Comparability, availability and use of medication eHealth services in the Nordic Countries

Abstract— A prescription and medication service that is optimised to protect against unnecessary harm is an essential component of a safer healthcare system. To this means, the Nordic countries have put considerable efforts in digitizing their prescription and dispensing processes and making medication related eHealth services available for clinicians, pharmacists and patients. As these e-services are being established and applied, there is a need to monitor and learn from their use. This paper reports from a sub-study of a larger activity on developing indicators for monitoring eHealth services in the Nordic countries. We describe different medication eHealth services and compare their availability to professionals and patients in the Nordic countries and the usage rates. We found that an ePrescription service is available for clinicians and patients in all Nordic countries, but services that enable renewal or viewing of prescriptions by patients are not commonly available yet. The usage rate of the e-services was not systematically registered in all the Nordic countries at the time of the study, so a comparison between the countries was impossible. A major challenge when comparing medication eHealth services is the fact that definitions of the service itself as well as the indicators used to monitor it vary between countries. The main output is a knowledge-based discussion from the Nordic context on indicators for monitoring eHealth services, evaluated by the potential outcome in terms of comparability and benchmarking

European Hospital Survey: Benchmarking deployment of e-Health services (2012–2013) Synthesis of Outcomes

A widespread uptake of eHealth technologies is likely to benefit European Healthcare systems both in terms of quality of care and financial sustainability and European society at large. This is why eHealth has been on the European Commission policy agenda for more than a decade. The objectives of the latest eHealth action plan developed in 2012 are in line with those of the Europe 2020 Strategy and the Digital Agenda for Europe. This report, based on the analysis of the data from the "European Hospital Survey: Benchmarking deployment of e-Health services (2012–2013)" project, presents policy relevant results and findings in this field. The results highlighted here are based on the analysis of the survey descriptive results as well as two composite indicators on eHealth deployment and eHealth availability and use that were developed based on the survey's data. Although they are closely interrelated, these results have been grouped in four sections. They are presented in detail in this document and briefly summarised below.JRC.J.3-Information Societ

European Hospital Survey: Benchmarking deployment of e-Health services (2012–2013) Composite Indicators on eHealth Deployment and on Availability & Use of eHealth functionalities.

eHealth has been on the European Commission Information Society's policy agenda for more than a decade, from the eEurope initiative(European Commission 1999) to the i2010 Strategy(European Commission 2005), and most recently the Digital Agenda for Europe (DAE)(European Commission 2010), eHealth was also one of the Lead Market Initiatives in 2007. Today it is the focus of one of the two first pilots under the EU2020 Strategy and its Innovation Union flagship initiative – the European Innovation Partnership on Active and Healthy Ageing. The key strategic orientations of the European Commission eHealth policy are defined in the eHealth Action Plan 2012-2020 where eHealth is referred to as "the application of information and communications technologies across the whole range of functions that affect the health sector and including products, systems and services that go beyond simply Internet-based applications"(European Commission 2004).JRC.J.3-Information Societ

International health IT benchmarking:learning from cross-country comparisons

Objective, to pilot benchmark measures of health information and communication technology (ICT) availability and use to facilitate cross-country learning. Materials and Methods, a prior Organization for Economic Cooperation and Development-led effort involving 30 countries selected and defined functionality-based measures for availability and use of electronic health records, health information exchange, personal health records, and telehealth. In this pilot, an Organization for Economic Cooperation and Development Working Group compiled results for 38 countries for a subset of measures with broad coverage using new and/or adapted country-specific or multinational surveys and other sources from 2012 to 2015. We also synthesized country learnings to inform future benchmarking. Results, while electronic records are widely used to store and manage patient information at the point of care- all but 2 pilot countries reported use by at least half of primary care physicians; many had rates above 75%- patient information exchange across organizations/settings is less common. Large variations in the availability and use of telehealth and personal health records also exist. Discussion, pilot participation demonstrated interest in cross-national benchmarking. Using the most comparable measures available to date, it showed substantial diversity in health ICT availability and use in all domains. The project also identified methodological considerations (e.g., structural and health systems issues that can affect measurement) important for future comparisons. Conclusion, while health policies and priorities differ, many nations aim to increase access, quality, and/or efficiency of care through effective ICT use. By identifying variations and describing key contextual factors, benchmarking offers the potential to facilitate cross-national learning and accelerate the progress of individual countries

E-health and e-welfare of Finland - Check point 2015

The new e-health and e-welfare strategy in Finland aims to support the renewal of the social welfare and health care services and the active role of citizens in maintaining their own well-being. The means include the development of knowledge management and increasing the provision of online services. The overall structural changes taking place in Finnish health and social care will also influence information and communication technologies (ICT). The report provides information about the change in the services and the service system brought on by ICT over time. The report illustrates the status in 2014 as compared with the strategic outcomes and objectives set on ICT to support performance and renewal of social welfare and health care. The results are condensed from four surveys for a comprehensive view: availability and use of ICT in health care as well as in social care, usability of the systems for physicians, and citizens´ use and anticipations. These are accompanied by a review of Finnish health care system and ICT development. For the international reader, the report provides an overview of progressive nationwide activities towards better e-services in Finland

E-health and e-welfare of Finland : Check Point 2022

The report provides an overview of progressive nationwide activities towards better e-services in Finland. The information system services of social welfare and health care are monitored by systematic gathering, analysis, and use of data, which allows the tracking of the progress of operations and the realisation of goals. In 2020 and 2021, six data collections were carried out to produce data for the monitoring of the Finnish ‘Information to support well-being and service renewal, eHealth and eSocial Strategy’. Some of the results presented in the report are also openly available in database cubes

Regional health information exchange outside of the centralized national services for public health care in Finland: A national survey

Health information exchange (HIE) is the mobilization of health care information electronically across organizations within a region, community, or hospital system. Nordic countries have been developing their health portals including national HIE services systematically. In Finland HIE begun with various regional health information exchange (RHIE) pilots in since 1998. The Kanta patient data repository component in the national HIE has been adopted in routine use since 2012. The current role of non-Kanta RHIE in relation to Kanta services is somewhat unclear. Our research questions are following: 1) Has the availability of RHIE services changed during 2017-2020? 2) What functional types of RHIE are there in Finland in 2020? 3) From the point of view of healthcare provider organizations, at what level is the availability to combine regional information seamlessly into the same view of local patient record systems? Data used in this study were collected using web-based questionnaires in 2017 and 2020 as part of the surveys for monitoring and assessment of social welfare and health care information system services in Finland. This study reported in this article covers all 21 public hospital districts and nearly all public primary health care centers. The quantitative data provided by the organizations were analyzed using SPSS software (version 25). The availability of a particular service or function was calculated as a percentage of all respondents in each sector. The results of this study show that the overall availability of RHIE services has not markedly changed 2017-2020. Functional types of RHIE meaning the role, use and types of RHIE in hospital districts in Finland varies greatly in 2020. We recognized three different types of non-Kanta RHIE in the non-combination organizations (one-way, symmetrical, full symmetrical). Seamless integration of at least some Kanta data into the same view as the main patient health record system data was more common than seamless integration of at least some non-Kanta regional data

Usability problems do not heal by themselves : National survey on physicians' experiences with EHRs in Finland

Purpose: Survey studies of health information systems use tend to focus on availability of functionalities, adoption and intensity of use. Usability surveys have not been systematically conducted by any healthcare professional groups on a national scale on a repeated basis. This paper presents results from two cross-sectional surveys of physicians' experiences with the usability of currently used EHR systems in Finland. The research questions were: To what extent has the overall situation improved between 2010 and 2014? What differences are there between healthcare sectors? Methods: In the spring of 2014, a survey was conducted in Finland using a questionnaire that measures usability and respondents' user experiences with electronic health record (EHR) systems. The survey was targeted to physicians who were actively doing clinical work. Twenty-four usability-related statements, that were identical in 2010 and 2014, were analysed from the survey. The respondents were also asked to give an overall rating of the EHR system they used. The study data comprised responses from 3081 physicians from the year 2014 and from 3223 physicians in the year 2010, who were using the nine most commonly used EHR system brands in Finland. Results: Physicians' assessments of the usability of their EHR system remain as critical as they were in 2010. On a scale from 1 ('fail') to 7 ('excellent') the average of overall ratings of their principally used EHR systems varied from 3.2 to 4.4 in 2014 (and in 2010 from 2.5 to 4.3). The results show some improvements in the following EHR functionalities and characteristics: summary view of patient's health status, prevention of errors associated with medication ordering, patient's medication list as well as support for collaboration and information exchange between the physician and the nurses. Even so, support for cross-organizational collaboration between physicians and for physician-patient collaboration were still considered inadequate. Satisfaction with technical features had not improved in four years. The results show marked differences between the EHR system brands as well as between healthcare sectors (private sector, public hospitals, primary healthcare). Compared to responses from the public sector, physicians working in the private sector were more satisfied with their EHR systems with regards to statements about user interface characteristics and support for routine tasks. Overall, the study findings are similar to our previous study conducted in 2010. Conclusions: Surveys about the usability of EHR systems are needed to monitor their development at regional and national levels. To our knowledge, this study is the first national eHealth observatory questionnaire that focuses on usability and is used to monitor the long-term development of EHRs. The results do not show notable improvements in physician's ratings for their EHRs between the years 2010 and 2014 in Finland. Instead, the results indicate the existence of serious problems and deficiencies which considerably hinder the efficiency of EHR use and physician's routine work. The survey results call for considerable amount of development work in order to achieve the expected benefits of EHR systems and to avoid technology-induced errors which may endanger patient safety. The findings of repeated surveys can be used to inform healthcare providers, decision makers and politicians about the current state of EHR usability and differences between brands as well as for improvements of EHR usability. This survey will be repeated in 2017 and there is a plan to include other healthcare professional groups in future surveys. (C) 2016 The Authors. Published by Elsevier Ireland Ltd.Peer reviewe

A composite index for the benchmarking of eHealth Deployment in European acute Hospitals. Distilling reality in manageable form for evidence based policy

This report presents the results of the multivariate statistical analysis performed by the authors on the data from the eHealth benchmarking Phase III survey. This survey, funded and managed by Unit C4 of DG INFSO, gathered data from a statistically representative sample of European acute hospitals in order to benchmark their level of eHealth deployment. The authors, after placing it within the appropriate policy context an within the broader academic debate on benchmarking in a policy perspective as part of the Open Method of Coordination, have rigorously and transparently constructed a composite index of Hospitals eHealth Deployment. They have also extensively discussed the results of the analysis and extracted implications and recommendations both for the benchmarking and evaluation agenda and for the broader policy agenda in this field. The topic covered falls within the scope of research activities carried out during the past three years by IPTS Information Society Unit in the specific domain of eHealth, both for what concerns its development and innovation dynamics and for what relates to benchmarking and evaluation. The Techno-economic Impact Enabling Societal Change (TIESC) Action of IPTS IS Unit, in fact, manages since 2009 the three-year project Strategic Intelligence Monitor for Personal Health Systems (SIMPHS) and focuses also on issues of measurement and evaluation . As mentioned, the survey producing the data analysed in this report has been funded and managed by DG INFSO Unit C4. The authors, in representation of IPTS, were part of the steering board of this project and were given the opportunity to access and use the data as soon as they were ready. We want, thus, to thank the Head of Unit C4 Lucilla Sioli for providing us such opportunity, the study Project Officer Virginia Braunstein for the support and collaboration during the realisation of this report, and Stefano Abbruzini (also from Unit C4) for useful comments provided on an earlier draft of this report. We also want to thank Maria Del Mar Negreiro Achiaga, Project Manager of the Deloitte/Ipsos consortium that realised the survey, for her collaboration and availability.JRC.DDG.J.4-Information Societ