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Kanta services for healthcare: Prescription service and Patient Data Repository

  1. @Kantapalvelut @khypp Kanta services for healthcare: Prescription service and Patient Data Repository Outi Lehtokari, Development Manager, Finnish Institute for Health and Welfare Konstantin Hyppönen, Chief Architect for Kanta Services, Kela (Social Insurance Institution, Finland)
  2. Pharma- ceutical database Kelain (web-based prescription) Delivery of medical certificates Archive of legacy patient data Prescription My Kanta PagesKanta client test service eHDSI ePrescription Dental care Archive of imaging data Kanta Personal Health Record Benefits: Data availability regardless of the person’s location Patient safety Support for new care processes Cost efficiency Data repository for social services Patient Data Repository
  3. With Kanta services, the citizen’s data is always up-to-date and available. Smooth flow of information enables better care. The users of Kanta services include citizens and professionals in pharmacies, healthcare services and social welfare services. Service providers in both public and private sector use Kanta services.
  4. Kanta is a data repository, not a user interface*. Kanta is actively used through patient record and pharmacy systems. Tiia Lundqvist4 *Kelain (web-prescription system) is a small exception to this general rule
  5. How do we ensure interoperability? Functional and security requirements  Joint testing is a statutory obligation for systems connected to Kanta  In addition to joint testing, systems must implement key functional requirements and pass data security audit  Functional requirements and audit criteria are defined by THL.  Systems are registered by National Supervisory Authority for Welfare and Health  Accredited auditing bodies verify the compliance with audit criteria  Every health and social service provider must in addition implement a self-supervision plan 5
  6. Use of Kanta Services in healthcare 6 Public primary healthcare centres of prescriptions and medicine dispensing data are electronic Patient Data Repository 100% Public hospitals 100% Prescription Centre Community pharmacies 100% 100% of Finnish population were prescribed medicine by electronic prescriptions 80% Private healthcare service providers 1,400 Private healthcare service providers 1,300 The first cross- border electronic prescription exchange between Finland and Estonia records on service events and treatments Over 1 billion 187 million electronic prescriptions persons has patient data in Patient Data Repository Over 6 million
  7. Prescriptions  From 1.1.2017 all prescriptions for humans are electronic (by law). Prescriptions may only be issued on paper and over the phone in exceptional situations.  Renewal requests can be submitted through healthcare, pharmacies and My Kanta pages.  A web-based prescription system (Kelain) is available for personal use by prescribers.  New: Finnish prescriptions may also be dispensed in Estonia and Croatia and later in other countries through eHDSI (My Health @ EU).  Upcoming: National medication list
  8. Dispensation of Finnish prescriptions abroad, average per day in 2019 8 Total: 5376 dispensations during 21.1-23.10.2019 Currently 600-800 dispensations per month 0,0 5,0 10,0 15,0 20,0 25,0 30,0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct *Data for Oct: until 23.10.2019 *
  9. Electronic prescription in Europe – a Finnish patient purchasing medication in a pharmacy abroad This is reality right now
  10. Patient Data Repository  Public healthcare organisations are obliged to enter patient records in a nationally centralised archive by law  Deployment is mandatory for private healthcare organisations, if they have an electronic system for long-term storage of patient records  In production since 2013  Contains  data from patient records (also dental care, optometric data)  summary data of the patient’s main health information (for example diagnoses, risks, laboratory results)  medical certificates  living will and wishes regarding organ donation  New: Sharing Images through Archive of Imaging data  New: Connection to the national data exchange layer (based on X-Road)  First service: transmission of medical statements to Finnish Transport and Communications Agency (Traficom) system for the issuance of driver’s licenses
  11. Change in healthcare mindset!  ”to share data, you have to store data in unified form”  Form of patient records: structured data and unified documentation  ”protect the information and take care of data confidentiality”  Access rights to patient records  Patients right to see the use of his data via My Kanta pages  Patients consent and right to restrict access  ”use the data!”  Check the previous and valid prescriptions before prescribing new ones  Check the patient history from other hospitals and healthcare centres 11
  12. Kanta Finland’s Digital Health and Social Care Treasure
  13. Secondary use of health and social data  Act on the Secondary Use of Health and Social Data passed on 26.4.2019  Facilitates better utilization of Finnish exceptionally comprehensive and high-quality health and social data resources  Establishes a data permit authority and a service operator (Findata), enabling a one stop service for all types of secondary use
  14. Data lake for health and social care Kanta services Reporting tools Analytics tools APIs, including ones for open data Other data loading capabilities Side data lakes Side data lakes Data production Data consumption Data virtualization Relational databases Data quality management Pseudonymization and anonymization Data search and refinement mechanisms Analytics and artificial intelligence environments Object stores Clustering and data segregation Directory services Logging and supervision tools APIs and micro services Secure user environments National registers Regional data lakes Demographic data and other data sources outside health and social services Research Development and innovation Teaching Knowledge management Steering and supervision Planning and reporting
  15. Summary  Finnish eHealth infrastructure is well-managed and is in active use  Services are based on legislation  Growth and expansion is continuing with new services  It has not been a mere technical change. Healthcare professionals must adopt new operations models.
  16. Thank you! Outi Lehtokari, Development Manager, Finnish Institute for Health and Welfare Konstantin Hyppönen, Chief Architect for Kanta Services, Kela (Social Insurance Institution, Finland) @Kantapalvelut @khypp