Transcript EHR Systems Use and Quality in Turkey_AKC

MINISTRY OF HEALTH TURKEY
Dr. Ali Kemal ÇAYLAN
Ministry of Health, Turkey, Deputy Director
21-22 November 2011 Belgrad
MINISTRY OF HEALTH TURKEY
Presentation plan
 Basic information about Turkey.
 Transformation Program and ehealth projects
 How data is collected
 Standards of the data
 Market
 Initiatives and plans
21-22 November 2011 Belgrad
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MINISTRY OF HEALTH TURKEY
Country details
— Basic facts about Turkey:
• Population: 73.7 million people (2010)
• 814.578 km2
• 81 Provinces
• 1469 Hospitals
‒ 893 Public hospitals
‒ 496 Private and NPO
‒ 125 University, Private and NPOrg.
• 103 000 Physicians
• 90 000 Nurses
21-22 November 2011 Belgrad
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MINISTRY OF HEALTH TURKEY
Health Transformation Programe
• Initiated in 2003
• Objectives
– Restructuring of the ministry
– Administrative
– Functionally
– Covering all the citizens by general health Insurance
– Implementing Family Medicine
– Promoting private sector to invest in health
– Realizing the e-transformation in the field of health
• Mission
is to lead innovation in the direction of current improvements, also to develop an
active, rapid, trustworthy, accessible healthcare systems which is not only respectful
to individual rights but also appropriate to international quality standards in order
to provide various solutions to our citizens for better health care.
21-22 November 2011 Belgrad
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MINISTRY OF HEALTH TURKEY
Main e-helth projects
— After 2005
• Family Medicine System(AHBS)
• Health-Net(Sağlık-Net)
• Public Health Centre(TSM)
• Centered Hospital Appointment System(MHRS)
• Drug Tracking System(İTS)
• Tele-medicine
— Health-Net, is a central repository for EHRs,
• Operational since January, 2009
• By December 2010, 98% of the public hospitals and 60% of the
private and university hospitals are connected to Health-Net
sending the EHRs of their patients on a daily basis
21-22 November 2011 Belgrad
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MINISTRY OF HEALTH TURKEY
Who sends data?
FAMİLY DOCTOR
II. and III. Level Public Hospitals
HOSPITAL University Hospitals
Private Hospitals
FORMAT CONTROL
CONTENT CONTROL
MINISTRY OF
HEALTH
LABORATORY
EHR
DATABASE
PROVİNCİAL
DİRECTORATE
OF HEALTH
Malaria and/or
Tuberculosis Control
Dispensaries
HEALTH
CENTRE
Alcohol and drug addiction
treatment institutions
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MINISTRY OF HEALTH TURKEY
taking a big step…
EHR systems: Integration
- Family Physician System
- 20.000 family physicians
- 73 million population
- 65 million patients data
- Over 40 different vendors
- Over 15 different functioning program
- Health-Net with 1589 healthcare organization
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MINISTRY OF HEALTH TURKEY
EHR systems: legal/regulatory
•
Health data is collected MoH
– MoH determines legislations and standards to collect data.
‒ Integration to Health-Net is accepted as performance criteria for
hospitals in a circular order since 2009.
– Family Physicians has an obligatory to send EHR to Family Physicians
Information System(AHBS) since 2005.
• Sharing of health data
– Health data is own by MoH
– EHR of a citizen can not be shared unless given permission by the
citizen
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MINISTRY OF HEALTH TURKEY
EHR systems: standarts
• The standards used in Health-Net:
– The National Health Data Dictionary (USVS v2) determines the
data elements, their data types and the sections in an EHR
– 65 data sets
– 413 data elements
– 53 data packages
– HL7 CDA for the EHR content structure
– HL7 Web service profile for transportation
– National Code System Server (SKRS) which includes ICD-10
*Ulusal
Sağlık Bilgi Sistemi/Sağlık-NET Entegrasyonu İle ilgili Genelge 2008/18,
http://www.saglik.gov.tr/TR/belge/1-6257/eski2yeni.html
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MINISTRY OF HEALTH TURKEY
EHR systems: quality assessment
 Health-Net
 There is rapid increase in the amount of health institutions sending data to
Health-Net.
 The 81 provincial health directorates were included to the quality assessment
and evaluation process to deal with this growing.
 Health-Net Quality Assessment application is opened to them to make cross
check between registered hospital records and Health-Net data. Comparison
is done both quantitatively and qualitatively.
 Every month, "province Health-Net quality assessment commission"
compares registered hospital records and NHIS data.
 A health institution receives a passing grade if registered hospital records
match Health-Net records over 90 percent for every dataset
 AHBS
 Quality tests are performed at MoH
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MINISTRY OF HEALTH TURKEY
EHR systems: quality assessment
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MINISTRY OF HEALTH TURKEY
Market history
• Market penetration
– The EHR system used in the primary care is the Family Medicine
Information System(AHBS) available both from MoH as well as
from vendors
– For secondary care(HBYS), there are a number of local EHR system
vendors (more than 80)
– The top three vendors have about 60% of the market share
– Almost all hospitals use locally developed EHR systems
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MINISTRY OF HEALTH TURKEY
EHR systems: market testing
‒ Current actions
‒ The need for requiring the use of quality assessed EHR systems is
well recognized
‒ The EHRs received by Health-Net are checked at random intervals
for quality and punitive actions are enforced
‒ Before Health-Net became operational, the interoperability of the
vendor EHR systems to Health-Net is tested with a testing tool,
namely, TestBATN
‒ TestBATN is also used for checking the capabilities of an EHR system
‒ Using TestBATN for EHR certification is being considered
‒ Turkish Standards Institute
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MINISTRY OF HEALTH TURKEY
EHR systems: initiatives, plans
• To improve the interoperability of EHR systems to
Health-Net, the following actions are considered:
– Communicating with the Turkish Standards Institute to
set the EHR standard for Turkey
– Establishing the body for certification of EHR systems
– Setting the certification mechanisms
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MINISTRY OF HEALTH TURKEY
Ministry of Health, Turkey,
Deputy Director
Dr. Ali Kemal ÇAYLAN
[email protected]
21-22 November 2011 Belgrad
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