1. Baltic eHealth -empowering regional development in the Baltic Sea Region Henning Voss Danish Centre for Health Telematics Baltic IT&I Riga April 2006

2. Benefits of cross-border telemedicine Mobility: –Travelling patients –Move the data – not the patient Improved access to more specialized healthcare Avoid bottlenecks Avoid doctors migration

3. Barriers to telemedicine Technical Interoperability Reimbursement not settled Legal issues Cultural and linguistic differences

4. Interoperability  We need: 1)Standards, terminology and semantic consensus 2)Network and security

5. Standards and semantic consensus in Denmark

6. Network and security in Denmark Internet-based Any data type From push to pull:  Receiver in charge  Patients access own data

7. Network and Security in the BSR - one step towards interoperability Sweden Norway Vilnius Tallinn Denmark BHN ???

8. The Baltic Health Data Network

9. Tools on the network Service Portal (yellow pages) Videoconferencing broker Collaboration Platform & Structured Reporting Tool Common PACS archive for hospitals (??) Telemedicine broker (??)

10. Guidelines Legal Reimbursement Organisational Cultural / linguistic

11. eUltrasound 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. eRadiology 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. 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. Initial Results Legal issues report BHN is established Collaboration platform Structured Reporting Tool Service Portal Reports on financial, cultural and technical issues (before summer)

16. Implications for potential medical users Solves interoperability problem Addresses other eHealth problems Demonstrates patient mobility

17. Discussion If successful the BHN could be the model for an European-wide secure and interoperable infrastructure.

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

19. Thank you for your attention ! More Info: Henning Voss: hvo@cfst.dk website: www.Baltic-eHealth.org Baltic eHealth is co-financed by the BSR Interreg III B programme