Norway government awards five-year national EHR contract to Accenture

Accenture has been awarded a five-year contract to develop and deploy a national EHR system by the Norwegian Directorate of Health, an agency governed by the Norwegian Ministry of Health and Care Services, is responsible for executing health polices, regulations and statutes, and monitoring public health and care services. For Accenture, this is another feather in the cap after implementing the national EHR (NEHR) system at Singapore and personally controlled electronic health record (PCEHR) at Australia.

According to the current agreement, the new EHR system is expected to provide medical personnel access to a single integrated patient medical record that contains demographics, clinical history, patient and physician interaction summaries, diagnostic assessments, procedures, and medications. Additionally, five million Norwegian citizens can also securely access and manage their personal medical record anywhere, anytime through the new EHR system.

The implementation of EHR systems in Norway has come a long way since its initial rollout at GPs in 1984 (Figure 1). As of 2009, the Norwegian EHR Research Centre (NSEP)-conducted annual EPJ Monitor indicated that the implementation of EHR systems has reached 98% by general practitioners and 83% at municipalities. Despite this large-scale deployment, a 2008 HIMSS report states that the three primary EMRs used across the nation (Profdoc Vision, Winmed, and Infodoc) have not been able to deliver a simple and flexible means of extracting data, and have required the use of a third party software, QTools.

The main push for electronic communication, storage, and consolidation of EHR systems in clinical workflow has been provided by the Norwegian Directorate for Health and Social Affairs, with support from national standardization bodies, health informatics communities in universities, national health IT, and the healthcare sector.

According to directives given by the Research Council of Norway to the Norwegian University of Science and Technology (NTNU), the NSEP was set up in 2003 to research and support the building and implementation of a core EHR system. NSEP’s EHR Watch 2008 annual report became the first national-level survey to provide insight into the status and direction of EHR adoption. As per the report, despite benefits of efficiency and financial gain, certain challenges were reported: high implementation cost, insufficient capabilities of systems, low integration of EHR with other ICT systems, reduced access to real-time medical data, and wide-spread use of paper-records. The ongoing project, providing insights into the country’s EHR status in 2009 and 2010, has been augmented by other nation-wide studies.

National ICT-unit conducted a study focusing on the prospect of a national core EHR; giving importance to the needs of specialized healthcare services. The study facilitated the initiation of an intermediate report by the Directorate of Health in 2009, a 2010 pilot project, and state budget proposals for the future implementation of a core EHR.

Other projects contributing to the national core EHR include:
• Lighthouse Projects (SUMO-projects): As a part of the Teamwork Strategy 2007, a series of lighthouse projects were initiated to lower the number of drug-related unintended incidents. The strategy was to automatically update the core-EHR every time a hospital, pharmacist, or other providers send data to the GP, facilitating monitoring and avoidance of discrepancy in the medication by the GP.
• 2004-2006 National solutions for Electronic interchange of health information project (ELIN): A Norwegian Medical Association project aimed at developing nationally approved solutions for electronic data exchange.
• Electronic interchange of health Information in Community care (ELIN-C): A Norwegian Nurses Association (NNO) and The Association of Local and Regional Authorities (KS) project, was initiated for developing interoperable systems that facilitate electronic exchange of data among GP, home/community care, and hospitals.

With the current contract with Accenture, Norway is close to realizing its goal of establishing a national core EHR. As the nation sets up its own national EHR system, we wait to see how it, along with EU Member States, Iceland, and Liechtenstein, work towards establishing cross-border eHealth connectivity across Europe, as agreed upon through a common declaration in 2007. This has also been recommended by a 2011 eHealth Strategies Report following the evaluation of advances made by the EU Member States in the eHealth scenario.

Figure 1: EHR implementation in Norway

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