Roald Bergstrøm, Senior Adviser
The Norwegian Directorate of Health, Norway roald.bergstrom@helsedir.no
e-health and e-welfare technology in
Norway
Once a time Norway was a poor Country
World Population and Global Changes
Norway!
Government levels
3 independent government levels
– the national government – the county councils
– the municipalities
4 Regional Health Authorities
North
Mid
West South/
East
Norwegian Health Care
• National authorities are responsible for specialized health care services
• Local governments are responsible for primary health care
• Private-sector enterprises
Financing
• Regular general practitioners (GPs) are self-employed
• In 1997, Norway introduced activity-based funding
• The key strengths of the Norwegian health care system are to provide a health care service for all based on need and regardless of personal income
Health Care expenditure in Norway
• Norwegian health care expenditure is close to 11% of GDP
Health expenditures and outcomes
• According to the OECD Norway spends more on health care per capita compared to other European countries
– Indicators of health status show that Norway is not better on important indicators of health
• Source: Health Economics Research Programme at the University of Oslo
Digital agenda: The new Government Strategy
• The Government strategy for ICT “Digital agenda”
– Fully digitally in the communication between the administration levels and the people
The Norwegian Directorate of Health
• The Norwegian Directorate of Health is responsible for the implementing of e-Health
– Electronic prescription – Electronic messaging – Electronic Patient Summary – My vaccines – Public Health Portal – One Citizen – One Journal – m-health and welfare technology – Standards
National plans related to eHealth
2011 2012 2013
2008 2009 2010
Health Net: National Infrastructure
• The Norwegian Health Net
– Connects:
• All hospitals
• All GPs
• 80 % of the municipalities
Electronic health records
• Norway is among the countries in the world with the greatest degree of implementation of EHR in the health care service
Electronic Collaboration
• Extensive use of electronic messaging
– National XML-standards that are partly based on CEN/TC251 prestandards
National services: ePrescriptions
• e-Presciptions
– Nationally deployed – All GPs – Advanced system
Electronic Patient Summary
• Critical information about the patient is made available for health workers across organizational borders
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The National Health Portal: www.helsenorge.no
• “My Health" online
– Goal is to assist people in taking better care of their own health while encouraging more active cooperation with the health service
Digital dialog
• Appointments
– possibility to book, cancel and modify appointments
• Prescription Renewal
– possibility to request renewal of prescriptions
• Email contact
– calls of more practical and administrative nature, as well as simple health advice
• E-consultation
– possibility to replace and / or supplement a physical consultation
White Paper 9: One citizen– one medical journal
• Change in the law
– all who treat the same patient can use a common
medical record
– Standards is mandatory
“One citizen - One record”
Standards is important!
The Demographic Change
• m-health, e-health and e-welfare technology and Ambient Assisted Living
– The demographic change of the population with an increasing number of chronic disease and patients with multiple illnesses
Ambient Assisted Living
• Ageing population
– Ageing population and the rise of non-communicable diseases
• There will be an ever growing market
– for new medicines – for new interventions – for new technology – for new instruments
e-health and p-health or e-health?
Personal health technology and the future of health
Messaging standards Security
Personal
Health-technology Care
Personal
Health-technology Care
Information Central
Specialist Health Community Privat
Data from medical device goes to Central Storage Archive Information Central (physically, virtually ore mobile phone) Data from medical device on national Health Portal
Data from medical device stored in Central Storage
Common equipment and standards both for private and state owned service and both for the care sector and special medical sector (hospital)
4
3
2
1
National Health Portal
The Connected Patient
Receiver: Hospital, Municipalities, Community Central , Relatives etc
Take better care of your own health?
Patients taking greater responsibility for their own health
Standardization problem
Architecture and Standards
Welfare technology and personal health technology equipment shall work together and communicate vital data whether the equipment is provided by the municipality, specialist or private care giver or center
mHealth:
WHO: 500 mill people will use mHealth within 2015Fighting the global health burden through new
technology:
WHO-ITU joint Program
on mHealth for NCDs
Nordic cooperation on standards?
Denmark and Continua
Health Record Network
(HRN) Interface
Vekt Pulse Oxiometer
Greie seg selv hjemme Hjerte / Utholdenhet
Medisinering Glucosemåler
Pulse / Blodtrykk Termometer
Fysisk aktivitet Overvåke grenseverdier
Electrocardiogram Insulinpumpe
Personlig helseteknologi
Data innsamling
Personal Area Network
(PAN) interface
Wide Area Network
(WAN) Interface
Servicesenter
Omsorg/Helse Journal
EHR PHR
CEN/ISO/IEEE 11073
White Paper 29 (2012–2013) ” Tomorrows Care”
The Directorate of Health is given the responsibility for the
standardization work on the welfare technology area
Conclusion
• Norway started with eHealth and telemedicine many years ago back in the nineties
• The Government is committed to eHealth
– We will introduce many new services both for the health sector and for the citizens in the coming years
Norway: e-Health Projects in action
• Electronic prescription
• Electronic messaging
• Electronic Patient Summary
• My vaccines
• Public Health Portal
• One Citizen – One Journal
• Standards
• Digital Dialog
• Welfare Technology
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Thank you!
R o a l d B e r g s t r ø m , S e n i o r A d v i s e r
T h e N o r w e g i a n D i r e c t o r a t e o f H e a l t h , N o r w a y roald.bergstrom@helsedir.no
