The following appeared a couple of days ago.
Portuguese model for e-health rollout: e-health records on a national scale
- Karen Dearne
- From: The Australian
- March 01, 2011
THE federal Health Department is looking to Portugal for direction in its e-health rollout, deputy secretary Rosemary Huxtable says.
"A number of countries are engaged in developing e-health records on a national scale," she told a Senate estimates hearing.
"In fact, I've recently had discussions with representatives of the government of Portugal, which is doing very similar work.
"Certainly the Scandinavian countries are well advanced in that regard, and France has been doing work in that area. Of course, large private insurers in the US like Kaiser Permanente have systems serving greater populations than ours."
Queensland Liberal senator Sue Boyce had queried whether there was a PCEHR (personally controlled electronic health record) system running anywhere in the world.
A Health statement to PCEHR contract bidders in January said there was "no single solution in place that meets all of the specifications. But every single component has been implemented successfully somewhere".
Ms Huxtable said Australia had been alive to international experience, and the risks and benefits of various approaches.
"Our design is very much a combination of top-down in terms of standards setting and the foundations, but also bottom-up where information is drawn in a live sense from existing systems into the e-health record," she said.
"Rather than having a single national repository, it's a process of aggregating information and using indexing technology (so medical providers) can view health summaries.
"I certainly took out of my discussions with the Portuguese that they were doing something quite similar and had come to it via a similar route."
Now I had not heard of Portugal (one of those economically crippled PIIGS some may recall) as being a major force or leader in e-Health.
As luck would have it I came upon a brand new review on e-Health in the EU.
European Countries on their Journey Towards National eHealth Infrastructures
Thursday, 24 February 2011
Since the publication of the European Commission's (EC) eHealth Action Plan in 2004, eHealth has gained significant momentum across Europe. "European countries on their journey towards national eHealth infrastructures - evidence of progress and recommendations for cooperative actions" is the title of a just released overview and synthesis report on eHealth in Europe. In addition, more than 30 individual reports detailing policy actions and deployment of eHealth applications in Member States and other European countries are available there as well.
The summary report traces European countries' progress along the goals set out in the eHealth Action Plan. It focuses on the core applications of EHR-like/patient summary and ePrescription systems. It also analyses governance, structural and legal issues as well as policy lifecycle aspects.
Study results show that in virtually all European countries surveyed, political as well as stakeholder interest in eHealth policies, and the planning and implementation of national or regional infrastructures has strengthened considerably. This concerns not so much the number of new priority objectives identified, infrastructure elements tackled or pilots run, but rather the overall level of awareness, activities and concrete undertakings. EC as well as Member State initiated activities and co-operations like epSOS or the eHealth Governance Initiative have both significantly contributed to this state of affairs and are witness thereof.
As Pēteris Zilgalvis, Head of the EC's ICT for Health Unit commented, "Europe is experiencing a strong political momentum to advance eHealth solutions for the benefit of both its citizens and health systems. The recommendations for further actions submitted in this study are based on a thorough analysis of eHealth strategies and implementation activities in European countries as well as the results of a validation workshop in September 2010 in Brussels ... now the challenge is to cooperatively address the issues identified."
empirica Communication and Technology Research, with more than 20 years of experience in research on eHealth and telemedicine topics, coordinated the study. The Finnish partner institute THL (National Institute for Health and Welfare), legal specialists from the law firm Time.lex and Professor Denis Protti (University of Victoria, Canada), contributed domain expertise. The study's communication efforts and final validation workshop were supported by the communication agency EMC Consulting Group.
A host of experts as well as reviewers from the i2010 Subgroup on eHealth contributed their intimate knowledge of the eHealth situation in their respective countries and validated the content of the country reports. This comprehensive collection of country information constitutes a unique resource and important database of up to date evidence on eHealth progress across Europe, which updates and complements the results of the earlier eHealth ERA study of 2007.
Download from eHealthNews.eu Portal's mirror: European countries on their journey towards national eHealth infrastructures - evidence of progress and recommendations for cooperative actions (.pdf, 1.060 KB).
The release is here:
A download of the document was fascinating to read.
Page 14 (of 58) tells us Portugal is mentioned.
On Page 29 we read:
Amongst the forerunners in designing a legal framework adapted to the use of eHealth are Denmark, England, Estonia, Finland, France, Norway, Scotland, Slovak Republic and Sweden. Almost all countries which do not (yet) have specific regulations with regards to one or more fields of eHealth, such as Austria, Cyprus, Latvia, Malta or Portugal, do have some regulation on health data, if only through the transposition of article 8 of the EU Data Protection Directive.29
On Page 37 we read:
Other countries such as Portugal have local implementations of ePrescription software in hospitals or pharmacies, but currently no electronic transfer of prescriptions from GPs to pharmacies is implemented.
On Page 46 we find:
Patient eCards are often based on or equivalent to multipurpose eCards for eGovernment services - including healthcare. In Finland for example, when providing citizens with a personal identity code, the Population Register Centre creates also an electronic identity for them (FINEID). The electronic client identifier is used for electronic user identification in secure online transactions. It is a dataset consisting of a series of numbers and a check character that helps identify Finnish citizens. In Portugal, an eCard for patients was deployed, that integrates previously issued cards in the field of personal identity card, taxpayer‟s card, social security card, voter‟s card and health system card. Their eID is a smartcard that provides visual identity authentication, with increased security, and elec-tronic identity authentication based on biometrics (photo and finger print) and electronic signature features.
And that seems to be it according to the Adobe Acrobat search.
There is also a 2007 review that is found here:
A classic from this report is here (Page 15)
“Means available to the general public for expressing their opinions on eHealth policies and plans
There are no particular means for the general public for expressing their opinions about eHealth policies in Portugal.”
From my review it is clear Portugal is going down a different e-Health path basic on an eCard (rather like an Access Card +) and that it is way behind Scandinavia, Holland and a range of other sites.
There is nothing unique or special I can see that is specifically relevant to Australia, other than they seem to have some administrative Health Portals.
Ms Huxtable seems to have been making it up as she went along when speaking with the Australian Portugal is in an average to poor e-Health place right now!
Senator Boyce is right. There is nothing remotely like the PCEHR being done anywhere and certainly not in Portugal!
Ps. A small factoid - Kaiser Permanente serves about ½ of the number of people in OZ! Of course their e-Health sadly makes Australia look just a little behind the game having integrated hospital, ambulatory care and patient access systems that are fully implemented and very well used.