Date Added: 3/27/2009
Posted by:
 birdie
 supporthitug.org

Author/Source:
 Sundhed.dk

Viewed: 231 times

Danish eHealth portal - Sundhed.dk

The Danish public health sector was faced with a challenge to provide a patient-centric and cross-sector health care infrastructure with the capability of collaboration and sharing of highly sensitive information in a secure and efficient manner. The solution was to provide general access to the patients and their health care professionals. The infrastructure had to support high availability coupled with the capability of deploying new functionality and access to secure information at a low cost.

The Danish health authorities cooperated to launch a portal named Sundhed.dk ("sundhed" means "health") in 2003. Sundhed.dk is a public, internet-based portal that collects and distributes health care information among its citizens and health care professionals.

About Sundhed.dk - patient portal

Prior to Sundhed.dk the Danish health service consisted of silos of information which comprised of individual solutions and databases with no means of integrating it together. Sundhed.dk helped share the information contained in these individual databases making the information available to the users 24/7.

Sundhed.dk was broken down and implemented in three main phases. The first phase which was launched in December 10th, 2003 was an informational portal. The next phase aimed at decreasing the number of duplicate lab orders by consolidating information from various sources into one central source. In 2004, the final phase of the portal was implemented, the portal now uses a patient record for each patient that has all the information necessary to identify a patient and his/her medical condition at the point of care.

Sundhed.dk is a consent based model where patients give permission either online or during the treatment. During treatment the patient's health care professional can receive verbal consent and then fill a form online on behalf of the patient. The consent information is available on Sundhed.dk and the patient has the ability to verify who accessed his/her information.

In January 2009, the site registered 304,000 unique visitors, 448,000 total visits and 2,800,000 page impressions. These numbers correspond to a total Danish population of 5.4 million.

Sundhed.dk is a complex platform and has high maintenance costs. The reasons for such high maintenance costs are the implementation approach which is very fragmented, law of privacy which limits the sites functionalities, and lack of a common data model.

In spite of this limitation Sundhed.dk provides every citizen and every health professional with access to personal health information and online services, provided that the have a digital signature. A digital signature is free and available to every person in Denmark above 15 years of age. Sundhed.dk then personalizes its pages based on the logged users attributes and shows relevant information especially around online lookups which are customized to the logged user's treatment needs.

The health professionals are including Sundhed.dk in their own channel strategy using all or a selected range of services.

The benefits of Sundhed.dk

Sundhed.dk has been a great success in Denmark as it provides its patients with most recent medical resources and information readily at their finger tips. The key feature of Sundhed.dk is that it is very user-friendly; patients do not have to go through a huge learning curve to be able to navigate and use the site. Patients are encouraged to make well-informed medical decision about their healthcare using the medical information provided online.

All Danish citizens have access to Sundhed.dk, enabling patients to communicate and patients and their families to get an overview of correct and updated health care information, making the health care services appear close-by, open and familiar.

Sundhed.dk puts the needs of the patients first; it also allows the patient to be accountable for their healthcare decisions. Sundhed.dk encourages its patients to educate themselves about health maintenance and wellness practices.

The implementation of prescription server within Sundhed.dk has not only automated the way medication is purchased and distributed but has also increased the annual savings of more than 12 million Euro. The Medicine profile on Sundhed.dk automatically registers all purchases of prescribed medication in Denmark as individual, personal medicine profiles for every citizen to help improve the quality of drug therapy. In the annual report 2003-2004 from the Danish Pharmaceutical Association, reference is made to Danish and international studies, which show that 6-14% of all cases of hospitalization in medical wards is due to problems related to medicinal products. Obviously, even a small reduction in medication errors has great impact on both economy and quality of life.

Benefits to GP's and Healthcare professionals

• they have web access to laboratory data;
• and can perform ICPC search of diagnoses from GP's electronic healthcare program (Linkportal).
• have access to eMedicine records;
• have access to their respective patients electronic patient records;
• can view waiting list information of hospitals;
• can send and receive emails through secure communications;
• and access to Cochrane library.

Benefits to Patients

• Patients have the ability to take part in their own treatment.
• Patients who are currently receiving AC therapy can make measurements themselves and then enter the results on Sundhed.dk. The algorithms calculate the patient's dosage and advice the patient's GP's with the required dosage adjustments. Patient's now can avoid the frequent visits to the local hospital.
• Sundhed.dk provides its patients the ability to order their medication online; the patients also have the option of having the medication delivered directly to their home address or to the pharmacy of their choice.
• DiaLog is a solution for diabetes patients. Along with education, preventive care and treatment, patients are also able to follow the development in their diabetes, intervene and exercise self-care.
• From 2008 6 online networks have been available to patient groups with different chronic diseases. These online networks have made it possible for patients to meet, discuss and exchange information about the diseases and the effects they have on their own lives. They can also ask questions to health professionals. The aim is to give each patient better possibilities of coping with their condition

Tactical Successes

The portal has the ability to adapt to any change. Currently 98 municipalities have access to the portal and can now easily access their patient information online 24/7. The municipalities also have the ability to access and join regional and national authorities through the portal.

Lab-results have been expanded to include biochemistry and pathology results and can now be reached nationwide.

Patients have the ability to view who accessed their information through "My Log".

Sundhed.dk integrates systems that are not only specific to the Danish health service but other regional or national health services. Organizations and communities could easily incorporate the Sundhed.dk's approach of developing shared services/solutions, so services/solutions developed for one region or one purpose can be used elsewhere as well. Recent initiatives that are in part inspired by Sundhed.dk are being planned and/or developed in Sweden, Singapore, Canada and Germany.

Sundhed.dk's existing infrastructure supports high availability combined with the capability of deploying new functionality and access to new information at low cost and with a minimum time to market. Sundhed.dk's has an abstraction layer on top of existing platforms and applications hence reducing the cost of having to buy new systems to support the portal. Sundhed.dk also has a service-oriented platform that can integrate easily into any solution/system.

References

http://www.epractice.eu/en/cases/sdk