Adrienn Aggod-Feko. ICEG European Center, Budapest email address: firstname.lastname@example.org
The main aim of this paper12 is to describe the importance of the healthcare sector and the role of ICT in support of health and health-related fields. The increasingly essential role of ICT in the health sector, assume the operation of the hospital information systems, which are necessary to deliver health care. The paper describes the Hungarian hospital informatics, mainly the complex health information systems, mobile informatics tools, solutions and the barriers to its further development. Furthermore the study presents the wide range of the existing health information systems in Europe to give an international dimension to the topic. The study shows how important are these systems in supporting the health and eHealth services.
The hospital information systems (HIS) are able to transmit, gather, and evaluate medical information. The effectiveness of these systems can be observed in different fields in the hospitals. The challenges of the health system acquire the use of state of the art HIS solutions. The role of these systems is also important to improve the quality of care to patients.
The study contains a Hungarian case study based on a survey, presenting the Hungarian situation. An international comparison will be also shown inside Europe regarding the health sector and the usage of different type of HIS. The paper explores the present state of the health sector and the hospital information systems, the main barriers to its further development. The present state of these systems in international comparison is analyzed through available statistical data and otherPage 457 information. Another part of the study utilized semi-structured questionnaire based personal interviews taken with at least three employees of a given hospital (nurse or laboratory assistant, doctor or its assistant, IT-specialist) in August 2009. In the frame of the case study altogether 90 interviews were conducted in 29 hospitals, which represent well the 140 hospitals in Hungary.
The already existent literature contains different aspects of this topic. The study tries to give an overview about these aspects and to complement them with a special focus on the complex health information systems in Hungarian hospitals. Based on the interviews the paper will summarize the main experiences and the future improvements of the hospital informatics.
The importance of health and eHealth field relation to hospital information systems
In recent years the importance of health sector and the cost-effective and secure use of information and communications technologies in support of health and health-related fields are substantial. WHO has identified three overall goals for health systems, such us to be effective in contributing to better health throughout the entire population; to be responsive to people's expectations, including safeguarding patient dignity, confidentiality and autonomy and being sensitive to the specific needs and vulnerabilities of all population groups; and to be fair in how individuals contribute to funding the system so that everyone has access to the services available, and is protected against potentially impoverishing levels of spending.
The proportion of health in GDP is significant in Europe. In international comparison, Hungary’s health spending is among the lowest in the OECD after Poland, Czech Republic and Luxembourg3.
Figure 1. Total expenditure on health (% of GDP)
[SEE THE FIGURE IN THE ATTACHED PDF]
Source: OECD 2009, http://www.ecosante.org/index2.php?base=OCDE&langs=ENG&langh=ENG. Portugal and Luxembourg have data only for 2006.
The importance of eHealth is also noticeable in recent years. The definition of eHealth according to the World Health Organization is „…the cost-effective and secure use of information and communications technologies in support of health and health-related fields, including health-care services, health surveillance, health literature, and health education, knowledge and research...”4
ITU defines the potential benefits of e-Health as follows:
• Faster and easier storage, transmission and access to medical data and health-related information for healthcare providers and professionals, citizens/patients, academics, researchers, policy makers and others.
• Capacity building and improved delivery of healthcare services, particularly in rural and remote areas.
• Reduction of operational and administrative costs in implementing healthcare services. The role of hospital information systems is essential in the development of eHealth services. The level of these services is different in the countries of Europe.
In the European Union the eHealth Action Plan5 was an important base of the development of national healthcare systems and health information systems, furthermore the i2010 Initiative, the eEurope Action Plan provided basis to the improvements. Now all member states have an eHealth strategy in dedicated documents or as part of wider eServices policies. More and more eHealth became an important element of national health system priorities, which assume the installation of a hospital information system. In Denmark, Sweden and Norway exists fully operational national ICT infrastructures specifically for supporting communications in the health sector. In the EU the priorities of the eHealth varied according to the culture and implemented activities of the country. For example some countries give priority to the Electronic Health Record system, Electronic Patient Records, while the others give priority to the eHealth networks, infrastructure or eCards with the assistance of health informatics.
There are some indicators which can measure and compare the eHealth levels in Europe. In this respect the most important eHealth Indicators are the Euro Health Consumer Index 20096 and the Patterns of eHealth use in the EU7.
The Euro Health Consumer Index 2009 includes the 27 European Union Member States, plus Norway and Switzerland, the candidate countries of Croatia and FYR Macedonia, and also Albania and Iceland. The index is made up of six sub-disciplines, these are:
Patient rights and information (relative weight: 175)
e-Health (relative weight: 75)
Waiting time for treatment (relative weight: 200)
Outcomes (relative weight: 250)
Range and reach of services provided (relative weight: 150)
Pharmaceuticals (relative weight: 150)
The top 3 countries were Netherlands, Denmark and Iceland with scores above 800. The main causes of Netherlands’ excellent healthcare system that it is characterised by a multitude ofPage 459 health insurance providers acting in competition, and being separate from caregivers/hospitals, as well as the country has the best and most structured arrangement for patient organisation participation in healthcare decision and policymaking in Europe. Denmark were good at eHealth, Patient rights and Information, but had a bit lower score in Outcomes. Iceland obtained the third position, due to its location, the country has been forced to build a system of healthcare services, which has the capability of a system serving a couple of million people (which is serving only 300 000 Icelanders).
Some countries also had good results, but other countries are under score 600 (Figure 1.) Romania and Bulgaria had the lowest scores at the Euro Health Consumer Index with the scores 489 and 448, but they are at the stage of assessing their options, choosing a...