Medication records and

e-Prescriptions

DenmarkMedCom

Danish Centre for Health TelematicsIb Johansen, MI

www.medcom.dk

MedCom

Health Telematics

Danish Centre for

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1 1†

e-Prescriptions – Medication records

Denmark

• MedCom• Danish Health Sector• Danish Health Care data Network• e-Prescribing

– ETP– Support systems

• Medication Record

MedCom

Health Telematics

Danish Centre for

r

1 1†

MedComThe Danish Health Care Data Network

FynComThe Funen Health Care Data Network

International ProjectsCoCo, Primacom, Wise, Picnic, Prestige, OpenECG, Baltic-eHealth

Coordination and Continuity in Primary Health Care

! Regional Networks! Using EU standards! Creating a market

Amtermed i MedCom

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Health-telematics

Danish Centre for

...

MedCom

Health Telematics

Danish Centre for

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http://

www.openecg.net

Sundheds-telematik-

Center for

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MedCom

Danish Health Sector

63 (41)Public hospitals – 21000 Beds>10 private hospitals- < 150 Beds

3400 GPs (2000 clinics) 804 Private specialists + 245 Part time 331 Pharmacies 2700 Dentists (1650 clinics)1793 Physiotherapist (550 clinics) 225 Chiropractors 546 Psychologists

15 Counties/Kbh/Frberg/Bornholm 271 Municipalities 1 private Health Insurance

VANS

Sundheds-telematik-

Center for

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MedCom

All using national MedCom EDI / XML-standards

MedCom

Health Telematics

Danish Centre for

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Why making Prescriptions electronic ?

Why making Prescriptions electronic ?

• Readable• No retyping• No misuse• Medicine ready when patient show up• Accessible from all Pharmacies• Reuse of data from GP to Pharmacy• Reuse data for Medicine profile / medication

record

Health Telematics

Danish Centre for

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MedCom

ijo©

0 100000 200000 300000 400000 500000 600000 700000 800000 900000

1000000 1100000 1200000 1300000

92 93 94 95 96 97 98 99 20 O1 O2 O3 O4 O5 O6

MedCom -The Danish Health Data NetworkMessages/Month

Prescriptions1039105 = 73%Prescriptions1289023 = 87%

Disch. Letters 682923 = 85 %Disch. Letters 1054314 = 88 %

Lab. reports543040 = 82 %Lab. reports844528 = 98 %

ReferralsReferrals115597 = 60 %ReferralsReferrals

Reimbursement

21049 = 92 %

MedCom

Health Telematics

Danish Centre for

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GP´s with EDI : 2150 = 98 %

Specialists with EDI: 639 = 80 %

Hospitals with EDI : 63 = 100%

Pharmacies with EDI: 331 = 100 %

Doctors on Call: 15 = 100 %

Health Insurance: 17 = 100 %

79 messages /min

Lab Requests44385 = 15 %

VANS

Sundheds-telematik-

Center for

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MedCom

e-Prescriptions Denmark

Sundheds-telematik-

Center for

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MedCom E-PrescriptionsSupporting systems-Patient

Sundheds-telematik-

Center for

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MedCom E-PrescriptionsSupporting systems-Patient

Sundheds-telematik-

Center for

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MedCom E-PrescriptionsSupporting systems-Patient

Sundheds-telematik-

Center for

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MedCom E-PrescriptionsSupporting systems, GP

X

Sundheds-telematik-

Center for

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MedCom E-PrescriptionsSupporting systems, GP

Common Data Foundation(CDF)

• Updated electronically every 2nd week

• Drug ID– Content generic, – Strength, – Package: size, price, – Form(i.e. tabl, liq)– Substitution – ATC code – Dosage and indication – Warnings, traffic– Dosage text– Indication text – And more

Sundheds-telematik-

Center for

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MedCom E-PrescriptionsSupporting systems, GP

Patient ElectronicMedicine profile (PEM)(Medication Record)

Sundheds-telematik-

Center for

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MedCom

e-Prescriptions Denmark

E-Prescription

server

VANS

Sundheds-telematik-

Center for

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MedCom E-PrescriptionsSupporting systems, Pharmacy,

Common Data

Foundation

Sundheds-telematik-

Center for

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MedCom E-PrescriptionsSupporting systems, Pharmacy,

Common Data

Foundation

CTR

National Medicine Account

database

<75 €, 75-200 €, 200-500 €

Sundheds-telematik-

Center for

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MedCom E-PrescriptionsSupporting systems, Pharmacy,

Common Data

Foundation

CTR

National Medical Account database

Sundheds-telematik-

Center for

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MedCom E-PrescriptionsSupporting systems, Pharmacy,

Common Data

Foundation

CTR

National Medical Account database

Reimbursement County

(1/month)

Sundheds-telematik-

Center for

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MedCom E-PrescriptionsSupporting systems, Pharmacy,

Common Data

Foundation

CTR

National Medical Account database

Reimbursement County

(1/month)

Private Health Insurance

(1/day)

Sundheds-telematik-

Center for

r

1 1†

MedCom E-PrescriptionsSupporting systems, Pharmacy,

Common Data

Foundation

CTR

National Medical Account database

Reimbursement County

(1/month)

Private Health Insurance

(1/day)

PEM

Sundheds-telematik-

Center for

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MedCom

GP-Clinic

Prescription /orders

Patient

From Hospitals

Cave

Interactions

Interactions

Medicine Prescribed / not prescribed.

CTR Account

100 % refunded

Generics

Compliance

• 2.nd fase Medication record– On the way to a National Medication database– Accessible using national certificate through Health Portal– For Health professionals and citizens– Reuse data, based on e-Prescriptions

Sundheds-telematik-

Center for

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MedCom E-PrescriptionsMedication database