HealthManagement, Volume 4 / Issue 5 / 2009

On October 30, a French team led by Dr. Pierre Biron from the Centre Léon Bérard in Lyon won the IT @ 2009 Trophy at Europe’s top event for healthcare IT innovation. Dr. Biron’s team showcased their SISRA Health Information System and DPPR Shared and Distributed Patient Record, which has been implemented in the Rhône- Alpes region of France (see page 6 and 7 for more details).

 

The two runners-up in the competition, which drew a total of 50-plus applicants from across Europe, were:

 

Digitisation of the Dutch Nationwide Breast Cancer Screening Programme.

This solution was presented by Bart Verdonck from the Netherlands, with the support of Philips Healthcare and RIVM (the National Institute for Public Health and the Environment).

 

In the Netherlands, RIVM provides a free nationwide breast cancer screening service for all women in the 50-75 years age group. Close to one million women are examined per year, representing more than 80% of the target group, the highest percentage worldwide.

 

The Dutch government has sought digitisation of the screening programme. RIVM assigned Philips and a consortium of specialised suppliers to handle all the IT aspects of this megaproject referred to as DigiBOB. The Philips iSite PACS forms the heart of this nationwide service, allowing radiologists to access new and historical patient data, including multiple mammograms, in seconds.

 

Screening mammography examinations are performed in 67 units, out of which 57 are mobile units (buses). The project was kicked off in early 2008 and by July 2010 all mobile screening units are expected to be integrated in the new system.

 

For patients, the system will enable a faster response time after the mammography examination and a faster scheduling of follow- up examinations, if required. The system needs to guarantee at least the same high quality standards as the current screening programme. And the expectations are that digital imaging will further improve the clinical quality of the programme. This is the first nationwide digital mammography screening installation in the world.

 

From Free Text to Standardised Language – The National Development Project of Nursing Documentation in Finland

This solution was presented by Kaarina Tanttu, from the Hospital District of South West Finland.

 

In 2002, Finland made a decision to have a nationally interoperable electronic health record (EHR) by the end of the year 2007. Furthermore, the decree launched in 2007 requires public health care organisations to join the national patient record archive by the end of the year 2011. The development process started in 2004 when the core data elements of the national EHR were introduced.

 

The Nursing Minimum Data Set (NMDS) is a part of the core data elements. The national nursing documentation model and the Finnish Care Classification (FinCC ) were developedin the national nursing documentation project 2005-2008. The national NMDS and FinCC were integrated during 2005-2007 into eight health recording systems in 33 health care organisations (piloting in 106 units/wards / three university hospitals, 11 district hospitals, 19 health care centres).

 

An education model and an eEducation environment were also developed to support the implementation. Based on the experiences and evaluation results the Finnish Care Classification can be implemented and used among all kinds of wards.

 

Overall, the quality of the nursing documentation is more uniform, patient-centered and in interdisciplinary use. The information concerning the wellbeing of the patient during the care episodes until discharge improves the care process and pathway. The data of nursing documentation can be used for managerial and administrative purposes.

 

FinCC has been also implemented in CDA R2 format by Health Level 7 Finland. The information on nursing process and the nursing discharge summary can be transformed and stored in the national archive of EHRs. The healthcare professionals can, by patient consent, search and reuse the same information in all EHR systems.

 

After the results of the national project, the nationwide implementation process started in Finland in October 2007 and will end in 2011.

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