https://www.tervisepank.ee

Tervisepank®

e-solution for primary careMadis Tiik, MD

CEO, Estonian Society of Family Doctors

06.04.2006

Estonian primary careKey facts

787 patient lists

1.251.385 insured patients

FDs: private entrepreneurs

100% funded by Estonian Health Insurance Fund

Total annual budget: ca EUR 40M

Monthly IT budget: ca EUR 75 per doctor

Computer literacy and use of internet in primary care

In 2003 there were 2.369 workers in the primary care units (doctors and nurses)

1920 were using computers daily (81%), from those1872 were using computers with internet connection (97%)

all together 1207 computers, from those1147 computers with internet connection

1350 doctors work in the primary care units1242 use computers daily (92%), from those

1237 use computers with internet connection (99%)

Digitalization in Estonian primary care

1994 – 1998: First software solutions for FDsPurely structured, mainly text fails

1998: EHIF financial support for FDsSoftware oriented to the needs of EHIF

First FD’s started using digital patient records only

Since 2001: All claims’ data sent to EHIF digitally3 – 4 local software companies

Software architecture: only local installations

Financial aspect: expensive license fees + monthly service fees

Flaws arising from existing architecture

Data not available in time-critical situations;Most data exchanged and stored on paper;Medical decisions often based only on data received from patients;Patients tied to their FD: mobile patient loses health record history;Collected data not comparable and exchangeable;Software not corresponding to the requirements of processing delicate personal information;Expensive maintenance and updating of softwareFDs expected to be IT power-users

Key requirements to the new solution

Functionality;Customer-friendly interfaces;Easily and independently learnable (ca 20 - 30 min);Central management, updating and archiving;Automatic claiming, reporting and statistics;Low requirements to the hardware;Easily scalable;Compliance with Data Protection Act.

Tervisepank – first PPP project in Estonian healthcare

Customer: Estonian Society of Family DoctorsDevelopment of functionality and logic

Financing: local private investors

Design and technology: local IT companies

Business model: operational lease of softwareNo upfront fees;

Everything (maintenance, archiving, updates, growth in functionality) included in fixed monthly price (ca EUR 40 per professional user).

Further joint development:Ideas from FDs;

Implementation by Tervisepank.

Time and costs

Business process mapping – 2003;

Design & programming, license from Data Protection Agency – 2004;

Real-time launch – 29.12.2004;

Real-time users – Q3 2005.

Direct investments > 300.000 EUR

Tervisepank – centralized IT system

Modern, web-based solution for primary care, but not limited to that;

All users use the resources on same servers;

Access through standard web browser and internet connection

All encrypted patient data kept in one database;

All updates are in force immediately to all system users;

Key functionality

Fully functional daily work environment driven by doctors’ needsKey functionality:

Practice administration and e-registry;Digital health record database;Patient management, disease curing and prevention;Medical decision making support;Documents, certificates etc;Claiming, reporting and statistics;Information exchange with third parties (laboratories, pharmacies etc).

Technical highlights

Estonian ID card based encryption model

Valid ID card

Valid ID PIN code

Technology: Microsoft .net 1.1.

MS SQL Server 2000

Highly scalable

Key security features

Unauthorized users are unable to connect personal data with medical records;FD can delegate his/her access rights to patients’ health records;System administrators do not have access to patients’ medical records;All activities are logged and saved;Approved by DPA

Win-win solution for doctors and patients

Professional users:Full digital, real time and constantly updating health record database on every patient;Accessible from everywhere, 24/7; More information = better care;Medical decision making support;Extensive savings in time = better care;Automatic reporting; No initial investment required, usage results in significant savings;Only system licensed by DPA.

Patients:All medical data in one secure place;Access to personal health records;Access to FD’s e-registry;Chance for alternative diagnosis;FD has more time for patient = better care;Report on persons viewing personal medical data.

Tervisepank – a virtual hospital of tomorrow

E-consultation;

Specialist doctors;

Hospitals;

Ambulance / emergency care;

Laboratories;

School healthcare;

Drug / genetic research.

Thank you !

For further information, please contact:

Mr. Loit Linnupõld

partner

Tervisepank

Ph: +372 502 4152

loit.linnupold@tervisepank.ee

https://www.tervisepank.ee

Mr. Madis Tiik

CEO

Estonian Society of Family Doctors

Ph: +372 510 9143

madis@pak.tt.ee