The e-Health landscape in 2019 in Belgium: Strategy and actions Belgabiz e-Health Seminar Budapest, 16 February 2017 DAUBIE, Mickaël NIHDI, National Institute for Health and Disability Insurance Mickael.daubie@inami.fgov.be

Context : Why develop an e-health strategy? Better e-Health = Better health Better e-health = Better public health (iradiations of medical imaging) Administrative simplification for health care providers Less cost for public authorities Less fraud Better health litteracy for the patient …

Context : How to develop a e-health strategy? Round tables in 2012, updating in 2015 All e-health actors must be involved: Healthcare providers Hospitals Patients Software Sick funds Public authorities Roadmap with 20 action points! http://www.plan-esante.be/

Actions 1&2: (Summarized) Electronic Health Records (1/2) All general practitioners will have an Electronic Health Record (EHR) for all their patients and will publish a Sumehr (Summarized Electronic Health Records) The Sumehr is accessible to any doctor IF informed consent given by patient IF therapeutic relationship Legal obligation since 2017 for new general practitioners, 2021 for older GP’s

Actions 1&2: (Summarized) Electronic Health Records (2/2) For all other health care professionals, a computerized patient record will be defined and they will be able to publish information from their EHR. Hospitals and laboratories publish their documents Information must be structured and coded

Action 3: Virtual Integrated Drug Information System (VIDIS)

Action 4: Electronic prescription Drug prescriptions (doctors & dentists) Already available now, mandatory in 2018 Medical imaging & Biology Not only electronic prescription => rational prescription (EBM scripts), results available for prescribers, possibility for radiologist to substitute with a more appropriate exam. Nurse Physiotherapist

Action 6: Share to collaborate To be able to share data, each health professional (Physician, pharmacist, nursing practitioner, physiotherapist, Hospital, etc.) must have a structured and coded EHR. The next step is publishing and sharing. It may take place initially within the same professional group The "multidisciplinary patient record" of a patient. It is an instrument which guarantees access to the published data of the different EHR’s of several groups of providers.

All incentives are linked to the effective use of e-health services! Action 9 : Incentives All incentives are linked to the effective use of e-health services! Financial incentives for GP’s: from 0 EUR to 5,050 EUR depending on the effective use of 6 e-health services Physiotherapist: 800 EUR Nurses: 800 EUR Dentists: 800 EUR

Action 10 : Patient Health Record Target: Establish a consolidated platform allowing the patient to have all the information in the same place: Analytical instrument available to the patient Patient could add information himself Other information could also be added from sick funds and other relevant sources such as declarations of the patient's willingness to donate organs or euthanasia Reflection is ongoing…

Action 14 & 15 : Administrative simplification Paperless for healthcare providers: Information on prices, electronic invoicing, information on patient coverage (insured of not, type of insurance,…) Paperless for the patient: attestation of care, medication prescription, proof of incapacity for work BACK TO WORK : supporting the multidisciplinary approach in the context of the reinstatement of people who are in work incapacity by setting up a secure environment in which communication between all health care professionals can be done in confidence. HANDICARE project for the recognition of disability

Action 18 : Inventory and consolidation of all registers In order to carry out the "inventory and consolidation" of all Belgian health and health care registries, the Healthdata.be service was set up within the Scientific Institute of Public Health. Targets: Facilitate the recording of health care data in Belgium through the implementation of simple processes Ensure the efficient and secure collection and dissemination of data from scientific databases

24 pilot projects will be launched in the coming weeks Action 19 : mobile health Create a framework in the health sector to integrate m-Health applications with specific attention to legal, financial and organizational aspects. 24 pilot projects will be launched in the coming weeks 5 usecases: Cardiovascular care, diabetes, mental health, chronic pain and stroke

1 Project manager for all the roadmap Action 20 : Governance One roadmap 20 action points => (minimum) 20 project leaders + steering committee 1 Project manager for all the roadmap 1 Strategic committee on regular basis with a dashboard / reporting Specific support for developping the legal framework

And other action points… (1/3) AP 5 & 7: Sharing of structured data via the HUB & METAHUBS systems AP 8: Bel(gian) Resident Assesment Instrument (BelRai): Assess the resident's ability to carry out its daily activities in order to propose a powerful tool that offers an adapted care plan. AP 11: Communication to health care providers and patient! AP12: Training Add an e-health module to each basic training Permanent training

And other action points… (2/3) AP 13: Standards and terminology policy (SNOMED-CT) AP 16: Traceability of implants and drugs: Implementation of tools to identify the origin and reconstruct the path of an implantable medical device, from its distribution on the Belgian market to its implantation (and explantation) in a patient residing in Belgium

And other action points… (3/3) AP 17: Data bank with healtcare providers informations Development and maintenance of a common data bank containing the data of the actors and institutions of care and allow the actors of care to consult and modify / add themselves some data

Thank you for your attention