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Electronic Health Record: different nations, different approaches

view.jpgIn a panel session at last week's International Healthcare Innovation Congress in London speakers from Denmark and Canada spoke about how their nations are tackling the Electronic Health Record (EHR).

Hans Erik Henriksen is Healthcare and Life Sciences Industry Leader, IBM North-East Region. Hans Erik emphasised the necessity of technical and semantic standards like HL7 version 3, however also noted the heavy dependency on change.

He saw the EHR as a journey to be divided into segments. Though parts of the healthcare system have chosen different routes, Denmark has a National eHealth portal, accessed by healthcare professionals and patients; for example, patients can order repeat prescriptions from their GP online.

I was particularly struck by the evolutionary approach that the small (population of about 5m) but perfectly organised Demark has taken. Its IT first replicated the look and feel of paper-based systems and evolved using the innovation of medical practitioners.

Don Sweete is Alliance Executive, Atlantic Region of Canada Health’s Infoway programme, which seeks to address some issues of an aging population, limited funds and the boom in high-cost drugs and procedures.

The programme has $1.2 bn in capital which it distributes to the 10 provinces and 3 territories of its federation when they achieve strategic goals. The method by which they are achieved is not prescribed.

Canada expects to have implemented a basic EHR—founded on registries that include information on medications and test and imaging results—by 2009, freeing patient information from the silos in which it is now stored. It will do that by emphasising interoperability based on architecture and standards, similar to those adopted by the Danes.

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I was also at the meeting, and have previously been impressed with the Danish approach. Details have been available online for ages http://www.sst.dk/upload/nit2003_mie2003.pdf and is characterised by
a) consistency of approach
b) building on what is already there
c) keeping the vision modest but purposeful
d) concentrating on the core patient information flows.

Much to recommend it.

Thanks, Andy.

Prof. Protti has also compared various nations' approaches to EPR. The slides from the associated presentation are here: http://northwest.assist.org.uk/resources/Ten%20Country%20comparison%20findings%20-%20ASSIST%20Liverpool%20Sep%2014%202006.ppt.

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