Yves Mahieu, EMC’s EMEA director of healthcare, described the second Finish initiative at the Hospital Management Symposium sponsored jointly by European Hospital and ECR 2008. The first project, called the eHealth Roadmap, was launched in the 1990’s as a series of regional data centers. It did not succeed because the software was proprietary, preventing data sharing. Additionally, the system was proprietary and therefore expensive to maintain, and slow.
In 2002, Finland’s national insurance company KELA was placed in charge of creating a new system that would be a national archive containing patient records that could be accessed through the Internet both by the individual patient and by any authorized medical service provider. The new archive will provide a single point of access that is safe and secure. Mr. Mahieu reported that 75% of the initial budget was used for IT security. He said that a limited number of data centers and a consolidated administrative and management staff significantly reduced expenses from what they could have been if a more decentralized IT architecture had been utilized.
With so many hospital information systems and PACS already installed in Finnish hospitals and medical centers, a decision was made that this capital IT investment should remain as long as the vendors of the products could guarantee interoperability. One of the project challenges has been verifying the interoperability and quite unanticipated, also dealing with the semantics and ambiguities of the language of standards. A dedicated organization, STAKES, has been established for the purpose of overseeing the standardization of healthcare codes.
Access to the EPR archive will be through the use of an electronic ID card. An additional electronic signature will be required of physicians using the ePrescription service.
When asked the method by which the Finnish government overcame objections by citizens, Mr. Mahieu said that there had been minimal resistance. He attributed this to the fact that Finns like and trust their government with social responsibilities, such as safe management of personal health records.
The initial investment for such records access efficiency is 50,000,000 euros. The cost on an annual basis is estimated at 10 euros per person per year.
Clinical research is expected to be significantly assisted by the database, which is designed for easy anonymization of data. Mr. Mahieu noted that no other country to date can provide access to its entire population for research, and that Finland will be the pioneer for at least several years in Europe.