Governmental and private eHealth and telemedicine initiatives in Lithuania

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1 Lithuanian Telemedicine Association Governmental and private eHealth and telemedicine initiatives in Lithuania Romualdas Jonas Kizlaitis Vice-President, Lithuanian Telemedicine Association Director, Informatics and Development Centre at Vilnius University Hospital Santariskiu klinikos East Europe eHealth Innovation Summit, Warsaw, 2015-01-15

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Governmental and private eHealth and telemedicine initiatives in LithuaniaRomualdas Jonas Kizlaitis

Vice-President, Lithuanian Telemedicine AssociationDirector, Informatics and Development Centre at Vilnius University Hospital Santariskiu klinikos

East Europe eHealth Innovation Summit, Warsaw, 2015-01-15

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LithuanianTelemedicineAssociation

The Ministry of Health of the Republic of Lithuania is coordinating and executing National Electronic Health System Development Program for the period of 2009 2015

Information Society Development Committee under the Ministry of Transport and Communications together with the Ministry of Health allocated more than 30 million Euro of the EU Structural Funds for eHealth projects. All projects from this financial period must be finished until August of 2015!

Governmental initiative

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LithuanianTelemedicineAssociation16 National projects

13 Regional projects

Some additional eHealth related national or institutional projects, financed by EU SF and supervised by other authorities like Ministry of Education and Science or Information Society Development Committee

Governmental initiative: EU SF funded eHealth projects

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LithuanianTelemedicineAssociation

National projects (Core Information Systems)

The central part of the system ("The development of E. health services and co-operation infrastructure)E. prescription (The development of the electronic service E. prescription)Medical image exchange (National medical picture archiving and information exchange system and services on the basis of the electronic creation)

Development of Patient Appointment Reservation System

National Clinical Decision Support System

East Lithuania Tele-cardiology information system (KardioELI)

Telemedicine in Western Lithuania Cardiology

Electronic services for health care professionals and health care institutions licensing

Electronic services for granting licenses for pharmaceutical and medicinal products

Unified medical terms classification for the development of high quality eHealth services in healthcare institutionsGovernmental initiative: EU SF funded eHealth projects

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LithuanianTelemedicineAssociationNational projects

dedicated for HIS and EMR development in teaching, tertiary level hospitals and outpatient clinics. All information systems will be integrated with national eHealth information systems.

Leading institutions:

Hospital of Lithuanian University of Health Sciences Kauno klinikosKaunas clinical hospitalVilnius University Hospital Santariskiu KlinikosVilnius city university hospitalVilnius University Hospital Zalgiris clinicKlaipda Seamens HospitalRepublican iauliai HospitalGovernmental initiative: EU SF funded eHealth projects

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LithuanianTelemedicineAssociationRegional projects

dedicated for HIS and EMR development in regional hospitals and outpatient clinics. All information systems will be integrated with national eHealth information systems. Leading institutions:

Klaipdos University Hospital Taurags HospitalRokikio Regional HospitalUtenos HospitalRadvilikio HospitalJonavos HospitalAlytaus S. Kudirka HospitalMarijampols HospitalRegional Teli HospitalElektrn Hospitalekins clinicVilnius Centre clinicKaunas ilaini clinicGovernmental initiative: EU SF funded eHealth projects

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LithuanianTelemedicineAssociationOther important projects

ADVANDCED TELEMEDICINE SERVICES

National Open Access Research Data Archive (MIDAS)

Prenatal and neonatal care information system

Development of electronic services for patients

Governmental initiative: EU SF funded eHealth projects

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LithuanianTelemedicineAssociationTelemedicine services for patients:

TeleKlinika (www.teleklinika.lt)Remote patient consultation over internet without leaving home

Telemedicine services for healthcare providers:

Telemedicine Research Centre (telemedcentre.com)Remote diagnostics in ophthalmology

iConsilium (www.iconsilium.eu)International diagnostic services, mostly Teleradiology for Scandinavian hospitals

Eres Optimus (www.teleradiologija.lt)Teleradiology services for Lithuanian Hospitals and Outpatient clinics

Private initiatives

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LithuanianTelemedicineAssociationLeader:Development of eHealth Services in Medical Campus of Santariks (SANTA-HIS2)National Clinical Decision Support SystemVilnius University Hospital Santariskiu Klinikos:ICT projects 2012 2015

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NATIONAL CLINICAL DECISION SUPPORT SYSTEMThe main goal - to create national platform for various clinical decision support tools and solutions

Signal processing subsystemImage analysis subsystemData transformation subsystemExpert subsystemKnowledge database

Vilnius University Hospital Santariskiu Klinikos:ICT projects 2012 2015

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LithuanianTelemedicineAssociation

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NATIONAL CLINICAL DECISION SUPPORT SYSTEMSignal processing subsystem can process and analyze imported signal data, formulate an expected diagnosis and assess its reliability. The analysis process is able to locate and show the key signals which the conclusions of the analysis was made:

EEG module is designed for epilepsy and other central nervous system diseases diagnosis;

ECG module is designed for heart disease diagnostics using electrocardiogram data.Vilnius University Hospital Santariskiu Klinikos:ICT projects 2012 2015

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LithuanianTelemedicineAssociationNATIONAL CLINICAL DECISION SUPPORT SYSTEMX-ray image analysis subsystem automatic interpret received images, analyze them, formulate an expected diagnosis and show the key x-ray areas which led to this diagnosis to assist in clinical decision-making:

Pneumonia and tuberculosis detection modulefor pneumonia and tuberculosis risk identification;

Skeletal age module for skeletal age determination;

Spinal disease recognition modulefor spine deformities, identification and evaluation.Vilnius University Hospital Santariskiu Klinikos:ICT projects 2012 2015

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NATIONAL CLINICAL DECISION SUPPORT SYSTEMData transformation subsystem provides tools for 3D reconstructions of computer tomography (CT), magnetic resonance imaging (MRI), ultrasound (US) and other instrumental investigations;

provides virtualization tools like virtual colonoscopy;

provides tools for various automated and manual analysis.

Expert subsystem a tool for healthcare professionals to share and use created by experts in their field of science and approved algorithms, diagnostics and treatment methods.

Knowledge database - part of information system where typical cases and standard diagnostic and treatment examples are stored.

Vilnius University Hospital Santariskiu Klinikos:ICT projects 2012 2015

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Leader:Development of eHealth Services in Medical Campus of Santariks (SANTA-HIS2)National Clinical Decision Support SystemDevelopment of Patient Appointment Reservation System (IPR-2)

Vilnius University Hospital Santariskiu Klinikos:ICT projects 2012 2015

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PATIENT APPOINTMENT RESERVATION SYSTEM

Paper based (obsolete) reservation system operator simultaneously worked with several registration journals

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University Hospital

GPPrimary levelSpecialistSecondary levelSpecialistSecondary levelSpecialistSpecialistSpecialist

SpecialistSecondary level

University Hospital

SpecialistSpecialistSpecialist

Reservations among specialists inside institution, including instrumental investigation

Patient appointment reservations, assisted by secondary level specialist

Reservations among specialists from different health care institutions

Primary Care Physician assisted Patient appointment reservation to various specialistsPATIENT

Patient is able electronically book appointment to his GP or any health care specialist

Information about all reserved visitsSMS remindersSMS confirmations

PATIENT APPOINTMENT RESERVATION SYSTEM

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Leader:Development of eHealth Services in Medical Campus of Santariks (SANTA-HIS2)National Clinical Decision Support SystemDevelopment of Patient Appointment Reservation System (IPR-2)ADVANDCED TELEMEDICINE SERVICES Partner:National Open Access Research Data Archive (MIDAS)Lead Partner - Vilnius UniversityTelemedicine for Western Lithuania CardiologyLead Partner Lithuanian University of Health Sciences

Vilnius University Hospital Santariskiu Klinikos:ICT projects 2012 2015

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Eastern Lithuania Cardiology Project

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Eastern Lithuania Cardiology Project

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RLKP

VU ligonins Santariki klinikosV Kauno medicinos universiteto klinikosV Abromiki reabilitacijos ligoninV Druskinink ligoninV Elektrn ligoninV Ignalinos ligoninV Kupikio ligoninV Molt ligoninV Rokikio rajono ligoninV irvint ligoninV venioni rajono ligoninV Trak ligoninV Utenos apskrities ligoninV Valkinink sanatorijaV Varnos ligoninV Vilniaus rajono centrin poliklinikaV Visagino ligoninV VU Antakalnio ligoninV Zaras ligoninV Auktadvario PSPCV Druskinink PSPCV Eiiki PSPCV Elektrn PSPCV Ignalinos rajono poliklinikaV Ignalinos raj polik Dkt padalinysV Ignalinos raj polik Didiasalio padalinysV Kupikio rajono sav. PSPCV Lentvario ambulatorijaV Molt rajono PSPCV Rokikio PSPCV Rdiki PSPCV alinink rajono sav. ligoninV alinink PSPCVI alinink PSPC, Dieveniki ambulatorijaVI alinink PSPC, Jain ambulatorijaV irvint PSPCV venioni rajono PSPCV venioni rajono PSPC, Pabrads padalinysV venioni rajono PSPC, venionli padalinysV Trak PSPCV Utenos PSPCV Utenos PSPC, Upali ambulatorijaV Utenos PSPC, Daugaili ambulatorijaV Utenos PSPC, Saldutikio ambulatorijaV Varnos PSPCV Varnos PSPC, Merkins ambulatorijaV Varnos PSPC Panoi BPG kabinetasV Vievio ambulatorijaV Vilniaus rajono Kalveli ambulatorijaV Vilniaus rajono Maiiagalos ambulatorijaV Vilniaus rajono Rudaminos ambulatorijaV Vilniaus rajono Pabers ambulatorijaV Vilniaus rajono Juodili ambulatorijaV Vilniaus rajono Nemenins poliklinikaV Visagino PSPCV Zaras rajono savivaldybs PSPCV Zaras rajono PSPC, Duset ambulatorija

Alytaus apskrities S.Kudirkos ligoninTeli apskrities ligoninKauno apskrities ligoninPanevio ligoniniauli ligoninKlaipdos Jrinink ligoninKauno Raudonojo kryiaus ligoninM.Marcinkeviiaus ligoninAlytaus poliklinikaekins poliklinikaVilniaus miesto Centro poliklinikaKauno Centro poliklinika Kauno ilaini poliklinikaKauno Kalniei poliklinikaPanevio miesto poliklinikaKlaipdos miesto PSPC

+IPRAlytaus raj, PSPCBir PSPCAnyki PSPCKaroliniki PSPCDainavos poliklinikaUkmergs PSPC

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Leader:Development of eHealth Services in Medical Campus of Santariks (SANTA-HIS2)National Clinical Decision Support SystemDevelopment of Patient Appointment Reservation System (IPR-2)ADVANDCED TELEMEDICINE SERVICESPartner:National Open Access Research Data Archive (MIDAS)Lead Partner - Vilnius UniversityTelemedicine for Western Lithuania CardiologyLead Partner Lithuanian University of Health SciencesNational Medical Imaging Project MEDVAIS Lead Partner - Ministry of HealthNational ePrescription ProjectLead Partner - Ministry of HealthICT projects 2012 2015

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International:

ICT for Health ended in 2013, created VivaPort portal

PrimCare IT ended in 2014, Santa Telemedicine pilot

FP7 project CARRE started in 2014Personalized patient empowerment and shared decision support for cardiorenal disease and comorbidities

Vilnius University Hospital Santariskiu Klinikos:ICT projects 2012 2015

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CARREpersonalized patient empowerment & shared decision support for cardiorenal disease and comorbiditiesunderstanding nature of comorbidity informed estimation of disease progressionpersonalized alerting, planning, educationThis project was supported by the European Commission

FP7-ICT-2013-611140 STREPduration: Nov 2013 Oct 2016EC contribution: 2.573,755

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Main Data Fusion UnitData ransmission protocol

USERSPreprocessingData coherencecheckData STW and HDW environment

Single input path

DUTH

OU

BED

VULSK

KTU

PIAP

www.carre-project.eu

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LithuanianTelemedicineAssociationCARRE is an EU FP7-ICT funded project with the goal to provide innovative means for the management ofcomorbidities (multiple co-occurring medical conditions), especially in the case of chronic cardiac and renal disease patients or persons with increased risk of such conditions.

Sources of medical and other knowledge will be semantically linked with sensor outputs to provide clinical information personalised to the individual patient, so as to be able to track the progression and interactions of comorbid conditions. Visual analytics will be employed so that patients and clinicians will be able to visualise, understand and interact with this linked knowledge and also take advantage of personalised empowerment services supported by a dedicated decision support system.

The ultimate goal is to provide the means for patients with comorbidities to take an active role in care processes, including self-care and shared decision-making, and also to support medical professionals in understanding and treating comorbidities via an integrative approach.24

Thank you for attention!

santa.ltsanta.ltVilnius University Hospital Santariki klinikos

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LithuanianTelemedicineAssociation