EHTO Trends in Health Telematics in the European Union
  
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Updated: Dec 6, 96
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DENMARK |
Health care in Denmark is administered by 15 County Councils, who own and operate almost all hospitals. They are also responsible for the basic set-up of primary care within each county. GPs, practising specialist and other clinicians operate on a semi-liberal basis with a mix of per capita and fee for service. They are reimbursed for most of their services by the counties according to collective contracts. Almost all citizens are registered with a GP who acts a "gatekeeper" to the system.
The counties administer the system fairly freely. For instance, each choose their IT systems suppliers individually, However, there are factors to ensure coherence and compatibility:
- Recognition of the need to seek common or compatible solutions - in informatics and generally
- National coding and classification schemes, including surgical procedures, drugs, radiology, hospitals and hospital departments, and diseases: ICD 10 from January 1st 1994
- National Register with 10-digit unique person identifier used in virtually all transactions with public authorities, not only in health care
- A National Minimum Basic Data Set on all hospital admissions since 1977. The register has gradually been extended to include psychiatry, out-patient visits, waiting lists etc.
Information systems: all county administrations, hospitals (PAS, HIS) and pharmacies are computerised, as are about 70 percent of GP's and other private clinicians.
The Danish Government "Information Society Action Plan" (March 1995) includes two strategic initiatives in the health care field:
- To create a Health Care Data network for seamless communication of messages (planned to include multi-media in the future) in the health care sector.
- To create a Danish concept model, minimum requirements, exchange formats etc for electronic health care records to make health care records and their elements compatible and transferable.
The data network is already well under way in the so called MedCom Project, which is currently developing, testing and implementing exchange formats for a number of frequent character-based messages: prescriptions, referral and discharge letters, laboratory requests and results etc. Wherever available CEN/TC 251 formats are adapted. Multimedia health care messages have not yet been dealt with at a national level.
The health care record initiative is in its initial phase. A pre-analysis was completed in January, 1996, with a larger study in the spring. This looks to create a consensus on a concept model and what exactly needs to be standardised. The main project is expected to start in autumn 1996, to develop and test in pilots the necessary standards, exchange formats etc. Wherever possible CEN models, standards and formats will be adapted.
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