EHR Systems Use and Quality in EHR Systems Use and Quality in Italy EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade

EHR EHR SSystems ystems UUsese and and QQualityuality in in Italy

EHR Systems Quality Labelling and Certification21 - 22 November 2011, Belgrade

Country contextCountry context

Basic facts about:- the country a regionally-based health service paid by taxes

provides universal coverage

- the health care systemnational level ensures general objectives

and fundamental principles;

regional governments ensure the actual care delivery

through Community Care Trusts (Local Health Units)and public and private accredited hospitals


Country contextCountry context

Basic facts about:- General IT status within the health sector

the Ministry of Health, the Ministry of Innovation and the Regions have agreed to operate jointly to carrying out the ehealth national strategies and particularly for EHR diffusion, through a State-Regions coordinating board.Formal certification process is not currently in place in Italy.


EHR EHR systemsystems:s: market market

Market for the different segments


Medical Systems in primary care about 20 Ml

Clinical Information Systems less than 10 Ml

Hospital information systems about 150 Ml

Department of Health Systems less than 15 Ml

Systems integration Hospital Territory about 200 Ml

Country Information System NSIS about 25 Ml

Regional systems about 50 Ml


Market shares


revenue (Ml euro) EHR Suppliers Products

Over 50DEDALUS Products supported by services

ENGINEERING Services (products are instrumental)

about 30

NOEMALIFE Products supported by services

EXPRIVIA most services

Santer Services

about 10 LUTECH Services

5 to 10

GPI most services

ADS-DP most products

SIGMA most services

Under 4IASI Products and services

10 companies. Products and services


Number of suppliers (approx.)


GP Hospital Homecare /Nursing

vendors 11 43 5

systems 13 43 5

int’l 1


Evolution of the market


million euro(source The Healthcare Information Technology Market, ref. Holding Bracco Esaote)

Mio Euro

Year 2000 2005 2010

HIS Other Modules 114 225 395GPSystems 52 64 108Other HCP 52 64 108Healthcare Networks 67 212 524Telemedicine 15 49 152Home Care Monitoring 361 72 106

Total 335 687 1395

Italian Market

Mio Euro

Year 2000 2005 2010

HIS Other Modules 114 225 395GPSystems 52 64 108Other HCP 52 64 108Healthcare Networks 67 212 524Telemedicine 15 49 152Home Care Monitoring 361 72 106

Total 335 687 1395

Italian Market

EHR systemsEHR systems:: legal/regulatory contextlegal/regulatory context

Formal certification process is not in place in Italy.

Most regional EHR infrastructures

verify the ability of GP systems to fit local rules and

approve their usage within the regional system.

The main producers of GP systems made a consortium

to self-certify the adherence of each system

to a basic set of requirements.



the MoH established in 2001 a Steering Board with central

government and regions to rule the New Nat’l Healthcare

Information System (NSIS) and semantic interoperability.

the Ministry of Innovation established in 2004 a eHealth Board

(TSE) with MoH and regions to harmonise e-health policies

Ministry of Innovation, Federation of Local Trusts and

Municipalities (Federsanità-ANCI), Forum of Public Administration

(ForumPA) and National Research Council (CNR) promoted a tool

to monitor readiness and adoption of ICT in Local Trusts

(LITIS – Levels of Technological Innovation in Healthcare).



The eHealth board (TSE) defines

the normative and technical framework,

IBSE, a national EHR federated infrastructure

and IPSE (the mirror project of EPSOS).

A law in the Parliament will formally

establish the EHR also for secondary uses;

a regulation will be produced after 6 months.


EHR systemsEHR systems:: quality assessment quality assessment

Several Regional Authorities are establishing their regional eHealth Board, according to local rules

and competence centers (e.g. Arsenal consortium among Local Trusts in the Veneto Region).

Some Regional Authorities are developing eHealth roadmaps with EHR’s development (some based on European Structural Funds)


EHR systemsEHR systems:: quality assessment quality assessment


EHR EHR systems: systems: initiativesinitiatives, plans, plansList and present the public initiatives

In March 2010, TSE began working on interoperability

between different regional EHR,

with the production of specific criteria

(Good Practice Requirements)

that indicate how to implement

validation of the phases of integration, conforms at

C1 “EHRS infrastructure component” and

C10 “EHRS Interoperability component”.


Closing slide Closing slide

Contact data and web sites

Angelo Rossi Mori, PROREC [email protected]

TSE www.sanitaelettronica.gov.it/ NSIS www.nsis.ministerosalute.it/


Documents

EHR Systems Use and Quality in EHR Systems Use and Quality in Italy EHR Systems Quality Labelling and Certification 21 - 22 November 2011, Belgrade