Promoting safer (mental) health information exchange in the Netherlands by using international medical standards (SNOMED CT and HL7 FHIR)
In the Netherlands different types of healthcare service providers use different information standards and digital systems (sometime even within their own organisation). This makes the exchange of medical data and prevention of mistakes very complex. Healthcare is increasingly occurring in networks. These are networks between patients, care providers, colleagues and organisations conducting research and contributing to the improvement of quality. Also, there is a need for patients to access and retrieve their medical data and participate in their own treatment.
In 2014 The Dutch Ministry of Health proposed plans to take a digital approach to make healthcare even safer, more patient-oriented and more efficient. This means that health organisations can digitally exchange information with patients in a standardized and secure manner. This helps people to take control of their own medical data and to be able to manage and use it securely within their own digital Personal Health Environments. A personal health environment (PHE) is a digital tool which you choose yourself and in which you can keep track of information about your own health and actively work on your health. The PHE allows you to manage and access medical data and also share it with others. This way you keep a grip on your health care data, from treatments to laboratory results, medications and vaccinations. And these data are yours and remain accessible throughout your entire life. In order to achieve this, it is important that, as a first step, all healthcare service providers use the same information (exchange) standards and legal contracts and healthcare information blocks. Healthcare suppliers must be Medmij certified. Medmij is a national trust framework on information exchange between a Personal Health Environment (PHE) and a healthcare institution.
The Dutch Ministry of Health, Welfare and Sport has started the MedMij program together with the Dutch Patients Federation, Nictiz and the Care associations. MedMij is an agreement system aimed at the safe exchange of health information. It is a framework of agreements and standards that is represented on government level in the so-called ‘Information Consultation’ (IB), a partnership without further legal entity. Nictiz, the centre of expertise for eHealth, develops and manages these standards (health information blocks) and provides advice on their implementation. The starting points of Medmij are:
the patient controls the exchange of health data;
patients have a free choice from the range of IT suppliers;
optimum interoperability occurs when exchanging health data;
the exchange of health data can be safe and user-friendly;
the privacy of all users is sufficiently guaranteed;
the exchange of health data meets legal requirements;
the chosen solutions are scalable and ready for the future;
MedMij only agrees on what is needed to break through barriers, no more and no less.
Recognition, supervision and compliance ensure that participation is not optional for service providers.
Currently a large funding program called VIPP, which focuses on IT optimization, is being implemented by the main sector organisation for mental health care in the Netherlands (GGZ Nederland). VIPP makes it possible that patients themselves have access to their digital files and documents and increase the use of e-mental health. Furthermore, data exchange within the entire care sector is supported, starting with medication safety. The arrangement is similar to an earlier program for hospitals. Currently programs have also started for general practitioners, long-term care and maternity care.
In 2022 mental healthcare service providers must be able to provide the possibility for patients to retrieve health information in Personal Health Environments (PHE’s) based on standardised Health Information blocks using SNOMED CT and HL7 FHIR communication to access the patient systems of healthcare service providers. This should lead to more control and shared decision making within the treatment process. Hereby health systems and apps are finally becoming interoperable.
Mental health service providers must also be able to digital prescribe medication to their patients and provide digital medication overviews to their patients and personnel.
The VIPP program also includes scaling up the use of e-Health by demanding the integration of direct access to e-health systems in the primary health system of professionals. Healthcare service providers need to achieve patient e-health usage percentages of between 10-15% in order to reach the minimum goals to keep the VIPP grant amount allocated to their organisation.
Although the first information blocks are not so exciting this is a very important first step. The mental health sector is already working on new information blocks like the (more dynamic) treatment plan and functionality to enable not only retrieving information but also digital cooperation between patient and professional.
For more information about the VIPP program in the Netherlands please contact Arq Foundation (firstname.lastname@example.org)