eHealth Suomi

kansainvlisess

vertailussa

LT Pivi Hmlinen

Johtava asiantuntija, THL

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Kansainvliset toimijat nkevt terveydenhuollon digitalisaatiokehityksen seurannan, sek kansallinen ett kansainvlisen, trkeksi

Koska

Terveydenhuollon digitalisaatiolle on asetettu suuria odotuksia terveydenhuollon kustannusten hallinnalle, tehokkuudelle, toiminnan laadulle, vaikuttavuudelle, potilasturvallisuudelle

Odotetaan ett se muuttaa terveydenhuoltojrjestelmn ja kansalaisen (asiakkaan/potilaan) vlist suhdetta tavalla, joka voimaannuttaa ihmiset itse hallitsemaan paremmin terveyteens ja sairauteensa liittyvi asioita

Odotetaan ett terveydenhuollon digitalisaatiokehityksess on tietoteknologiateollisuuden osana merkittvi mahdollisuuksia taloudellisesta nkkulmasta Euroopassa/USA:ssa/ ym. eri maissa

Sosiaalihuollon digitalisaatiosta on vasta alettu keskustella, eik se ole viel astella, jossa sille olisi juurikaan kv-seurantaa.

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Keskeiset kansainvliset toimijat seuraavat eHealth kehityst

EU Komissio; sairaaloiden ja perusterveydenhuollon kyselyt

OECD eHealth Benchmarking projekti

WHO Global Observatory for eHealth

Pohjoismainen ministerineuvosto; Nordic eHealth Benchmarking

Commonwealth Fund kyselyt (ei Suomi)

HIMSS (Healthcare Information and Management Systems Society ) sairaalabenchmarkingpalvelu

Tilastoviranomainen (Tilastokeskus/Eurostat) seuraa vestn digitalisaation kyttastetta ja joitain yrityksiin liittyvi mittareita

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

http://ec.europa.eu/eurostat/web/ess

WHO

WHO hyvksyi vuonna 2005 ptslauselman, jonka mukaan WHO focuses on strengthening health systems in countries through the use of eHealth ja vuonna 2013 ptslauselman recognized the need for health data standardization as part of eHealth systems and services, and the importance of proper governance and operation of health-related global top-level Internet domain names, including .health.

Ptslauselmien toimeenpanon seuraamiseksi WHO:n Global Observatory for eHealth on seurannut maiden eHealth kehityst kyselyill vuosina 2005, 2009, 2013 ja 2015 (ei viel julkaistuja tuloksia)

WHO julkaisee aakkosjrjestyksess kaikkien jsenmaidensa eHealth politiikkojen (policy) koosteet. http://www.who.int/goe/policies/countries/en/ Vertailua indikaattoritasolla on WHO aluetoimistojen alueiden vlill ja lisksi eri aiheisia fokusoituja raportteja. Suomi on vastannut kyselyihin, mutta Suomi/muut maat tarkkuustasolta ei ole julkaistu tuloksia.

http://www.who.int/goe/publications/en/

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

http://www.who.int/goe/policies/countries/en/http://www.who.int/goe/policies/countries/en/http://www.who.int/goe/policies/countries/en/http://www.who.int/goe/publications/en/http://www.who.int/goe/publications/en/

OECD eHealth Benchmarking OECD nkee digitalisaation trkess roolissa terveydenhuoltojrjestelmien

uudistuksissa ja saatavuuden, laadun ja tehokkuuden edistmisess. Seuranta on trke digitalisaation vaikutusten arvioimiseksi ja vertaiskehittmisen tueksi. Nkemystens pohjalta OECD kynnisti vuonna 2008 yhteistyn maiden digitalisaatiokehityst kuvaavan mittariston kehittmiseksi.

Malli survey valmistui vuonna 2013, saatavilla OECD:n verkkosivuilta. http://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdf

Suomalainen kokemus eHealth kyselyjen tekemisest ja Pohjoismaisen ministerineuvoston alainen asiantunijaverkostoty on merkittvll tavalla ollut tukemassa OECD:n mallikyselyn valmistelua.

OECD:n terveysministerikokous 2010 called for OECD support to strengthen national health information infrastructure to provide the evidence needed to improve health care quality and the performance of health system. Tm osaltaan tuki eHealth banchmarking tyn jatkamista.

Joukko maita sitoutui pilotoimaan mallikysely. Suomessa se integroitiin osaksi terveydenhuollon tietoteknologiakartoitusta ja kytettvyyskysely. Nin Suomella on kytssn data, joka voidaan hydynt OECD:n benchmarking yhteistyss. 10 maata testaa parhaillaan kysely. (Brasilia, Kanada, Suomi, Saksa, Israel, Hollanti, Etel-Korea, USA, Sveitsi). Tuloksia on Suomen tavoin kansallisesti julkaistu eri tavoin, mutta yhteisi benchmarking raportteja ei ole julkaistu, ne ovat vasta viranomaisten omien typapereiden tasolla.

http://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdf

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

http://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdfhttp://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdfhttp://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdfhttp://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdfhttp://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdfhttp://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdfhttp://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdfhttp://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdfhttp://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdfhttp://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdfhttp://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdfhttp://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdfhttp://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdfhttp://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdfhttp://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdfhttp://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdfhttp://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdfhttp://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdfhttp://www.oecd.org/els/health-systems/Pilot-Countries-Measuring-ICTs-in-the-Health-Sector.pdf

EU

15-vuotta terveydenhuollon (ja muun) digitalisaation editmist Euroopassa: eEurope initiative 1999, i2010 Strategy 2005, EU Digital Agenda for Europe, Europe 2020 Initiative,

eHealth Lead Market Initiative

eHealth Action Plan 2012-2020, Directive 2011/24, Article 14

eHealth Network the network aims to enhance interoperability between electronic health systems and continuity of care and to ensure access to safe and quality healthcare.

EU:n eHealth politiikassa tavoitellaan sit, ett rajat ylittvss hoidossa mys potilastieto liikkuisi

rajojen yli. Tt varten kaikkiin jsenmaihin tarvitaan

tiedonvlitykseen riittvn kypst eHealth infrastruktuurit.

EU:n nkkulmasta on siksi trke tiet millainen jsenmaiden

Digitalisaatiokehitys on.

- Pydll eurooppalaisten potilaiden palvelut ja

eurooppalaisen terveydenhuollon ja sen IT:n markkinat

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

EU general practitioners kyselyt (perusterveydenhuolto)

Survey 2007 (European Commission and Empirica (2008), Benchmarking ICT use among general practitioner in Europe):

Tanska, Hollanti, Suomi ja Ruotsi todettiin edellkvijmaiksi perusterveydenhuollon digitalisatiokehityksess

Survey 2013 (Codagnone C & Lupiaez-Villanueva F 2013)

Benchmarking deployment of eHealth among General Practitioners II 2013. Mukana 31 maata (EU27+ Kroatia, Islanti, Norja ja Turkki), kysely 9196 perusterveydenhuollon lkrille. Kokonaisuudessaan kuusi parasta maata olivat Tanska, Espanja, Norja, Viro, Hollanti ja Suomi. Maakohtaiset tulokset raportoitiin komposiitti-indikaattoreina ja mailla oli hiukan eri profiilit niiden suhteen. (EHR, HIE, Telehealth, and PHR). Suomen sijoitukset; 8. EHR, 4. HIE, 2. telehealth ja 14. PHR. Yksittisist asioista pth radiologiassa Suomi paras.

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Codagnone C & Lupiaez-Villanueva F. (2013)

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Codagnone C & Lupiaez-Villanueva F. (2013)

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Codagnone C & Lupiaez-Villanueva F. (2013)

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Codagnone C & Lupiaez-Villanueva F. (2013)

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

EU erikoissairaanhoidon (sairaaloiden) kyselyt

2010 kysely (Deloitte & Ipsos 2011).

The e-health usage in European acute care hospitals , sairaaloiden tietohallintojohtajille ja johtaville lkreille osoitettu kysely vuonna 2011. Mukana oli satunnaisotos sairaaloita 27 EU maata + Kroatia, Islanti ja Norja. Tuloksissa Suomi oli EU keskitason ylpuolella 11/13 kytetyll indikaattorilla. Parhaiten Suomen sairaalat suoriutuivat seuraavissa: Internetyhteydet, PACS, laboratoriotiedonvaihto ja ohjeet potilastiedon shkisest ksittelyst. Yleisess kytss olevan shkisen reseptin puute ja teknisten vikojen korjausnopeus olivat heikoimmat kohdat.

2012 kysely: (Joint Research Centre of the European Commission 2013)

Euroopan Komissio toisti vuoden 2010 kyselyn. Sairaalaotos suoritettiin kuitenkin uudestaan mutta indikaattorit olivat samat. Tuloksia pidettiin vertailukelpoisina. Suomi oli tss vliss ottanut shkisen reseptin yleiseen kyttn. Suomi oli parahiten suoriutuneiden joukossa. Maat pantiin kokonaistuloksen perustella jrjestykseen joka oli Tanska, Viro, Ruotsi ja Suomi. Suomi oli EU keskitason ylpuolella kaikilla mittareilla 13/13. Parhaat pisteet tulivat laajakaistan kytst, shkisest reseptist, lhete-palaute jrjestelmist joissa on potilaskertomusintegraatio.

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Sabies-Figuera Ramon, Abadie Fabienne 2013c

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Sabies-Fuguera R,

Maghiros, Abadie F (2013B)

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Sabies-Fuguera R, Maghiros, Abadie F (2013A)

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Sabies-Fuguera R, Maghiros, Abadie F (2013A)

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Sabies-Fuguera R,

Maghiros, Abadie F (2013B)

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Sabies-Fuguera R,

Maghiros, Abadie F (2013B)

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Nordic eHealth Benchmarking

Pohjoismainen ministerineuvosto perusti minsteritasoisen eHlsa-yhteistyryhmn nostamaan terveyden- ja sosiaalihuollon digitalisaatiota esiin pohjoismaisena yhteistyasiana.

Kaikki pohjoismaat ovat globaalisti tarkasteltuna digitalisaatiokehityksess hyvll tasolla. Maiden vlisiss ratkaisuvalinnoissa on jonkun verran eroja, tm synnytt mielenkiintoisen asetelman vertailulle ja vertaisoppimiselle.

eHlsa-ryhmn alaisuuteen perustettiin tutkimusryhm, joka alkoi kehitt pohjoismaiseen vertailuun sopivia eHealth indikaattoreita.

Tutkimusryhm julkaisi vuonna 2013 menetelmraportin ja vuonna 2015 julkaistiin raportti, jossa on kokeiltu 49 indikaattoria.

Uutuutena pohjoismaisiin indikaattoreihin on otettu muutamia indikaattoreita, jotka kertn kyselyjen sijaan lokitiedoista.

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Proportion of HIE functionality availability of public health care organisations

Hyppnen, Kangas et al. 2015

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Proportion of PHR-functionality availability of public care organisations

Hyppnen, Kangas et al. 2015

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Usage rate of HIE functionalities

Hyppnen, Kangas et al. 2015

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Usage rate of PHR-functionalities Hyppnen, Kangas et al. 2015

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Usability of functionalities

Hyppnen, Kangas et al. 2015

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Yhteenveto

Kansainvliset toimijat pitvt (sosiaali- ja ) terveydenhuollon digitalisaatiokehityksen seurantaa trken koska sille on asetettu isoja odotuksia eik muutosten mr, suuntaa ja vaikutuksia voida tiet ilman dataa.

Kansainvlinen vertailu keskittyi pitkn tasolle, jossa seurattiin onko internetti, onko shkisi potilasasiakirjoja eik seuranta ollut digitalisaation edellkvijiden nkkulmasta kovin keskeist.

Tilanne on muuttunut: terveydenhuollon digitalisaatio etenee nopeasti globaalisti (ks. WHO tiedot) ja EU:n ja USA:n kaltaiset toimijat alkavat tavoitella EU:n tai jopa globaalia arkkitehtuuria (vrt. mobiilipuhelut, netti, pankkijrjestelmt, nettikauppa)

Tilanne on muuttunut: digitalisaatio on edennyt tasolle, jossa on aivan uudenlaista pohjaa maiden vliselle vertaisoppimiselle ja kansainvliselle tutkimusyhteistylle digitalisaation vaikutusten arvioinnissa.

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Level of IMPACT

electronic

commerce Efficiency gains

activity Employment, skills

INTENSITY Work organisation

New products, services

business models

READINESS Transaction/ business size Contribution to wealth creation

Nature of transaction/ business

"Potential" usage

access

technology and

socio-econimic

infrastructure

TimeS-curve model for technology adoption with evaluation focus in different phases (OECD 2005, 223 )

the full impact of the change can

be seen only after enough saturation

has been reached

Where are we now ?

Kanta

EPR Repository

Kanta

ePrescription eSocial services

Direct eServices

(booking etc)

An ongoing study

on the

adaptation level,

usability and

patient experiences

2015-

ePrescrpiton in full operation

My Kanta in full operation

Clinical documents shared via Kanta public sector

Modern registers Avohilmo, implantti

Finland is like a living lab for

Impact of eHealth

Omakanta

Other Nordic

countries

and many other

countries are

now ready for

benchmarking

and studies on

impact

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

paivi.hamalainen@thl.fi

Kiitos!

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

Kirjallisuutta

Adler-Milstein, J., Ronchi, E., Cohen, G., Pannella Winn, L. and Jha, A., 2013. Benchmarking Health IT among OECD countries: better data for better policy. Jam Med. Inform Assoc, 0, pp. 1-6.

Codagnone C & Lupiaez-Villanueva F. (2013) Benchmarking Deployment of eHealth among General Practitioners Final report. European Commission. Directorate-General of Communications Networks. Content & Technology. Available at https://ec.europa.eu/digital-agenda/en/news/benchmarkingdeployment-ehealth-among-general-practitioners-2013-smart-20110033

Sabies-Fuguera R, Maghiros, Abadie F (2013A) . Joint Research Centre of the European Commission (2013). European Hospital Survey: Benchmarking. Deployment of e-Health Services (20122013) . Composite Indicators on eHealth Deployment and on Availability and Use of eHealth Functionalities ISBN 978-92-79-34780-1 (pdf) ISSN 1831-9424 (online). Available at http://ec.europa.eu/digital-agenda/en/news/european-hospital-survey-benchmarkingdeployment-ehealth-services-2012-2013

Hyppnen, H., Faxvaag, A., Gilstad, H., Hardardottir, G.A., Jerlvall, L., Kangas, M., Koch, S., Nohr, C., Pehrsson, T., Reponen, J., Walldius, and Vimarlund, V., 2013. Nordic e-health Indicators: Organisation of research, first results and plan for the future. Oslo: Nordic Council of Ministers.

Hyppnen, H., Kangas, M., Reponen, J., Nohr, C., Villumsen, S., Koch, S., Hardardottir, G., Gilstad, H., Jerlvall, L., Pehrsson, T., Faxvaag, A., Andreassen, H., Brattheim, B., Vimarlund, V. and Kaipio, J., 2015. Nordic e-health Benchmarking. Status 2014 TemaNord 2015:539. Copenhagen: Nordic Council of Ministers.

Sabies-Fuguera R, Maghiros, Abadie F (2013B) , Deployment of e-Health Services (20122013) . Synthesis of Outcomes. ISBN 978-92-79-34776-4 (pdf) ISSN 1831-9424 (online). Available at http://ec.europa.eu/digital-agenda/en/news/european-hospitalsurvey-benchmarking-deployment-ehealth-services-2012-2013

Sabies-Figuera Ramon, Abadie Fabienne. Joint Research Centre of the European Commission (2013c). European Hospital Survey: Benchmarking. Deployment of e-Health Services (20122013) Country Reports. ISBN 978-92-79-34778-8 (pdf) ISSN 1831-9424 (online). Available at http://ec.europa.eu/digital-agenda/en/news/european-hospital-surveybenchmarking-deployment-ehealth-services-2012-2013

STePS tulosseminaari/ Suomi KV vertailussa/ LT Pivi Hmlinen

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