1. eHealth Marketplace -From point-to-point pilots to a pan-European eHealth Marketplace Henning Voss Danish Centre for Health Telematics TTeC 12-14 June 2006 Tromsø

2. Partners Facts: Ten partners Five countries Start: 2004 End: 2007 Budget: 2 M€

3. The idea… Introduction of eHealth in Rural areas Better access to specialized healthcare Less out migration from rural areas Healthcare and migration?

4. Factors having great importance for choice of current settlement, % (n=1988) Rural healthcare under pressure: 48 46 Av: 39 Ageing population Lack of specialists 3 out of 4 doctors position cannot be permanently filled

5. The idea… Introduction of eHealth in Rural areas Better access to specialized healthcare Less out migration from rural areas

6. 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)

7. 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

8. Results Tools that facilitate use of eHealth:  Cross border eHealth infrastructure  Guidelines on how to overcome barriers for eHealth  Best practise examples

9. Results: eHealth Infrastructure Norway Vilnius Tallinn Sweden BHN Denmark ???

10. Results: Guidelines on how to overcome barriers for eHealth Legal (finalized) Reimbursement (pending) Organisational (pending) Cultural / linguistic (pending) => Contract template…

11. 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

12. 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)

13. Structured Reporting Tool

14. 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)

15. Follow up Today Basic infrastructure Point-to-point Guidelines on paper BSR Future eHealth marketplace Many-to-many Guidelines integrated Europe

16. 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