Status of Healthnet and Telemedicine in Iceland

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Status of Healthnet and Telemedicine in Iceland
Ingimar Einarsson Director Dep. of Planning and
Development Ministry of Health and Social
Security Reykjavik, Iceland ingimar.einarsson_at_htr.
stjr.is
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Figures on Iceland

• Population 290 thousand
• Size of country 100 thousand square km
• Export (fob) Fish (60), industry (40)
• Well established Communication infrastructure
• Fibre connection around the country (Gb/s)
• Fibre connection to Europe (4 Mb/s) and America
  (45 Mb/s). (Cantat-3)
• New cable in 2003/2004. Need for 155 Mb/s 2001
• 80 have access to Internet

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Organisation of Healthcare
Sec./Tert. Care
Primary Care

• Healthcare centers in every local community
• Few private GPs in the Reykjavik area

• 1 University Hospital (in Reykjavik)
• 3 Regional specialized hospitals
• 19 Local hospitals
• Specialists in private practice in Reykjavik area

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Strategy for Information Society

• Declaration of the
• Government 1996
• The Icelandic Information Society
  http//www2.stjr.is/framt/vision00.htm
• Main issues for Health
• Give the citizen good access to Healthcare
  service and information on Health by the use of
  IT.
• Increase Quality and Economics in Healthcare
  service by strategic use of IT
• Maintain privacy and security with the use of IT

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IT Strategy for Healthcare

• Ministry of Health and Social Security 1997
• The Icelandic Health Information Policy
• Strategy for the use of IT in Healthcare
• Data security and data storage
• Privacy
• Public access to Healthcare
• information (HealthWeb)
• Use standards (CEN and others)

http//heilbrigdisraduneyti.is/interpro/htr/htr.ns
f/Files/Stefnum/file/Stefnum.pdf
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The Icelandic Healthnet
Strategy 1997

• Provide connection to all institutions related to
  Healthcare
• Use the Healthnet to provide proper bandwith for
  various communications
• Use open standards
• Provide secure connections and communications

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The Icelandic Healthcare Network
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The Icelandic Healthnet
Executive plan 2000

• General framework for IT communication in
  Healthcare service
• Special project on Security issues
• Security Policy, Security Rules, Directory
  services
• Development projects 2000 - 2003
• Clinical Messages, Telemedicine, EHCR, various
  databases.
• Information path to various databases

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Structure of the Icelandic Healthnet

• Virtual network, not a physical network
• Comprises communication rules and security
  mechanisms
• Directory services (authenticate partners)
• Security policy, security standard based on IST
  ISO/IEC 17799
• Secure access, data integrity (encryption),
  electronic signature (PKI)

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Icelandic HealthnetDevelopment projects

• Telemedicine
• Shared Records
• Lab tests (RR)
• Radiology (RR)
• Electronic
• prescription

• Medicinal database
• National accident
• registration
• General Directorate
• of Health DB
• Hospital care info
• RAI,Req.f.nurs. Home
• Central database

• Specialist bills
• Physioth. bills
• Dentist bills
• Hospital care
• info
• Web forms

• European projects
• Nordic projects
• Local research
• projects

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Ongoing/coming projects
Ongoing
Coming

• Telemedicine
• Teleradiology
• Emergency medicine
• Teleobstetrics (US videoconf.)
• Electronic prescription
• Accident registration
• RAI, Req. f. Nurs.home
• Physioth. Reimb.m

• Telemedicine
• Psychiatry
• Distant learning
• Shared records
• Lab tests RR
• Radiology RR

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Management of Healthnet

• Ministry of Health and Social Security
• General Directorate of Health
• Institute of Social Security
• Regional hospitals
• Health clinics
• Icelandic Medical Association
• Icelandic Nurse Association.
• Icelandic Software comp. association
• ICEPRO (electronic commerce)

4 persons nominated by the Ministry
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Telemedicine/Telecare

• Trends and National Plan

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Goals for Telemedicine

• Telemedicine must be an integrated part of the
  healthcare service
• Provide equal access to healthcare
• Increase competence
• Ethical issue Increase quality by seeking
  consultant but protect privacy

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Current status of projects

• Started in 1993 with Teleradiology.
• Projects centered around the University hospital
  and with cooperation with local hospitals and
  Healthcare centres.
• Projects in different parts of the country.
• About 10 projects running today.

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Telemedicine projects
Started
Planned

• Radiology
• US in Obstetrics
• Psychiatry
• Pathology
• Emergency medicine
• Surgery
• Distant learning

• Ophthalmology
• Ear, Nose and Throat
• Home Care
• Cardiology
• Dermatology
• Oncology

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Plan for Telemedicine

• Phase I Development Plan, 2000-2003
• Phase II Executive plan 2004-2006
• Part of the Icelandic Healthnet
• Financed mainly by government
• the Icelandic Information society
• Ministry of Health and Social Security
• Research funds and other funds

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Relation to other plans

• Healthnet and Telemedicine has links to
• National Health Plan to year 2010
• (in line with WHOs HEALTH 21)
• Plan for Quality Measures in Healthcare service.