1. 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

2. 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 …

3. 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!

4. 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

5. 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

6. Action 3: Virtual Integrated Drug Information System (VIDIS)

7. 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

8. 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.

9. 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

10. 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…

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. Thank you for your attention