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RIDE D211 - SRDC (Software Research and Development Center) - Home

    IST- 027065 RIDE 14/05/2010

    RIDE

    A Roadmap for Interoperability of eHealth Systems in Support

    of COM 356 with Special Emphasis on Semantic

    Interoperability

    COORDINATION ACTION

    PRIORITY 2.4.11 Integrated biomedical information for better health”: eHealth

    RIDE D.2.1.1 - European Current practices in providing semantic interoperability in eHealth domain: Survey of

    eHealth Practices (Czech Republic)

    Due Date: June 15, 2006 (Month 4+45 Days) Actual Submission Date: May 4, 2006

    Project Start Date: January 01, 2006

    Project End Date: December 31, 2007

    Project Duration: 24 months

    Leading Contractor METU-SRDC

    Organization:

IST 027065 RIDE Deliverable 2.1.1

    Document History:

    Version Date Changes From Review V0.1 February 10, Initial version created METU All partners

    2006

    V0.2 May 3, 2006 Final version METU All partners

    Project co-funded by the European Commission within the Sixth Framework Programme (2002-2006)

    Dissemination Level

    Public PU

    Restricted to other programme participants (including the Commission Services) PP

    Restricted to a group specified by the consortium (including the Commission Services) X RE

    Confidential, only for members of the consortium (including the Commission Services) CO

    Page 2 of 19 2

IST- 027065 RIDE 14/05/2010

    RIDE Consortium Contacts:

    1 METU-SRDC Inonu Bulvari 06531 Ankara Turkey Prof. Dogac Asuman +90-312-+90(312)21010asuman@srdc

    2105598 04 .metu.edu.tr 2 OFFIS Escherweg 2 26121 Oldenburg Germany Dr. Eichelberg Marco +49-441-+49-441-9722-eichelberg@o

    9722-147 102 ffis.de 3 IFOMIS Campus 66041 Saarbrücken Germany Prof. Smith Barry +49(0)681/30+49(0)681/302phismith@bu

    Saarbrücken 2-64777 -64772 ffalo.edu 4 EUROREC co IDISS - 42400 Saint France Prof. DeMoor Georges +32-9-2403439 georges.demo

    Croix-Rouge Chamond or@ugent.be +32-9-Française 2403421

    route de Platon

    5 CNR Piazzale Aldo 00100 Roma Italy Prof. Rossi Mori Angelo +39 06 86 +39 06 86 090 angelo@itbm.

    Moro 7 090 250 340 rm.cnr.it 6 NTUA, ICCS 42, Patision 10682 Athens Greece Prof. Mentzas Gregoris +3021077238+30210772355gmentzas@so

    street 95 0 ftlab.ntua.gr 7 NUIG, DERI University na Galway Ireland Prof. Vitvar Tomas +353 91 +353 91 tomas.vitvar

    Road 495270 495270 @deri.org 8 IHE-D Stresemannalle60596 Frankfurt Germany Prof. Wein Berthold B. +49-241-559 +49-241-559 wein@radiolo

    e 19 559 1 558 2 gie-aachen.de 9 OLE HazenakkerstraB9520 Zonnegem Belgium Dr. Ceusters Werner +32 475 486 - werner.ceuste

    at 20a (Sint-587 rs@ecor.uni-

    Lievens-saarland.de

    Houtem)

IST 027065 RIDE Deliverable 2.1.1

    1 INTRODUCTION .......................................................................................................................... 5 2 EXECUTIVE SUMMARY ............................................................................................................ 5 3 EXISTING POLICIES TO ENCOURAGE EHEALTH SERVICES FOR THE PUBLIC/

    PATIENTS.............................................................................................................................................. 5 CURRENT SITUATION REGARDING ONLINE INTERACTION WITH ONES OWN DOCTOR ................................. 6 CURRENT SITUATION REGARDING TELEPHONE CONSULTATION ................................................................ 6 OVERALL SUPPLY-DEMAND MATCH REGARDING EHEALTH SERVICES ...................................................... 7 EXISTING SPECIFIC POLICIES/REGULATIONS FOR ONLINE OR TELEPHONE-BASED CONSULTATIONS ............. 7 COUNTRY-SPECIFIC BARRIERS TO IMPLEMENTATION AND UPTAKE OF EHEALTH SERVICES ........................ 7 COUNTRY-SPECIFIC FACILITATORS WHICH ENCOURAGE IMPLEMENTATION/UPTAKE OF EHEALTH ............. 7 CHARACTERISTICS OF NATIONAL HEALTH CARE SYSTEM WHICH AFFECT USAGE OF EHEALTH ................... 7 4 TELEMEDICINA.CZ - TELEMEDICINE PROJECTS IN CZECH REPUBLIC ...................... 8 5 ROSCH FOUNDATION ................................................................................................................ 9 6 IZIP INTERNET MEDICAL DATABASE ................................................................................ 9 7 NETC@RD PROJECT ................................................................................................................ 10 8 IKEM CZ INSTITUTE FOR CLINICAL AND EXPERIMENTAL MEDICINE .................. 10 OVID ................................................................................................................................................. 10 DATA NETWORK OF HEALTH DEPARTMENT (DSRZ) MEDICON.CZ ......................................................... 10 9 EUROMISE ................................................................................................................................. 11 10 BRANCH CONTACT ORGANIZATION - HEALTHCARE (BCO) ................................... 12 11 COORDINATION CENTER FOR DEPARTMENTAL MEDICAL INFORMATION

    SYSTEMS ............................................................................................................................................. 12 12 NATIONAL HEALTH REGISTERS ..................................................................................... 13 IS TRANICON................................................................................................................................... 13 NATIONAL CARDIOSURGERY REGISTRY (NKCHR) ............................................................................... 13 NATIONAL ONCOLOGY REGISTRY (NOR) ............................................................................................. 14 NATIONAL REGISTRY OF VASCULAR SURGERY ...................................................................................... 14 NATIONAL REGISTRY OF ARTERIAL REPLACEMENTS .............................................................................. 15 OPHTHALMOLOGY REGISTRY (OFR) .................................................................................................... 16 NOSOCOMIAL INFECTION REGISTRY (RNI) ........................................................................................... 16 RIP REGISTRY OF INTENSIVE CARE .................................................................................................... 17

    Page 4 of 19 4

IST 027065 RIDE Deliverable 2.1.1

    1 INTRODUCTION

    RIDE is a roadmap project for interoperability of eHealth systems leading to recommendations

    for actions and to preparatory actions at the European level. This roadmap will prepare the ground

    for future actions as envisioned in the action plan of the eHealth Communication COM 356 by

    coordinating various efforts on eHealth interoperability in member states and the associated states.

    Since it is not realistic to expect to have a single universally accepted clinical data model that will

    be adhered to all over the Europe and that the clinical practice, terminology systems and EHR

    systems are all a long way from such a complete harmonization; the RIDE project will address

    the interoperability of eHealth systems with special emphasis on semantic interoperability.

    This document is a survey of current eHealth practices in Czech Republic.

    2 EXECUTIVE SUMMARY

    The executive summary of eHealth in the Czech Republic is as follows:

    ? A national eHealth policy is mentioned in the Ministry of Informatic's strategic document

    "State Information and Communications Policy e-Czech 2006". Two important

    statements in the document are as follows; Replace the existing health insurance cards by

    smart cards compatible with EU standards, according to EU schedules and By the end of

    2006: build up an information network connecting points of care in the Czech Republic to

    such points in the EU and enabling the sharing of public health data and coordination of

    activities in the events of life and health emergency.

    ? IZIP project is one of the important projects in Czech Rebuplic which

    provides Internet Access to Patient's Medical Information.

    ? There exists some national regisries including;

    o IS TRANICON: Waiting lists for kidney transplantation, register of dead organ

    donors, register of patients after the transplantation has been done.

    o National cardiosurgery registry (NKCHR)

    o National oncology registry (NOR)

    o National registry of vascular surgery

    o National registry of arterial replacement

    o Ophthalmology registry (OFR)

    o Nosocomial Infection registry (RNI)

    o RIP registry of Intensive care

3 EXISTING POLICIES TO ENCOURAGE EHEALTH SERVICES FOR THE

    PUBLIC/ PATIENTS

    Consistent with the National Information Policy, the central government (Ministry of Public

    Health) seeks to provide a complete information service. Websites serve as a guidepost, there are

    Page 5 of 19 5

IST 027065 RIDE Deliverable 2.1.1

    a lot of links to clubs and syndicates, universities, hospitals, schools and health insurance

    companies. This website (www.mzcr.cz) is considered as a central access point for eHealth

    service.

A national eHealth policy is mentioned in the Ministry of Informatic's strategic document "State

    Information and Communications Policy e-Czech 2006". Main principles are outlined as follows:

    ? The Government is aware that the use of the latest ICT is an essential condition for the

    affordability and quality of healthcare and will actively promote them. At the same time,

    deployment of ICT is viewed as a way of increasing the efficiency of the care provided

    and achieving a higher quality of citizens' lives.

    ? The state is going to link its activities related to patient identification, accessibility of

    health records, and interconnection and cooperation of health-care providers closely to

    such activities of the EU in order to achieve maximum compatibility.

    ? To provide public health information and services, for instance related to healthy living,

    pollution status, options for prevention, availability of care, teleconsultation, etc., the

    Government intends to use the same means that are used to provide other online e-

    government services, that is above all the Public Administration Portal. Key tasks relating to eHealth:

    ? Gradually: replace the existing health insurance cards by smart cards compatible with EU

    standards, according to EU schedules.

    ? By the end of 2006: build up an information network connecting points of care in the

    Czech Republic to such points in the EU and enabling the sharing of public health data

    and coordination of activities in the events of life and health emergency.

    ? By the end of 2005: roll out a system providing public health information. Local government (in regions) do not provide much useful service online. There usually are lists

    of medical centres in the region but without more specific information or hyperlinks.

    More advanced initiatives for making eHealth navigation do exist, but their range is only local

    and they tend to be limited to some part of eHealth service.

    Current situation regarding online interaction with one’s own doctor

    Doctors usually consult and discuss individual health problems by the phone. Online

    consultations are not usual yet in Czech Republic. Regarding test results, there are some (private)

    doctors who place test results on a secured area on their websites. Patients have their own user

    name and password to access. Prescription renewal is not possible via e-mail; all patients will

    have to visit their doctor for this task. Online appointment scheduling may be possible with some

    doctors only in the big cities. Otherwise patients will have to use the phone.

    Current situation regarding telephone consultation

    While online communication between doctors and patients is still unusual in the Czech Republic,

    telephone communication is used widely. The following possibilities for telephone consulting are

    available:

    ? communication with own family doctor during normal office hours;

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IST 027065 RIDE Deliverable 2.1.1

    ? communication with general practitioner after hours - high quality service available, in

    the case of serious health troubles even 24 hours a day, for a fee;

    ? communication with medical centre/hospital

    ? information services which giving general advice but no help with urgent health

    problems;

    Emergency phone lines (155 - Quick health service, consultations in the very difficult situations or in the case of unexpected serious health troubles; 112 - Integrated save system; psychological help (numbers 800).

    Overall supply-demand match regarding eHealth services

    "At present there are a lot of health websites in the Czech Republic. Unfortunately, they do not add up to form a comprehensive system of e-health service provision, since supply is not integrated and no single health portal has been set up yet - users will have to use search engines to locate help.

    The level of demand for e-health services corresponds with the spread of Internet take-up which is reaching more and more households. The Internet is usually used by the young generation and this fact limits the use of online health services for those who need them most. Information on injuries, birth control, and so on are demanded more frequently at the moment than information on health issues which are more related to old age."

    Existing specific policies/regulations for online or telephone-based consultations There are no regulatory constraints on online or telephone-based medical consultations. These services are provided by private organizations. Clinics and doctors will have their own individual policies.

    Country-specific barriers to implementation and uptake of eHealth services

    The main demand side barrier is still the relatively high price for an Internet connection. Also, citizens (and doctors too) do not have the digital skills needed for making efficient use of the medium.

    Country-specific facilitators which encourage implementation/uptake of eHealth

    The support by the central government in the context of the priority "e-society development" will act as a driving force for the future development of e-health in the country.

    An other factor is the private sector which is about to realise the size of the business opportunity with regard to e-health. The further spread of Internet connections and other ICT infrastructure will generally act as boost for demand.

    Characteristics of national health care system which affect usage of eHealth

    The main pillar of the healthcare system is the public health insurance system with a small complicity of the patients. It will be necessary to solve two main problems for improving the possibilities of the patients to obtain information and to manage his health by some e-health system:

    ? to improve the general communication between the doctors and the patients and

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IST 027065 RIDE Deliverable 2.1.1

    ? to configure a payment system for doctors who spend their time by working with own e-

    health system (relationships between doctors and health insurance company). 4 TELEMEDICINA.CZ - TELEMEDICINE PROJECTS IN CZECH

    REPUBLIC

    There has been an interesting project of Information platform organized by

    Prof. Rosch Foundation with the support of Czech Telecom. The aim of this

    project was a support of new technologies through the pilot project that were

    mainly focused on the clinical applications (teleconsultations of the doctors

    during the surgery or the transmission of these surgeries for the purposes of

    distant education and training of the doctors). The site is available at

    http://www.telemedicina.cz.

Below is the map of the Czech Republic with the regional location of the

    projects. The picture shows that most of the telemedicine activity of the

    planned or executed projects within Telemedicina.CZ is located in:

    ? Prague region

    ? Southern Moravia, mainly in Brno

    ? Northern Moravia and Silesia, mainly in Olomouc and Ostrava

    There is also bigger activity in Eastern Bohemia, mainly in Hradec Kralove.

    Lower activity can be seen in all the regions of the Czech Republic.

    The biggest activity is in the regions neighbouring with Poland and Slovakia,

    centrally the biggest activity is in the Prague region.

    Figure 1 Map & Projects

    1. Interventional teleradiology

    2. Acute neurotraumatology

    3. Home (tele-)working for neurosurgeons

    4. Telepathology

    Page 8 of 19 8

IST 027065 RIDE Deliverable 2.1.1

    5. Interconnection of the Olomouc country hospitals

    6. Telecardiology

    7. Telehematology

    8. Teleortography

    9. Teleconsultations and treatment of acute myocardial infarction

    10. Teleconsultation of laparoscopic executions

    11. Interconnection of Brno region hospitals

    12. Teletraumatology

    13. Teleconsultation in the area of pediatric auxomology and syndromology

    14. Interconnection of Injury hospital Brno with cooperating hospitals

    15. Teleendoscopy

    16. Teledermatology

    17. Telearthroscopy

    18. Telebronchoscopy

    5 ROSCH FOUNDATION

    Since established in 1998, the Foundation and its partners have participated in the following activities:

    ? Five point-to-point tele-video medical specialty conferences between Prague and Portland, Oregon.

    ? Two multi-point televideo medical conferences between Prague, Graz and Portland, Oregon, USA.

    ? Regular multi-point televideo conferencing and teleconsutation services between a constellation of five Czech hospitals in Prague, Hradec Kralove, Olomouc and Brno. ? Technical planning and performance of more than 20 hours of transmission of live cases and multi-point panel discussion to the 6th and 7th International Workshop in interventional radiology.

    ? Live case transmission with demonstration of new minimal invasive procedures to five international meetings in Europe and Asia.

    ? Performance of a three-hour tele-meeting on advances in minimal invasive treatment with physicians in Japan.

    ? Teleconsultation in neurosurgery between 10 hospitals in Northern Moravia for facilitating diagnosis of head and spine trauma injury management.

    ? Home working via PCs and ISDN services for neurosurgeons at the Ostrava Hospital in the Czech Republic.

    ? Telepathology consultation at 6 Czech hospitals.

    ? Telecardiology at several Czech hospitals with successful transmission of echocardiographic studies and teleconsultations.

    6 IZIP INTERNET MEDICAL DATABASE The abbreviation IZIP in Czech language means Internet Access to Patient's

    Medical Information. The objective and substance of the IZIP project is to

    place the medical database of the insured patient into the public information

    network - the Internet.

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IST 027065 RIDE Deliverable 2.1.1

    The database consists of selected parts of medical documentation written into IZIP by the attending physicians. Both the doctor and the patient may at any

    time use a computer with internet access to view the results of clinical

    examinations, laboratory tests and X-ray pictures as well as a list of

    prescribed and used medicaments.

    The IZIP project is executed by a private company IZIP Ltd., Prague, with the support of General Health Insurance Fund of the Czech Republic (VZP CR) and

    other partners such as IBM, Czech Telecom, Eurotel, Komercni banka and others. The application solution, software and implementation are supplied by IBM, and the Czech Telecom and Eurotel look after the data transfer.

    7 NETC@RD PROJECT

    Czech Republic prepares countrywide introduction of new health insurance cards for the ensured persons of VZP (70% of population) at the middle of 2004. The card reverse will have European health insurance card (EHIC) format and CR will be one of the first countries where EHIC will be implemented.

Goal of the pilot project

    The goal is to securely identify the insured person and to create the pre-requisite for the automated authorization of the transactions.

    Costs related to the Czech part: 310,000,- EUR

8 IKEM CZ INSTITUTE FOR CLINICAL AND EXPERIMENTAL

    MEDICINE

    IKEM hosts CZI MEDICON?, Healthcare Informatics Center for the development and

    operation of application and communication environment of the healthcare data network in the Czech Republic. It is a valuable resource for public, health

    outcome researchers, and academicians both in and outside of the Czech

    Republic.

    OVID

    System Ovid Web Gateway is an instrument for searching and working with

    bibliographical and full text information from the area of biomedicine. It is accessible to all employees of the member institutions of the consortium on

    the address: http://gateway.ovid.com/autologin.html

    Data Network of Health Department (dSRZ) medicon.cz

    DSRZ is multifunctional network of selected health institutions that are the

    base for future infrastructure of National Health Informational System (NZIS) and serve for informational and communicational needs of health department

    with country coverage, especially in the area of selected Informational System

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