Denmark, U.S. military on parallel paths to e-health

Denmark is on an aggressive path toward crafting an international e-health system while the U.S. military health system attempts a similar feat to support servicemen around the world.

"We want international interoperability for NATO, defense and tourists" said Arne Kverneland, head of the health informatics department within Denmark's National Board of Health.

On Monday, at the World Health Care Congress in Washington, he juxtaposed his country's e-health approach with the U.S. plan, citing the common aim to increase quality of care and decrease healthcare costs by computerizing health records.

Denmark, which spends about half of what the United States does on health as a share of gross domestic product, is ahead of America in instituting e-health records, or EHRs, with more than 90 percent of general practitioners using computerized records. Now Denmark is developing the content and structure for an international EHR standard.

Danish doctors began relying on EHRs years ago, without government incentives. Some in the audience asked Kverneland how that happened, noting that U.S. doctors are struggling to adopt EHR systems, even with government support.

Kverneland answered, "They gained money by using electronic health records." Time savings translated into dollar savings, he said.

In 2004, the U.S. military began deploying an EHR system worldwide, leading the nation toward the president's goal of ensuring that most Americans have electronic records by 2014.

"Our military families move frequently. ... We recognize that our providers anywhere in the world" need to have access to the same clinical information, said Carl Hendricks, chief information officer of the Defense Department's military health system. Full operational capability is slated for 2014.

Compatibility between state healthcare systems and the military e-health system is a challenge "only because of the [many] standards that exist out there," Hendricks said.

Currently, the military health information exchange can send records to Veterans Affairs Department treatment centers but cannot receive records from the VA. Defense is now testing programs that would link its EHR system with the VA and Virginia and Florida.

"If you want interoperability, if you want the patient to have a free choice" in picking procedures, doctors and other healthcare elements, Kverneland said, "you need to standardize the information. And I think the United States needs to do that in some way also."