Catalan Agency for Health Information, Assessment and Quality

Catalan Agency for Health Information, Assessment and Quality Joan Guanyabens i Calvet CAHIAQ CEO Barcelona, 15 th May 2012

Definition of the Personal Health Folder DESCRIPTION PROJECTS ACTIONS DEPLOYMENT solutions interoperability facilitate Anella TicSalut isalut.cat Healthcare model Catalan Health System personalization resources citizens standards ICT share 2.0 Internet assistance on-line health applications communication proveiders participation Health Plan quality data management professionals integration tools corresponsability accessibility Information systems personnel infrastructures information sector interaction Health Department homogenization technology Virtual space necessity security services contents untransferable, PHF, is a virtual space where the Health Department store and offer to all the Catalan citizens, through internet, relevant information of their health status to implicate citizens in the care of their own health. 2

The PHR precedent: The Shared Medical Record DESCRIPTION ICT tools to offer quality care to citizens PROJECTS Shared Medical Record evolution Shared Medical Record for Professionals Personal Health Folder for Citizens REPOSITORY ACTIONS DEPLOYMENT HEALTH CENTER CENTRAL REPOSITORY SECURITY CLINICAL WORK STATION 3

The Shared Medical Record : Sources of information DESCRIPTION 1 st level Citizens information Insurance central registry PROJECTS 2 nd level Intensive care centers Primary care centers Healthcare centers Primary care centers ACTIONS DEPLOYMENT 3 rd level Patient information level Centers with reports and documents to share Database Healthcare authority 4

The Shared Medical Record : Available information Healthcare Centers Information DESCRIPTION PROJECTS ACTIONS Primary healthcare Diagnosis Healthcare reports Immunizations Specialized attention, social-medical attention and mental health Discharge report Emergency reports Specialized outpatient clinic reports Diagnosis procedures Pathology and laboratory reports Radiological image Imaging diagnosis reports Other diagnosis tests reports Health Department Information DEPLOYMENT MDS Hospital Diagnosis Procedures Prescribed / Dispensed drugs Electronic prescription Living Will Living will registry 5

Gencat Salud Agency ICT Fronts of work for 2012-2015 Access and functioning Interactivity personalization DESCRIPTION PROJECTS INFORMATION (CONTENTS) COMUNICATION (WEB 2.0) The Personal Healt Folder will provide information regarding medical reports, medication and vaccines MY HEALTH FOLDER Patient-patient training Professional tools Healthcare interaction: pilot tests SERVICES AND PROCEDURES SERVICES AND PROCEDURES (personalized) ACTIONS Actual procedures extension through the Procedures Virtual Office PUSH: RSS, podcast, bulletins my contents my services my communities DEPLOYMENT Functioning All data from the folder will be available on a simple, intuitive and secure way, ensuring data confidentiality and patient rights Access Access mechanisms work only with digital certification (idcat, CATCert and digital ID) to ensure both privacy and patient rights 6

Principles and main objectives DESCRIPTION Principles of the PHR The citizen as owner of his data available nowadays Main objectives Encourage citizens co-responsibility for their own health PROJECTS ACTIONS Generate confidence in the system Shared model of information management Use of communication standards and catalogs Enable the participation of citizens in the management of preventive actions and health care Improve the quality of care, the coordination between different health care levels and between the professionals involved DEPLOYMENT Future goal Reach and interactive model of consultation and work between patients and the Health system (professionals included) to promote citizen s commitment with their health 7

Personal Health Folder: Access Information Functions DESCRIPTION FUNCTIONS PROJECTS ACTIONS ACCESS PHF Citizen identification and certification INFORMATION SMR Information from citizen SMR CAP Data from the citizen s CAP PROCEDURES Management, professional, entities PREVENTION Mental Health and sports SELF-CONTROL Diabetes, COPD and Sintrom OTHERS Expert patient DEPLOYMENT O No customizable items P Customizable items 8

DESCRIPTION PROJECTS ACTIONS DEPLOYMENT Personal Health Folder: Access Information Functions The Department of Health asks if the citizens wants their medical information opendata. This opendata information is available, safely and anonymously, to who wants to develop and add new features to the PHF. The development of new features will be done always based on opensource. The Department of Health establish the interoperability and security framework to develop new features. INFORMATION FUNCTIONS 9

Benefits DESCRIPTION Citizens Commitment to give the citizens more autonomy, preventive capacity and care of their own health which allows greater autonomy and comfort Prevention and monitoring PROJECTS Recognizes the HPR as the main source of health information Unique view of health services ACTIONS DEPLOYMENT Health Providers Government Reduction of errors and redundant tests Better and more efficient use of health resources Cost reduction as a consequence of the citizen s prevention and more commitment in the care of their own health Importance of citizen as central actor 10

From usability tests to reality DESCRIPTION 2008 2009 2010 2011 2012 2013 2014 2015 Usability test PROJECTS The pilot test executed throughout 2009 in Calella has been evaluated positively and the PHR will be extended progressively in 2010 to the rest of the territory. Usability test results ACTIONS 97 % valued the folder information as very or quite useful DEPLOYMENT Navigability has been declared as good or very good in 73% of the answers The language used was considered very or quite useful by 92% of the volunteers Ratings related to information on: Prescription drugs: 7.5 Medical reports: 7.3 Information on vaccines: 6.8 11

Future Actions DESCRIPTION 1. Extend the PHF to all citizens of Catalonia PROJECTS 2. Increase the functionality of the PHF ACTIONS 3. Promote access to the PHF through different channels DEPLOYMENT 4. Promote the diffusion of digital certificates for citizens 12

Future Actions DESCRIPTION PROJECTS ACTIONS DEPLOYMENT 1. 2. 3. 4. Extend the PHF to all citizens of Catalonia Citizens with access to PHF 800000,0 700000,0 600000,0 500000,0 400000,0 300000,0 200000,0 100000,0,0 Territory 17000,0 BHA Calella BHA Malgrat de Mar BHA Lloret de Mar i Palafolls BHA Terrassa BHA Mataró Sabadell and Tordera 46530,0 Collective Blood donors (aprox. 1.500) Diabetics (in progress) 682793,0 2009 2010 2011 2012 8,8% of the Catalan population has access to the PHF 13

Future Actions DESCRIPTION 1. Increase the functionality of the PHF PHF future contents PROJECTS 2. With: - Administration - Entities - Professionals Communication and interaction with professionals Tracking and monitoring Telemetry Second opinion ACTIONS DEPLOYMENT 3. 4. Usability and accessibility standards Multichannel Access to different forms of digital identification Access to accredited sources Performing procedures and access to services Common internet services and resources Acces to citizen s health information Presence in social networks Customized Health and services content Health Tips Prevention Self control Emergency notification and risk situations Health 2.0 Expert patient 14

Future Actions DESCRIPTION 1. Increase the functionality of the PHF Patient's medication plan PROJECTS 2. On-line medication plan is available through the PHF ACTIONS DEPLOYMENT 3. 4. Value - Added Services New services to facilitate management of citizens health 15

Future Actions DESCRIPTION 1. Promote access to the PHF through different channels Access to PHF via mobile phone and other devices PROJECTS 2. ACTIONS DEPLOYMENT 3. 4. Access to PHF through the Health Channel Successfully completed the pilot for access to the PHF from the mobile phone with a digital certificate 16

Future Actions DESCRIPTION 1. Promote the diffusion of digital certificates for citizens DNIe idcat PROJECTS ACTIONS DEPLOYMENT 2. 3. 4. 45 distribution offices 25 million certificates issued (Spain) 227 distribution offices 174,034 certificates issued To ensure the safety of citizen access to the PHF, is required the accreditation through a digital certificate (DNIe, idcat or other) 17

Evolution of ICT functionality and mobility on Health Five years ago, the Personal Health Folder was born as a virtual space where de Health Department store and offer to all the Catalan citizens, through internet, relevant information of their health status to implicate citizens in the care of their own health. 2008 2009 2010 2011 2012 2013 2014 2015 Definition of the Personal Health Folder as a Strategic Project in the IS-ICT Plan Usability testing of the Personal Health Folder in Calella 17.000 citizens with access (Calella BHA and blood donors) 88.727 citizens with access (Incorporation of Malgrat de Mar and Lloret de Mar BHA and Palafolls) Certificates edni: 25 million Certificates CatCert: 174.034 Allow access to diabetics Access to Medication plan Services for a personalized follow-up of patients Allow access to all Catalan citizens Common internet resources and services Communication and interaction with health professionals Involvement and presence in social networks Procedures Virtual Office to access different services - Pilot to access the PHF via mobile Access via Canal Salut MOBILITY IN HEALTH CONTENTS AND FEATURES +

ehealth Task Force Report Redesigning health in Europe for 2020

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S.L. 3 S.L. 2 S.L. 1 Catalonia ICT Strategy ICT Strategic Plan 2012-2015 In response to the Health Plan 2011-2015, the ICT Strategic Plan defines the strategy of the Agency on ICT issues. ICT Strategic Plan 2012-2015 SYSTEMS Strategic Lines Transform the medical record of Catalonia into an information and shared services network AGENTS Citizens Deploy a multichannel communication and attention network for citizens Ensure the infrastructures and services needed to build a new healthcare model 34

WORK FRONT 2 WORK FRONT 1 Agency ICT Fronts of work for 2012-2015 Fronts of works origin The fronts of work for the 2012-2015 horizon are defined by the Health Plan and the ICT Strategic Plan Agency ICT s work fronts for 2012-2015 Transform the medical record of Catalonia into an information and shared services network Deploy a multichannel communication and attention network for citizens 35

FRONT WORK 2 Agency ICT Fronts of work for 2012-2015 Front of work two Deploy a multichannel communication and attention network for citizens Action Plan 2.1 Support the deployment of infrastructure and services for Sanitat Respon to allow the availability of information Action Plan 2.2 Consolidate the Health Channel as the unique platform for interaction with all stakeholders Action Plan 2.3 Extend and provide services to the Personal Health Folder for all citizens of Catalonia Action Plan 2.4 Define the strategy and implement the project of Health 2.0 36