The Use of the eID for Health Professionals within the Nationwide Infrastructure in The Netherlands. Sprenger M. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

1. The use of e-ID in the
national infrastructure of the
Netherlands
Michiel Sprenger, PhD
Senior Adviser IT & Innovation
National Institute for IT in Healthcare

2. e-ID for health care professionals
and providers

3. Agenda
• Introduction to eHealth in the Netherlands
• e-ID in the Netherlands
• Some application areas
• Questions

4. Agenda
• Introduction to eHealth in the Netherlands
• e-ID in the Netherlands
• Some application areas
• Questions

5. The Netherlands in EU
Area: #22/27
Pop: #8/27

6. IT proliferation
• Hospitals:
• HIS 100%
• PACS 100%
• Clinical overview: 80%
• Order management (CPOE): 30%
• General Practitioners: 100%
• Pharmacies: 100%
• Nursing homes: 10%

7. Interconnection cross-
enterprise - current
• Many local and regional initiatives
• NO regions in Health system, only in collaboration (+IT)
• Dominant: Edifact messaging:
• >100M messages / year
• Prescriptions
• Lab-results
• Discharge letters
• Patient summaries
• Islands, not interconnected
• Security doubtful
• Need for national standards

8. Healthcare in
the Netherlands
• Multi-enterprise business model:
• 100 hospitals, 4500 GP practices, 1800
pharmacies, 100 locum tenency services for
GP’s, each responsable for own finance, medical
policies, investments, and IT
• Thus: interoperability problems
are large on all levels
•  Urge for standards
•  Much debate (“polder”-model)

9. Upfront Choice for health IT
• Leave information at the source
• Responsibility
• Unambiguousness
• Security
• Fits to business
situation
•  Connectivity, not
“system” building

10. Nationwide electronic
patientrecord (“the EPD”)
• It is not a record, nor a system
• It is an infrastructure
• Leaving information at the source
• In the (electronic) working environment of the
Health Care Professional or Provider (HCP)
• Under the responsibility of the source HCP
• Enabling selective and safe information exchange
between HCP’s and between HCP’s and patients

11. Standards
• HL7v3 for messaging (www.hl7.org)
• SNOMED-CT for “language” unification
Systematitized Nomenclature of Medicine – Clinical
Terms
(www.ihtsdo.org)
• IHE for implementation guidelines
Integrating the Healthcare Enterprise
(www.ihe.net)
• Many others

12. Infrastructure
• Standardised communication
• Safe communication
• Logging
• Identification: patients, HCP’s
• Patient consent registration & handling
• Index function: search, find, transfer

13. Agenda
• Introduction to eHealth in the Netherlands
• e-ID in the Netherlands
• Some application areas
• Questions

14. HCP register - UZI
• National register of:
• Health care professionals (persons)
• Health care providers (institutions)
• UZI register (Unique HCP Identification)
• UZI card

15. Health care professionals
• General Practitioners (8.000)
• Pharmacists (1.800)
• Nurses (140.000)
• Medical specialists
• Dentists
• Etc
• Total >200.000
• Role codes: 70

16. Health care providers
• GP practices (4.500)
• Pharmacies (1.800)
• Hospitals (100)
• Etc
• Total >8000

17. UZI-certificates
• Authenticity (person + institution)
• Confidentiality (person + institution)
• Non-repudiation (person) – “signature”

18. Authorisation
• Identification
• Authentication
• Role code
• Authorisation scheme for application
• Patient consent
• Treatment relation
• Logging of transactions

19. Agenda
• Introduction to eHealth in the Netherlands
• e-ID in the Netherlands
• Some application areas
• Questions

20. Diabetes - program
• Driver: Quality
• Exchange of all data relevant to diabetes between
the (many) healthcare professionals involved
• Self-management
• Reports
20

21. Diabetes HCP’s involved
• General Practitioner (often also the manager)
• Diabetes nurse
• Podotherapist
• Physical therapist
• Dietician
• Internal medicine specialist
• Ophthalmologist
• Neurologist
• .....
21

22. Diabetes - status
• Care standard - ready
• Information model – ready
• Architecture – ready
• Implementation guidelines (44 HL7v3 messages)
– ready
• 2 pilots running
22

23. Questions ?
sprenger@nictiz.nl