objectives - 2 To create cooperation network between organisations providing health care services for border regions of two countries - Preili hospital, Ludza district hospital, Zarasai hospital and also Kaunas Medical University Hospital and Pauls Stradins Clinical University Hospital in order to ensure experience exchange among them leading to improved diagnostic and other health care services provided in both countries. To establish functioning mechanism of data transmission and interpretation service delivery, which will serve as basis for inclusion in the network other hospitals facing similar problems; To promote teleradiology as valid and effective solution for hospitals facing problem of shortage of medical personnel, which allows to deliver high quality health care services for the patients.

20 R-Bay project (1) Partners 8 clinical sites The project supported by European Commission s eten programme.

21 R-Bay project (2) R-Bay - a counterpart to ebay, an Online Marketplace, within the field of eradiology, i.e. an emarketplace for the buying and selling of imaging related ehealth services. The emarketplace will enable the viewing and consulting of images from another organisation, region or nation, thus enabling sharing of healthcare resources on a pan- European basis.

22 R-Bay project (3) On the emarketplace providers will make their services available at a specified price and with standardised specifications, and the costumers will buy the services over a trusted and secure network. R-Bay services includes: consultation and second opinion (einterpretation) processing and analysis (eprocessing) supports services in earchiving and etraining.

23 HDN.EU project (1) Partners: Austria, Belgium, Denmark, Estonia, Germany, Finland, Great Britain, Greece, Iceland, Lithuania, The Netherlands, Norway, Serbia, Slovenia, Spain, Sweden Objective: establish a project-group about proliferating health-data network infrastructure across Europe based on a topology-independent network infrastructure and the deployment of a connection agreement system between the participating countries and regions

24 HDN.EU project (2) This project aims to add value to the communication between stakeholders, improve security in the network and provide transparency and documentation for the users in the administration of the security components in the network.

25 International fashion, national activities, value added for Europeans Electronic medical records is a buss word all over Europe Most of countries (Baltic states included) do have certain achievements in the field Being implemented nationally (under assumption that at least elementary electronic translation is developed and regulation on information exchange settled) the tool becomes one of most important elements of European market of health services

26 National solutions that may have international implications Scheme of Medical Saving Accounts (MSA) is under discussion in Lithuania. Personal income tax has to be reduced and savings for households had to be transferred to personal accounts. If policy will be approved almost all residents of the country will have medical debit cards to pay for medical products electronically in Lithuania from mid of year If international agreements are achieved the travelers may use money from MSA outside the country thus contributing towards more safe travel as well as better integration of health care markets in EU countries.

27 Discussions How to assure synergies between the rule of the low and drive for cooperation and efficiency?