National eHealth Projects
Electronic Health Record, Digital Registration, Digital Image, and Digital Prescription projects (see more detailed information under the section “Projects”) will be funded from the EU Structural Funds during the time period of 2005 – 2008.
The main goals of the project are:
- Decreasing the bureaucracy in doctors’ work process, and allowing for a more efficient distribution of work time.
- Making time critical medical information accessible for an attending physician.
- Making health care services more patient friendly
The total cost of these eHealth projects is approximately 34.7 million kroons. The most extensive project is the Electronic Health Record in the course of which a base infrastructure will be developed for integration of health care providers and centralization of key patient data. Digital Image, Digital Registration, and Digital Prescription will use the same message administration, authorization, central data storage, etc. services created in the framework of the EHR project.
The Foundation has a project manager’s role considering the three medical projects (Electronic Health Records, Digital Registration, and Digital Image) funded from the EU Structural Funds. During the realization of the projects it is important to ensure their interoperability, i.e. digital images and referrals will start using the IT base infrastructure (message administration environment) being created throughout the EHR project. In order to ensure the harmonized realization of the Structural Fund projects the Foundation has employed a Systems Analyst, a Software Architect, an EHR Project Manager, and a Project Manager of associated projects.
A Documentation Assistant is responsible for the project documentation and reporting associated with the rules of the Structural Funds. In relation to the Structural Funds there will be altogether 17 procurement contracts concluded, and a Specialist of Contract Law will be employed to compile and manage these contracts. During the projects’ implementation process, the Foundation will accept from tenderers the project documentation and analysis of the system to be implemented, information system along with the technical documentation, phase reports, and the projects as a whole.
At the time the documentation is being accepted, the Foundation verifies the compliance of the project documentation with the initial functions and legislation established in the invitation to tender, makes sure that the implemented information system’s functionality conforms to what was ordered, and that the project phase reports are compatible with the project plan. The respective work is carried out by the Foundation’s Quality Manager who will assess the project’s acceptance criteria in her report to the Ministry of Social Affairs.
During the time the Structural Fund projects’ are implemented, there will be approximately 1500 participants (medical care institutions, pharmacies, research institutions, state authorities, and family physicians) interfaced with the EHR system. The Foundation will enter into contracts with all of these participants, and will manage the rights associated with the counterparties. There will be eight client service representatives working at the Foundation throughout the administrative phase of the EHR. The Foundation is planning to optimize digital communication opportunities by creating an efficient service environment for the purpose of administrating contracts, users and rights, and by doing so the Foundation will reduce up to 50% costs on client service labour compared to organizations with similar activity profile and number of clients.
Development and management of classifiers, standards, and treatment guidelines of health care field
Standardization of the information circulating in the health care field is an essential prerequisite for integrating the health care system participants. For the purpose of standardization international standards, classifiers, and nomenclatures (SNOMED, HL7, etc.) will be implemented in addition to the existing information. For the purpose of integration the Foundation will acquire the rights of specific classifiers, and will become a member of respective organizations.
The Foundation manages respective classifiers and standards nationally, i.e.:
- Translates and harmonizes terminology
- Publishes (on the internet, compiles and publishes books)
- Compiles methodological materials
- Carries out the users’ training
- Provides user support
- Constantly updates information
- Participates in international cooperation
During the EHR project there will be a choice made concerning the IT standards in order to determine which standards will be implemented nationally. The Foundation makes this information accessible to all involved parties, manages versions, and ensures automatic functionality of information used by different information systems.
The Foundation will publish in cooperation with professional associations the accepted treatment guidelines on the Internet, and will standardize the automatic handling process of treatment guidelines in the information systems of health care institutions. In order to carry out these respective tasks, the Foundation employs specialists of medical classifiers, IT standards, and treatment guidelines.
Coordinates and develops the harmonisation of the provider information systems
The Foundation participates in procurements related to health care system’s know-how, and ensures that they are interfaced with the EHR system. The Foundation will participate in creating the basic procurement functions as well as in assessing the procurement outcome. The Foundation will compile the general recommended requirements for the tender documentation, that when followed, enable the creation of systems that can be interfaced with the EHR system, and are capable of using the already established components.
The realization of the EHR project will set a premise to integrate the complete health care system of Estonia. The integration is going to be a gradual process because the health care institutions vary in their IT capabilities and software use. The organizations with better IT capabilities will join the EHR system throughout the project duration.
In order to speed up integration, the Ministry of Social Affairs will apply for a Transition Facility project financing in order to update local information systems. The procurement process will begin in 2007 and the project will come into effect in 2009.
The Foundation will prepare procurements’ technical components as well as the general requirements for the development of local information systems.
Development and administration of the national health registers
The state has created several registers (approximately 20), and is planning to create more registers in order to get an overview of public health and health trends of the nation. Sending data to the registers creates a considerable amount of extra work for the doctors, and the verification of data is a substantial task for the highly qualified registrars.
A significant leap in quality and savings on labour can be achieved by utilizing the method of automated collection and pre-verification of data, through which the doctor will be released from the obligation to compile a register notification. There is a plan to create register notifications in the digital format, and to assign the responsibility of filling out these notifications to the information system of the health care institution. The digital notifications will be implemented with the digital signature feature in order to assure the liability for providing accurate information.
The Foundation will employ a Project Manager of digital register notifications who will work out respective standards, and to coordinate the implementation of these standards within the information systems of the health care institutions.
Other Administrative Projects
The Foundation will coordinate within the administrative area of the Ministry of Social Affairs the IT projects and procurements between the ministry and other organizations. At the time the procurements are implemented, the Foundation will remain as an administrator of the central segment of the IT systems on a business logic level as well as it will coordinate the provision of IT base infrastructure services to procured applications (i.e. determines the conditions of the hosting service or if needed orders an appropriate service). Following projects will be coordinated by the Foundation from the IT perspective during the first years:
- Implementation of geriatric EstRai software
- Medical register of causes of death
- Implementation of school health portal
- Centralization of infectious diseases information and electronic notification
- Creation of vaccination information system
The Foundation will be the keeper of the know-how of development projects if needed, and the Foundation will train administrators of respective applications.