EHR Systems Use and Quality in Romania George

EHR Systems Use and Quality in Romania George Mihalas, past CEO of National Center for Health Statistics and Informatics Ministry of Health EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

Country context (i) Basic facts about: the country ◦ Population: 21, 504, 442 (2002) Population ◦ Life expectancy at birth: 73. 4 y (WHO 2009) Basic facts about: the health care system ◦ HC expenditure: 5. 5% of GDP (WHO 2008) expenditure ◦ Public sector hc expenditure as % of total hc expenditure: 81. 7% (OECD 2007) ◦ Organization: central / district auth. / local units Organization Ministry of Health (Mo. H) / 41 District Health Authorities National Health Insurance House (NHIH) / 41 District HIH EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

Country context (ii) Basic facts about: General IT status/setup/ developments within the health sector ◦ Availability of IT in healthcare in Romania: Romania Computers (GP and hospitals): almost 100% (2010) Internet connection: 31% (2007) Professional IT support: <10% (2007) Broadband connection: <5% (2007) ◦ Link between e-health system and health system: system Most present implementation = result of national hc strategy NHIH imposed “SIUI” = Integrated Unique Information System Several hospitals – HIS from private companies EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

EHR systems: market (i) - Market penetration - (% of use in primary care and in secundary care (hospitals) Simplified version (SIUI) = 100% (mandatory) in both primary care and hospitals Extended version: ◦ primary care ~ 50% (from small companies) ◦ hospitals ~90% large hospitals, ~30% small hospitals EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

EHR systems: market (ii) Number of applications on the market for the different market segments (approx. ) Primary care: ~20, but only ~10 have acceptable quality care Hospitals: 5 better known applications Hospitals Pharmacies: ~6 Pharmacies Dentistry: 2 -3 Dentistry EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

EHR systems: market (iii) Market segmentation Primary care: several providers, no visible leading group care ◦ (C-Med in West Romania ~10%) Hospitals: Hospitals ◦ Info. World, Romanian Soft Co. (>50%), Total Soft, etc Number of suppliers In Romania a developper is usually the supplier Evolution Constant, but slow increase EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

EHR systems: legal/regulatory context Any legislation / regulation: Yes [1] ◦ about the use of EHR systems? Not explicit (incl. in[1]) ◦ about functionalities of the systems related to functional system requirements? No related to data-exchange and/or interoperability? No (*) Note: it does exist only related to protection of personal data [2] [1] Ministry of Health: Strategic Plan of the Ministry of Public Health for 2008 -2010 [2] Law no 677 on the Protection of individuals with regard to Processing of Personal Data and onthe Free movement of such Data, November 2001 EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

EHR systems: quality assessment Any current actions ◦ regarding quality assessing the EHR systems? ◦ regarding requiring the use of quality assessed EHR systems? Yes: Developpers need accreditation from NHIH for compatibility of their soft with “SIUI” Any incentive for using quality assessed / certified EHR systems? No EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

EHR systems: initiatives, plans List and present the public initiatives / projects, if any ◦ ◦ To To promote / enforce the use of EHR systems assure quality of the systems improve interoperability recognise quality labelling and certification Pro. Rec Romania ◦ Participated in both Q-REC and EHR-QTN ◦ Several Workshops for dissemination and promotion of EHR certification Bucharest 2007, 2009 & Timisoara 2010, 2011 ◦ Pro. Rec Romania site: Ro List of all developpers Eurorec Seal online support ◦ Forms for application and self evaluation ◦ Complete information package etc EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

Ideas, proposals Present any other: ◦ ideas, proposals ◦ message to the audience, authorities… Need of “pressure” for accepting the necessity of EHR certification Create incentives for the use of EHR certified systems Present state: lack of “motivation” for developpers EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

Closing slide Contact data: ◦ Prof Dr George Mihalas, University of Medicine and Mihalas Pharmacy, Timisoara and Pro. Rec Romania ◦ Lect Dr Mircea Focsa, University of Medicine and Focsa Pharmacy, Timisoara and Pro. Rec Romania Web and e-mail addresses: ◦ mihalas@umft. ro ◦ focsam@prorec. ro ◦ www. prorec. ro EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade