15 years experience with Quality Labelling and Certification Morten BRUUN-RASMUSSEN mbr@mediq.dk MEDIQ Vilnius, Lithuania. 26th January, 2012

AGENDA The Danish Health Care Sector Certification EuroRec Seal Messaging General Practitioner EHR systems Shared Medication Record MEDIQ

The Danish Health Care Sector 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 2/12/10 MEDIQ

Interoperability (ALT model) Continuity and quality presentation clinical content model format & storage transmission terminology functionality Organisational level presentation clinical content model format & storage transmission terminology functionality FUNCTIONAL Communication Application level Clinical Interoperability Logical level Semantic interoperability TECHNICAL Technical level Technical interoperability MEDIQ

3 EuroRec Seal MEDIQ

EuroRec Seal - Guideline Test environment Test scenarios Test data Conformance criteria's Schedule for testing Test log Delivery document Functional testing/certificaion MEDIQ

EuroRec Seal MEDIQ

4 Messaging MEDIQ

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 Technical testing/certification + Functional testing/certification MEDIQ

5.5 mill. messages per month MEDIQ

Test results are published 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

Functional testing/certificaion ICPC 2 - requirements 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 MEDIQ

Conformance levels Test Group Tests Type Conformance level Baisic functionality 28 O1 100% Core functionality 21 O2 80% Extented functionality 26 O3 40% Advanced functionality A 0% MEDIQ

ICPC test results are published Percent of tests passed MEDIQ

Shared Medication Record (SMR) 6 Shared Medication Record (SMR) MEDIQ

SMR: Paradigm shift FROM sending TO sharing MEDIQ

What is SMR? Central SMR service Secure Health-care network A Service provider of online medication data to share and update Secure Health-care network - Transport - Security, - Connection Service-platform Local EMR/EHR Local service consumer that 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

Morten BRUUN-RASMUSSEN Thank you.. Morten BRUUN-RASMUSSEN mbr@mediq.dk MEDIQ