SlideShare a Scribd company logo
1 of 38
Download to read offline
Health Record Banks are Essential for Effective Health Information Infrastructure 
William A. Yasnoff, MD, PhD, FACMI 
CEO, Health Record Banking Alliance 
Adjunct Professor, Health Science Informatics, Johns Hopkins University 
WCIT 
Guadalajara, Mexico 
September 30, 2014 
© 2014
2 © 2014 
Outline 
 Goals of Health Information 
Infrastructure (HII) 
 Comprehensive Electronic Patient 
Records 
 Population Health and Prevention 
 The Health and Prevention Promotion 
Initiative (HAPPI): A Self-Funding 
Organization for Prevention, 
Population Health, and Electronic 
Records 
 Next Steps
3 © 2014 
HII Goals Support the Triple Aim 
 Better Health 
 Better Care 
 Lower Costs 
Challenges 
Prevention 
Population Health 
Consumer Tools 
Better Decisions 
Consumer Tools 
Avoid Errors 
Avoid Duplication 
Prevention 
Prevention 
& Population 
Health 
Comprehensive 
Electronic 
Patient 
Records
4 © 2014
5 © 2014 
HII Goal 1: Individual Records 
 Comprehensive electronic patient 
records when & where needed 
 Individual (patient care) 
 Aggregate (research, public health) 
 Basic Requirements 
 All information must be electronic 
 all providers must use EHRs 
 Mechanism to bring together 
scattered information for each 
person (“Health Information 
Exchange” or HIE)
6 © 2014 
Current Efforts are Failing 
 HHS: Current efforts “alone will not be 
enough to achieve the widespread 
interoperability and electronic exchange of 
information necessary for delivery reform 
where information will routinely follow the 
patient regardless of where they receive 
care.” -- ONC/CMS RFI 3/7/13, p. 5 
 PCAST: HIE efforts through the states “will 
not solve the fundamental need for data to 
be universally accessed, integrated, and 
understood while also being protected.” – 
Dec 2010, p. 40
7 © 2014 
 Adler-Milstein et al HIE Survey (Annals of 
Internal Medicine, May 2011) 
 179 HIEs surveyed 
 Only 13 met Meaningful Use Stage 1 
– 3% of hospitals, 0.9% of physicians 
 Only 6 of 13 self-reported as sustainable 
 None of 179 met expert panel definition of 
comprehensive system, calling “into 
question whether RHIOs* in their current 
form can be self-sustaining and 
effective.” (abstract) 
*Regional Health Information Organizations 
Current Efforts are Failing 
(continued)
8 © 2014 
 Multiple HIEs have already failed 
 Washington, DC 
 Kansas 
 Tennessee 
 CalRHIO 
 CareSpark (Kingsport, TN) 
– Long touted as national leader 
 No patients currently receive care 
with guaranteed availability of 
comprehensive records from all 
sources 
Current Efforts are Failing 
(continued)
9 © 2014 
 Why are HIEs failing? 
 Substantial resources: $564 million 
Federal funds allocated March 2010 
 Challenges well known 
– Privacy 
– Stakeholder Cooperation 
– Sustainability 
Current Efforts are Failing 
(continued)
10 © 2014 
 Wrong Path 
 Trying to replicate manual process of 
contacting other providers directly for 
records 
Current Efforts are Failing 
(continued) 
HIE 
Index 
Other 
EHRs 
Assembly 
Clinician 
EHR 
Patient 
Encounter 
5 
4 
3 
1 2 
Diagram © Health Record Banking Alliance, 2013. Used by permission.
11 © 2014 
 Complex and Expensive 
 All EHRs must be online 24/7 to 
respond to queries 
 Real-time reconciliation of records 
 Requires unique patient identifier 
– Politically impractical 
– Privacy threat 
 Must have expensive 24/7 network 
operations center to monitor all 
contributing EHRs 
Current Efforts Can’t Work
12 © 2014 
 Increasing Errors with More Data Sources 
Current Efforts Can’t Work 
(continued) 
Source: Lapsia V, Lamb K, Yasnoff WA: Where should electronic records 
for patients be stored? Int J Med Informatics 81:821-827, 2012.
13 © 2014 
 Increased Liability 
 Patients cannot review or annotate 
data 
 Providers and HIE responsible for 
correctness 
 No propagation of corrections 
Current Efforts Can’t Work (continued)
14 © 2014 
 Not Financially Sustainable 
Current Efforts Can’t Work (continued) 
0 
10 
20 
30 
40 
50 
60 
70 
80 
90 
100 
0 20 40 60 80 100 
Value of Info (%) 
Completeness of Information (%) 
Value vs. Completeness of Health 
Information 
Source: Yasnoff WA: Health Information Infrastructure. In Biomedical Informatics: 
Computer Applications in Healthcare and Medicine, Fourth Edition (Shortliffe & 
Cimino, eds.). New York: Springer-Verlag, 2014, pp. 423-441.
15 © 2014 
 Unable to Protect Privacy 
 Where can consumers indicate their 
privacy preferences? 
 If data left at sources, consumers 
must set and maintain their 
preferences at every source  too 
complex and inconvenient 
Current Efforts Can’t Work (continued)
16 © 2014 
 Unable to Ensure Stakeholder 
Provision of Patient Information 
 Stakeholder participation in HIE is 
voluntary 
– Difficult to get cooperation 
– Difficult to maintain cooperation 
 Only patient requests for 
information must be honored by all 
stakeholders 
Current Efforts Can’t Work (continued)
17 © 2014 
 Unable to Facilitate Robust Data 
Searching 
 Distributed records  sequential 
search 
 Sequential search is too slow to be 
practical 
Current Efforts Can’t Work (continued)
18 © 2014 
Consequences for Stakeholders 
Stakeholder Problems 
Health 
Plans/Insurers 
1. Continually escalating costs 
2. No comprehensive patient records 
Hospitals/ACO 
s 
1. Inadequate/incomplete patient information on 
admission and in ER 
2. Uncontrollable financial risk (e.g. from 
readmissions) 
3. Ineffective/inefficient prevention activities 
Physicians 1. EHRs just “electronify” existing silo of patient 
records 
2. No comprehensive patient records  better care 
3. Ineffective/inefficient prevention activities 
Patients 1. Preventable errors 
2. Preventable adverse events 
3. Unnecessary repeat tests/procedures 
4. Continually escalating costs 
Government/C 
ommunity 
1. Continually escalating costs 
2. Prevention efforts ineffective/underfunded 
3. Data unavailable for policy & research
19 © 2014 
HIT Architecture Choices 
 Distributed architecture – does not work 
 Leave information in place; retrieve in 
real time when needed 
 Problems 
– Inefficient 
– Error prone 
– Does not scale 
– Hard to protect privacy 
– Impractical to search data 
 Centralized architecture (health record 
banks)
20 © 2014 
Solution: 
Health Record Bank (HRB) 
 Secure community-based repository 
of complete health records 
 Access to records completely 
controlled by patients (or designee) 
 “Electronic safe deposit boxes” 
 Information about care deposited 
once when created 
 Required by HIPAA (in U.S.) 
 Allows EHR incentives to physicians 
to make outpatient records electronic 
 Operation simple and inexpensive
21 © 2014 
http://www.healthbanking.org/video1.html 
What is a Health Record Bank?
22 © 2014 
HRB Architecture 
Patient 
Records 
Clinician 
EHR 
Patient 
Encounter 
HRB 
1 
3 
2 
Diagram © Health Record Banking Alliance, 2013. Used by permission.
23 © 2014 
HRB Rationale 
 Operationally simple 
 Records immediately available 
 Deposit new records when created 
 Enables value-added services 
 Enables research queries 
 Patient control 
 Trust & privacy 
 Stakeholder cooperation (HIPAA) 
 Low cost facilitates business model 
 Creates EHR incentive options 
 Pay for deposits 
 Provide Internet-accessible EHRs
24 © 2014
25 © 2014 
How HRBs Create Value 
Health Record Bank 
including 
free/subsidized EHRs 
for physicians 
More complete 
electronic health 
Enables delivery of record information 
optional services with 
compelling value 
Patients sign up for 
HRB accounts 
(recommended by 
physicians) 
Enables physicians to 
provide better patient 
care 
$
26 © 2014 
HRB Business Model 
 Costs (with 1,000,000 subscribers) 
 Operations: $6/person/year 
 EHR incentives: $10/person/year 
 Revenue 
 Advertising: ~$3/person/year 
(option to opt out for small fee) 
 Reminders & Alerts: >= 
$18/person/year 
– “Peace of mind” alerts 
– Preventive care reminders 
– Medication reminders 
 Queries: >$3/person/year 
 No need to assume/capture any health 
care cost savings (!!)
27 © 2014 
Pro Forma Example (Houston) 
($1,000) 
$0 
$1,000 
$2,000 
$3,000 
$4,000 
$5,000 
$6,000 
$7,000 
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 
"Expenses ($K)" 
"Revenue ($K)" 
"Net ($K)" 
Month 
Initial Capital: $4.4 MM 
Breakeven: 16 months 
EBITDA Year 4: $41 MM+
28 © 2014 
HII Goal 2: 
Prevention & Population Health 
 Definition – Improving the health 
outcomes of a group of individuals 
 U.S. not doing this well 
 Per capita health care spending >2x 
other industrialized nations 
 But outcomes poor – U.S. ranks 24th 
of 30 OECD countries in life 
expectancy 
 Only 3% of spending on prevention 
while 75% of medical costs relate to 
preventable chronic conditions 
 How can we improve?
29 © 2014 
Prevention & Population Health 
 Challenges 
 New activity 
– Providers do not do this now 
– Must hire staff & establish 
procedures 
 Inefficient for each provider 
– More costly per capita to focus on 
limited populations 
 Benefit externalities 
– Member “churn” limits ROI for 
prevention 
– No incentive for long-term 
prevention investments
30 © 2014 
Prevention & Population Health 
 Potential Solution: Collaborative 
Community Prevention Organization 
 All providers pool resources 
 Community organization does 
prevention & population health for all 
 Issues 
 Ongoing funding 
 Continuous provider cooperation 
– Initial capitalization 
– Annual operational funding 
 Incentives good but not compelling 
 Need comprehensive patient info
31 © 2014
32 © 2014 
Health and Prevention 
Promotion Initiative (HAPPI) 
 Combine Community Prevention 
Organization with Health Record Bank 
 Health Record Bank 
 Provides needed information 
Ensures all-electronic records 
 Generates revenue (apps, ads, data) 
 Provides funds for itself and more 
 Excess funds from HRB Pay for 
Prevention and Population Health
33 © 2014 
How does a HAPPI work? 
PATIENT CONTROL 
CENTRAL REPOSITORY 
Stakeholder 
Cooperation 
ensures 
Electronic Patient Data 
provides 
Benefits 
1. Clinical: Quality,Costs 
2. Reminders/Alerts 
3. Research 
produces 
pay 
for 
enables 
Prevention 
(stakeholder need) 
empowers 
Privacy 
protects 
Financial 
Incentives 
ensure 
Key 
Design 
Decisions 
Initial Steps: 
1. Free/subsidized EHRs for physicians 
2. Physicians recruit patients for free HRB accounts
34 © 2014 
All Stakeholders Benefit 
Stakeholder Benefits 
Health 
Plans/Insurers 
1. Lower care costs (better info) 
2. Prevention lowers future costs 
3. Sustainable after initial investment *** 
Hospitals/ACOs 1. Prevention services 
2. Better info/tools for care 
3. Patient portal 
4. Sustainable after initial investment *** 
Physicians 1. Free/subsidized EHRs 
2. Better info/tools for care 
3. Prevention services 
Patients 1. Better care 
2. Tools for health and prevention 
3. Control over own records 
4. Basic accounts free 
Government/Commu 
nity 
1. Lower costs 
2. Prevention 
3. Information for policy & research 
*** key benefit
35 © 2014 
The Triple Aim 
 Better Health 
 Better Care 
 Lower Costs 
Challenges 
Prevention 
Population Health 
Consumer Tools 
Better Decisions 
Consumer Tools 
Avoid Errors 
Avoid Duplication 
Prevention 
Prevention 
& Population 
Health 
Comprehensive 
Electronic 
Patient 
Records 
HAPPI
36 © 2014 
Next Steps 
 Implement HAPPI Pilots 
 Looking for candidate communities 
 Need outside funding to reduce risk 
 Disseminate Lessons Learned 
 Organize HAPPI Projects in Multiple 
Communities
37 © 2014 
SUMMARY 
 HII Goals Include Prevention & 
Population Health 
 Health Record Banks Can Provide 
Comprehensive Electronic Patient 
Records Needed 
 Incentives for EHR Adoption 
 Excess Revenue 
 Combine Community Prevention with 
HRB  Health and Prevention 
Promotion Initiative (HAPPI) 
 HAPPI  Successful HII & Achieving 
the Triple Aim
38 © 2014 
Questions? 
William A. Yasnoff, MD, PhD, FACMI 
william.yasnoff@nhiiadvisors.com 
703/527-5678

More Related Content

What's hot

Health Rosetta Case Study - City of Kirkland, Washington
Health Rosetta Case Study - City of Kirkland, WashingtonHealth Rosetta Case Study - City of Kirkland, Washington
Health Rosetta Case Study - City of Kirkland, WashingtonDave Chase
 
Chandy Ravikumar
Chandy RavikumarChandy Ravikumar
Chandy RavikumarChandy1221
 
The Paradigm Shift from Healthcare to Population Health
The Paradigm Shift from Healthcare to Population HealthThe Paradigm Shift from Healthcare to Population Health
The Paradigm Shift from Healthcare to Population HealthPractical Playbook
 
Andrew fenton ehi 31.10 Population Health Management & Target Architecture
Andrew fenton ehi 31.10 Population Health Management & Target ArchitectureAndrew fenton ehi 31.10 Population Health Management & Target Architecture
Andrew fenton ehi 31.10 Population Health Management & Target ArchitectureAndrew Fenton
 
Onc july atlanta 2011
Onc  july atlanta 2011 Onc  july atlanta 2011
Onc july atlanta 2011 Paul Grundy
 
FTC Spring Privacy Series: Consumer Generated and Controlled Health Data
FTC Spring Privacy Series: Consumer Generated and Controlled Health DataFTC Spring Privacy Series: Consumer Generated and Controlled Health Data
FTC Spring Privacy Series: Consumer Generated and Controlled Health DataBrian Ahier
 
Computer Information Systems and the Electronic Health Record
Computer Information Systems and the Electronic Health RecordComputer Information Systems and the Electronic Health Record
Computer Information Systems and the Electronic Health RecordRebotto89
 
013 Am09 Presentations Harris
013 Am09 Presentations  Harris013 Am09 Presentations  Harris
013 Am09 Presentations HarrisSimon Prince
 
The Future Health Ecosystem Today
The Future Health Ecosystem TodayThe Future Health Ecosystem Today
The Future Health Ecosystem TodayDave Chase
 
Patient Centered Medical home talk at WVU
Patient Centered Medical home talk at WVUPatient Centered Medical home talk at WVU
Patient Centered Medical home talk at WVUPaul Grundy
 
Healing Hands Clinic : Success Story of India's Best Piles, Fissure and Fistu...
Healing Hands Clinic : Success Story of India's Best Piles, Fissure and Fistu...Healing Hands Clinic : Success Story of India's Best Piles, Fissure and Fistu...
Healing Hands Clinic : Success Story of India's Best Piles, Fissure and Fistu...HealingHands3
 
HIMSS - Real Payer and Provider Collaborations - Final
HIMSS - Real Payer and Provider Collaborations - FinalHIMSS - Real Payer and Provider Collaborations - Final
HIMSS - Real Payer and Provider Collaborations - FinalDaniel Abdul
 
Reimbursing Chronic Care Management
Reimbursing Chronic Care ManagementReimbursing Chronic Care Management
Reimbursing Chronic Care ManagementBen Quirk
 

What's hot (20)

mHealth for providers in India
mHealth for providers in IndiamHealth for providers in India
mHealth for providers in India
 
Dr Rachel David
Dr Rachel DavidDr Rachel David
Dr Rachel David
 
Health Rosetta Case Study - City of Kirkland, Washington
Health Rosetta Case Study - City of Kirkland, WashingtonHealth Rosetta Case Study - City of Kirkland, Washington
Health Rosetta Case Study - City of Kirkland, Washington
 
Chandy Ravikumar
Chandy RavikumarChandy Ravikumar
Chandy Ravikumar
 
The Paradigm Shift from Healthcare to Population Health
The Paradigm Shift from Healthcare to Population HealthThe Paradigm Shift from Healthcare to Population Health
The Paradigm Shift from Healthcare to Population Health
 
Andrew fenton ehi 31.10 Population Health Management & Target Architecture
Andrew fenton ehi 31.10 Population Health Management & Target ArchitectureAndrew fenton ehi 31.10 Population Health Management & Target Architecture
Andrew fenton ehi 31.10 Population Health Management & Target Architecture
 
HIE 101
HIE 101HIE 101
HIE 101
 
Onc july atlanta 2011
Onc  july atlanta 2011 Onc  july atlanta 2011
Onc july atlanta 2011
 
FTC Spring Privacy Series: Consumer Generated and Controlled Health Data
FTC Spring Privacy Series: Consumer Generated and Controlled Health DataFTC Spring Privacy Series: Consumer Generated and Controlled Health Data
FTC Spring Privacy Series: Consumer Generated and Controlled Health Data
 
Computer Information Systems and the Electronic Health Record
Computer Information Systems and the Electronic Health RecordComputer Information Systems and the Electronic Health Record
Computer Information Systems and the Electronic Health Record
 
013 Am09 Presentations Harris
013 Am09 Presentations  Harris013 Am09 Presentations  Harris
013 Am09 Presentations Harris
 
PCPCC Medical Home update, April 2010
PCPCC Medical Home update, April 2010PCPCC Medical Home update, April 2010
PCPCC Medical Home update, April 2010
 
The Future Health Ecosystem Today
The Future Health Ecosystem TodayThe Future Health Ecosystem Today
The Future Health Ecosystem Today
 
Patient Centered Medical home talk at WVU
Patient Centered Medical home talk at WVUPatient Centered Medical home talk at WVU
Patient Centered Medical home talk at WVU
 
Healing Hands Clinic : Success Story of India's Best Piles, Fissure and Fistu...
Healing Hands Clinic : Success Story of India's Best Piles, Fissure and Fistu...Healing Hands Clinic : Success Story of India's Best Piles, Fissure and Fistu...
Healing Hands Clinic : Success Story of India's Best Piles, Fissure and Fistu...
 
Population Health Management
Population Health ManagementPopulation Health Management
Population Health Management
 
Homeless Navigator Feb. Issue
Homeless Navigator Feb. IssueHomeless Navigator Feb. Issue
Homeless Navigator Feb. Issue
 
HIMSS - Real Payer and Provider Collaborations - Final
HIMSS - Real Payer and Provider Collaborations - FinalHIMSS - Real Payer and Provider Collaborations - Final
HIMSS - Real Payer and Provider Collaborations - Final
 
Reimbursing Chronic Care Management
Reimbursing Chronic Care ManagementReimbursing Chronic Care Management
Reimbursing Chronic Care Management
 
THE LARGE DATA DEMO - ONE MODEL
THE LARGE DATA DEMO - ONE MODELTHE LARGE DATA DEMO - ONE MODEL
THE LARGE DATA DEMO - ONE MODEL
 

Viewers also liked

World Congress on Information Technology 2014 - México
World Congress on Information Technology 2014 - MéxicoWorld Congress on Information Technology 2014 - México
World Congress on Information Technology 2014 - MéxicoWCIT 2014
 
Uluwatu studio villa & villa
Uluwatu studio villa & villaUluwatu studio villa & villa
Uluwatu studio villa & villaErry Soewito
 
Manifestandomissentimientos página de inicio
Manifestandomissentimientos   página de inicioManifestandomissentimientos   página de inicio
Manifestandomissentimientos página de iniciotecnomecanica
 
Dirt On Design / Greg Houston & Merika Ramundo
Dirt On Design / Greg Houston & Merika RamundoDirt On Design / Greg Houston & Merika Ramundo
Dirt On Design / Greg Houston & Merika RamundoABQLA_presentations
 
WCIT 2014 André Jean Marc Loechel - Living Labs
WCIT 2014 André Jean Marc Loechel - Living LabsWCIT 2014 André Jean Marc Loechel - Living Labs
WCIT 2014 André Jean Marc Loechel - Living LabsWCIT 2014
 
WCIT 2014 Amnon Shvo - Translational & interoperable health infrastructure
WCIT 2014 Amnon Shvo - Translational & interoperable health infrastructureWCIT 2014 Amnon Shvo - Translational & interoperable health infrastructure
WCIT 2014 Amnon Shvo - Translational & interoperable health infrastructureWCIT 2014
 
WCIT 2014 Gary Beach - The Skills Gap
WCIT 2014 Gary Beach - The Skills GapWCIT 2014 Gary Beach - The Skills Gap
WCIT 2014 Gary Beach - The Skills GapWCIT 2014
 
Implementación de un repositorio y de una política institucional de acceso ab...
Implementación de un repositorio y de una política institucional de acceso ab...Implementación de un repositorio y de una política institucional de acceso ab...
Implementación de un repositorio y de una política institucional de acceso ab...WCIT 2014
 
Open Science: Expanding Frontiers in Research and Accelerating Innovation
Open Science: Expanding Frontiers in Research and Accelerating InnovationOpen Science: Expanding Frontiers in Research and Accelerating Innovation
Open Science: Expanding Frontiers in Research and Accelerating InnovationWCIT 2014
 
Aplicaciones web 2_0_google_docs (1)
Aplicaciones web 2_0_google_docs (1)Aplicaciones web 2_0_google_docs (1)
Aplicaciones web 2_0_google_docs (1)marielizjacome
 
WCIT 2014 Reinhold Haux - Educational programs and courses in health informat...
WCIT 2014 Reinhold Haux - Educational programs and courses in health informat...WCIT 2014 Reinhold Haux - Educational programs and courses in health informat...
WCIT 2014 Reinhold Haux - Educational programs and courses in health informat...WCIT 2014
 
Cooperation of HRB with Healthcare Providers and Communication with their Ope...
Cooperation of HRB with Healthcare Providers and Communication with their Ope...Cooperation of HRB with Healthcare Providers and Communication with their Ope...
Cooperation of HRB with Healthcare Providers and Communication with their Ope...WCIT 2014
 

Viewers also liked (20)

IIC Conference
IIC ConferenceIIC Conference
IIC Conference
 
ДжеНтли
ДжеНтлиДжеНтли
ДжеНтли
 
HRS Минск
HRS МинскHRS Минск
HRS Минск
 
World Congress on Information Technology 2014 - México
World Congress on Information Technology 2014 - MéxicoWorld Congress on Information Technology 2014 - México
World Congress on Information Technology 2014 - México
 
Uluwatu studio villa & villa
Uluwatu studio villa & villaUluwatu studio villa & villa
Uluwatu studio villa & villa
 
Manifestandomissentimientos página de inicio
Manifestandomissentimientos   página de inicioManifestandomissentimientos   página de inicio
Manifestandomissentimientos página de inicio
 
Big Rally
Big RallyBig Rally
Big Rally
 
Dirt On Design / Greg Houston & Merika Ramundo
Dirt On Design / Greg Houston & Merika RamundoDirt On Design / Greg Houston & Merika Ramundo
Dirt On Design / Greg Houston & Merika Ramundo
 
Suomi kids
Suomi kidsSuomi kids
Suomi kids
 
WCIT 2014 André Jean Marc Loechel - Living Labs
WCIT 2014 André Jean Marc Loechel - Living LabsWCIT 2014 André Jean Marc Loechel - Living Labs
WCIT 2014 André Jean Marc Loechel - Living Labs
 
WCIT 2014 Amnon Shvo - Translational & interoperable health infrastructure
WCIT 2014 Amnon Shvo - Translational & interoperable health infrastructureWCIT 2014 Amnon Shvo - Translational & interoperable health infrastructure
WCIT 2014 Amnon Shvo - Translational & interoperable health infrastructure
 
WCIT 2014 Gary Beach - The Skills Gap
WCIT 2014 Gary Beach - The Skills GapWCIT 2014 Gary Beach - The Skills Gap
WCIT 2014 Gary Beach - The Skills Gap
 
Implementación de un repositorio y de una política institucional de acceso ab...
Implementación de un repositorio y de una política institucional de acceso ab...Implementación de un repositorio y de una política institucional de acceso ab...
Implementación de un repositorio y de una política institucional de acceso ab...
 
Open Science: Expanding Frontiers in Research and Accelerating Innovation
Open Science: Expanding Frontiers in Research and Accelerating InnovationOpen Science: Expanding Frontiers in Research and Accelerating Innovation
Open Science: Expanding Frontiers in Research and Accelerating Innovation
 
TUT Coffee
TUT CoffeeTUT Coffee
TUT Coffee
 
Aplicaciones web 2_0_google_docs (1)
Aplicaciones web 2_0_google_docs (1)Aplicaciones web 2_0_google_docs (1)
Aplicaciones web 2_0_google_docs (1)
 
Kiewit
KiewitKiewit
Kiewit
 
WCIT 2014 Reinhold Haux - Educational programs and courses in health informat...
WCIT 2014 Reinhold Haux - Educational programs and courses in health informat...WCIT 2014 Reinhold Haux - Educational programs and courses in health informat...
WCIT 2014 Reinhold Haux - Educational programs and courses in health informat...
 
CV Erry Soewito
CV Erry SoewitoCV Erry Soewito
CV Erry Soewito
 
Cooperation of HRB with Healthcare Providers and Communication with their Ope...
Cooperation of HRB with Healthcare Providers and Communication with their Ope...Cooperation of HRB with Healthcare Providers and Communication with their Ope...
Cooperation of HRB with Healthcare Providers and Communication with their Ope...
 

Similar to Health Record Banks are Essential for Effective Health Information Infrastructure

Chronic disease and population health management
Chronic disease and population health managementChronic disease and population health management
Chronic disease and population health managementNapier Healthcare
 
Health Information Strategy for New Zealand Sharing personal health information
Health Information Strategy for New Zealand Sharing personal health informationHealth Information Strategy for New Zealand Sharing personal health information
Health Information Strategy for New Zealand Sharing personal health informationHealth Informatics New Zealand
 
National Health IT Board Update: Putting Evidence to Work and Creating Eviden...
National Health IT Board Update: Putting Evidence to Work and Creating Eviden...National Health IT Board Update: Putting Evidence to Work and Creating Eviden...
National Health IT Board Update: Putting Evidence to Work and Creating Eviden...Health Informatics New Zealand
 
iHT² Health IT Summit New York - Presentation “Harnessing EHRs and Health IT ...
iHT² Health IT Summit New York - Presentation “Harnessing EHRs and Health IT ...iHT² Health IT Summit New York - Presentation “Harnessing EHRs and Health IT ...
iHT² Health IT Summit New York - Presentation “Harnessing EHRs and Health IT ...Health IT Conference – iHT2
 
Health Informatics- Module 4-Chapter 2.pptx
Health Informatics- Module 4-Chapter 2.pptxHealth Informatics- Module 4-Chapter 2.pptx
Health Informatics- Module 4-Chapter 2.pptxArti Parab Academics
 
Where in USAID’s Health Systems Strengthening (HSS) Approach is the Community...
Where in USAID’s Health Systems Strengthening (HSS) Approach is the Community...Where in USAID’s Health Systems Strengthening (HSS) Approach is the Community...
Where in USAID’s Health Systems Strengthening (HSS) Approach is the Community...CORE Group
 
Registered Nurse Model
Registered Nurse ModelRegistered Nurse Model
Registered Nurse ModelCynthia Smith
 
Personal Health Records
Personal Health RecordsPersonal Health Records
Personal Health RecordsRRR784
 
An Electronic Health Record ( Ehr )
An Electronic Health Record ( Ehr )An Electronic Health Record ( Ehr )
An Electronic Health Record ( Ehr )Tracy Huang
 
Case Study “HIE Consumer & Stakeholder Engagement: Privacy and Security of Pa...
Case Study “HIE Consumer & Stakeholder Engagement: Privacy and Security of Pa...Case Study “HIE Consumer & Stakeholder Engagement: Privacy and Security of Pa...
Case Study “HIE Consumer & Stakeholder Engagement: Privacy and Security of Pa...Health IT Conference – iHT2
 
Misadventures in Interoperability
Misadventures in InteroperabilityMisadventures in Interoperability
Misadventures in InteroperabilityCedric Dark
 
People, health professionals and health information Working together in 2014
People, health professionals and health information Working together in 2014People, health professionals and health information Working together in 2014
People, health professionals and health information Working together in 2014Health Informatics New Zealand
 
Intorduction to Health information system presentation
 Intorduction to Health information system presentation Intorduction to Health information system presentation
Intorduction to Health information system presentationAkumengwa
 

Similar to Health Record Banks are Essential for Effective Health Information Infrastructure (20)

Chronic disease and population health management
Chronic disease and population health managementChronic disease and population health management
Chronic disease and population health management
 
Health Information Strategy for New Zealand Sharing personal health information
Health Information Strategy for New Zealand Sharing personal health informationHealth Information Strategy for New Zealand Sharing personal health information
Health Information Strategy for New Zealand Sharing personal health information
 
Engaging Hard-to-Reach Populations into HIV Care: Inreach
Engaging Hard-to-Reach Populations into HIV Care: InreachEngaging Hard-to-Reach Populations into HIV Care: Inreach
Engaging Hard-to-Reach Populations into HIV Care: Inreach
 
National Health IT Board Update: Putting Evidence to Work and Creating Eviden...
National Health IT Board Update: Putting Evidence to Work and Creating Eviden...National Health IT Board Update: Putting Evidence to Work and Creating Eviden...
National Health IT Board Update: Putting Evidence to Work and Creating Eviden...
 
iHT² Health IT Summit New York - Presentation “Harnessing EHRs and Health IT ...
iHT² Health IT Summit New York - Presentation “Harnessing EHRs and Health IT ...iHT² Health IT Summit New York - Presentation “Harnessing EHRs and Health IT ...
iHT² Health IT Summit New York - Presentation “Harnessing EHRs and Health IT ...
 
Health Informatics- Module 4-Chapter 2.pptx
Health Informatics- Module 4-Chapter 2.pptxHealth Informatics- Module 4-Chapter 2.pptx
Health Informatics- Module 4-Chapter 2.pptx
 
Ph rs v3
Ph rs   v3Ph rs   v3
Ph rs v3
 
Where in USAID’s Health Systems Strengthening (HSS) Approach is the Community...
Where in USAID’s Health Systems Strengthening (HSS) Approach is the Community...Where in USAID’s Health Systems Strengthening (HSS) Approach is the Community...
Where in USAID’s Health Systems Strengthening (HSS) Approach is the Community...
 
Health informatics
Health informaticsHealth informatics
Health informatics
 
Health informatics
Health informaticsHealth informatics
Health informatics
 
Health informatics
Health informaticsHealth informatics
Health informatics
 
Registered Nurse Model
Registered Nurse ModelRegistered Nurse Model
Registered Nurse Model
 
Personal Health Records
Personal Health RecordsPersonal Health Records
Personal Health Records
 
An Electronic Health Record ( Ehr )
An Electronic Health Record ( Ehr )An Electronic Health Record ( Ehr )
An Electronic Health Record ( Ehr )
 
Case Study “HIE Consumer & Stakeholder Engagement: Privacy and Security of Pa...
Case Study “HIE Consumer & Stakeholder Engagement: Privacy and Security of Pa...Case Study “HIE Consumer & Stakeholder Engagement: Privacy and Security of Pa...
Case Study “HIE Consumer & Stakeholder Engagement: Privacy and Security of Pa...
 
Misadventures in Interoperability
Misadventures in InteroperabilityMisadventures in Interoperability
Misadventures in Interoperability
 
His
HisHis
His
 
Ehr History
Ehr HistoryEhr History
Ehr History
 
People, health professionals and health information Working together in 2014
People, health professionals and health information Working together in 2014People, health professionals and health information Working together in 2014
People, health professionals and health information Working together in 2014
 
Intorduction to Health information system presentation
 Intorduction to Health information system presentation Intorduction to Health information system presentation
Intorduction to Health information system presentation
 

More from WCIT 2014

Open Access - Activities of the Max-Planck-Gesellschaft
Open Access - Activities of the Max-Planck-GesellschaftOpen Access - Activities of the Max-Planck-Gesellschaft
Open Access - Activities of the Max-Planck-GesellschaftWCIT 2014
 
Acceso Abierto: experiencia de Brasil
Acceso Abierto: experiencia de BrasilAcceso Abierto: experiencia de Brasil
Acceso Abierto: experiencia de BrasilWCIT 2014
 
Avances del Acceso Abierto en Argentina y desafíos en el contexto latinoameri...
Avances del Acceso Abierto en Argentina y desafíos en el contexto latinoameri...Avances del Acceso Abierto en Argentina y desafíos en el contexto latinoameri...
Avances del Acceso Abierto en Argentina y desafíos en el contexto latinoameri...WCIT 2014
 
Experiencia peruana: Ley 30035 para la creación del Repositorio Nacional Digi...
Experiencia peruana: Ley 30035 para la creación del Repositorio Nacional Digi...Experiencia peruana: Ley 30035 para la creación del Repositorio Nacional Digi...
Experiencia peruana: Ley 30035 para la creación del Repositorio Nacional Digi...WCIT 2014
 
Redalyc: un modelo de Acceso Abierto desde México para Iberoamérica
Redalyc: un modelo de Acceso Abierto desde México para IberoaméricaRedalyc: un modelo de Acceso Abierto desde México para Iberoamérica
Redalyc: un modelo de Acceso Abierto desde México para IberoaméricaWCIT 2014
 
Latindex and Open Access
Latindex and Open AccessLatindex and Open Access
Latindex and Open AccessWCIT 2014
 
Repositorios de Acceso Abierto "La ruta verde Mexicana"
Repositorios de Acceso Abierto "La ruta verde Mexicana"Repositorios de Acceso Abierto "La ruta verde Mexicana"
Repositorios de Acceso Abierto "La ruta verde Mexicana"WCIT 2014
 
Open Access in Portugal: from UMinhoo to national initiatives
Open Access in Portugal: from UMinhoo to national initiativesOpen Access in Portugal: from UMinhoo to national initiatives
Open Access in Portugal: from UMinhoo to national initiativesWCIT 2014
 
WCIT 2014 Ramesh Krishnamurthy - Critical need for standardization of  e-heal...
WCIT 2014 Ramesh Krishnamurthy - Critical need for standardization of  e-heal...WCIT 2014 Ramesh Krishnamurthy - Critical need for standardization of  e-heal...
WCIT 2014 Ramesh Krishnamurthy - Critical need for standardization of  e-heal...WCIT 2014
 
WCIT 2014 Som Mittal - Managing risks in an interdependent economy risks rela...
WCIT 2014 Som Mittal - Managing risks in an interdependent economy risks rela...WCIT 2014 Som Mittal - Managing risks in an interdependent economy risks rela...
WCIT 2014 Som Mittal - Managing risks in an interdependent economy risks rela...WCIT 2014
 
WCIT 2014 Peter Elkin - Human computer interaction, evaluation, usability tes...
WCIT 2014 Peter Elkin - Human computer interaction, evaluation, usability tes...WCIT 2014 Peter Elkin - Human computer interaction, evaluation, usability tes...
WCIT 2014 Peter Elkin - Human computer interaction, evaluation, usability tes...WCIT 2014
 
WCIT 2014 Matt Stamper - Information Assurance in a Global Context
WCIT 2014 Matt Stamper - Information Assurance in a Global ContextWCIT 2014 Matt Stamper - Information Assurance in a Global Context
WCIT 2014 Matt Stamper - Information Assurance in a Global ContextWCIT 2014
 
WCIT 2014 Jaime Reyes - Innovation & entrepreneurship ecosystem in Jalisco
WCIT 2014 Jaime Reyes - Innovation & entrepreneurship ecosystem in JaliscoWCIT 2014 Jaime Reyes - Innovation & entrepreneurship ecosystem in Jalisco
WCIT 2014 Jaime Reyes - Innovation & entrepreneurship ecosystem in JaliscoWCIT 2014
 
WCIT 2014 Gail Breslow - Creativity, Collaboration, and Community: Inspiring ...
WCIT 2014 Gail Breslow - Creativity, Collaboration, and Community: Inspiring ...WCIT 2014 Gail Breslow - Creativity, Collaboration, and Community: Inspiring ...
WCIT 2014 Gail Breslow - Creativity, Collaboration, and Community: Inspiring ...WCIT 2014
 
WCIT 2014 Andrew Stott - Implementing a successful government open data program
WCIT 2014 Andrew Stott - Implementing a successful government open data programWCIT 2014 Andrew Stott - Implementing a successful government open data program
WCIT 2014 Andrew Stott - Implementing a successful government open data programWCIT 2014
 
WCIT 2014 Rohit Tandon - Big Data to Drive Business Results: HP HAVEn
WCIT 2014 Rohit Tandon - Big Data to Drive Business Results: HP HAVEnWCIT 2014 Rohit Tandon - Big Data to Drive Business Results: HP HAVEn
WCIT 2014 Rohit Tandon - Big Data to Drive Business Results: HP HAVEnWCIT 2014
 
WCIT 2014 Laura García Vitoria - Living Labs: the World Transforms into a Lab...
WCIT 2014 Laura García Vitoria - Living Labs: the World Transforms into a Lab...WCIT 2014 Laura García Vitoria - Living Labs: the World Transforms into a Lab...
WCIT 2014 Laura García Vitoria - Living Labs: the World Transforms into a Lab...WCIT 2014
 
WCIT 2014 Brian Cheng - Unleashing enterprise transformation through mobile &...
WCIT 2014 Brian Cheng - Unleashing enterprise transformation through mobile &...WCIT 2014 Brian Cheng - Unleashing enterprise transformation through mobile &...
WCIT 2014 Brian Cheng - Unleashing enterprise transformation through mobile &...WCIT 2014
 
WCIT 2014 Robert Kahn - The Evolution of the Internet
WCIT 2014 Robert Kahn - The Evolution of the InternetWCIT 2014 Robert Kahn - The Evolution of the Internet
WCIT 2014 Robert Kahn - The Evolution of the InternetWCIT 2014
 
WCIT 2014 Ricardo del Olmo - Colaboración Público-Privada para el Desarrollo ...
WCIT 2014 Ricardo del Olmo - Colaboración Público-Privada para el Desarrollo ...WCIT 2014 Ricardo del Olmo - Colaboración Público-Privada para el Desarrollo ...
WCIT 2014 Ricardo del Olmo - Colaboración Público-Privada para el Desarrollo ...WCIT 2014
 

More from WCIT 2014 (20)

Open Access - Activities of the Max-Planck-Gesellschaft
Open Access - Activities of the Max-Planck-GesellschaftOpen Access - Activities of the Max-Planck-Gesellschaft
Open Access - Activities of the Max-Planck-Gesellschaft
 
Acceso Abierto: experiencia de Brasil
Acceso Abierto: experiencia de BrasilAcceso Abierto: experiencia de Brasil
Acceso Abierto: experiencia de Brasil
 
Avances del Acceso Abierto en Argentina y desafíos en el contexto latinoameri...
Avances del Acceso Abierto en Argentina y desafíos en el contexto latinoameri...Avances del Acceso Abierto en Argentina y desafíos en el contexto latinoameri...
Avances del Acceso Abierto en Argentina y desafíos en el contexto latinoameri...
 
Experiencia peruana: Ley 30035 para la creación del Repositorio Nacional Digi...
Experiencia peruana: Ley 30035 para la creación del Repositorio Nacional Digi...Experiencia peruana: Ley 30035 para la creación del Repositorio Nacional Digi...
Experiencia peruana: Ley 30035 para la creación del Repositorio Nacional Digi...
 
Redalyc: un modelo de Acceso Abierto desde México para Iberoamérica
Redalyc: un modelo de Acceso Abierto desde México para IberoaméricaRedalyc: un modelo de Acceso Abierto desde México para Iberoamérica
Redalyc: un modelo de Acceso Abierto desde México para Iberoamérica
 
Latindex and Open Access
Latindex and Open AccessLatindex and Open Access
Latindex and Open Access
 
Repositorios de Acceso Abierto "La ruta verde Mexicana"
Repositorios de Acceso Abierto "La ruta verde Mexicana"Repositorios de Acceso Abierto "La ruta verde Mexicana"
Repositorios de Acceso Abierto "La ruta verde Mexicana"
 
Open Access in Portugal: from UMinhoo to national initiatives
Open Access in Portugal: from UMinhoo to national initiativesOpen Access in Portugal: from UMinhoo to national initiatives
Open Access in Portugal: from UMinhoo to national initiatives
 
WCIT 2014 Ramesh Krishnamurthy - Critical need for standardization of  e-heal...
WCIT 2014 Ramesh Krishnamurthy - Critical need for standardization of  e-heal...WCIT 2014 Ramesh Krishnamurthy - Critical need for standardization of  e-heal...
WCIT 2014 Ramesh Krishnamurthy - Critical need for standardization of  e-heal...
 
WCIT 2014 Som Mittal - Managing risks in an interdependent economy risks rela...
WCIT 2014 Som Mittal - Managing risks in an interdependent economy risks rela...WCIT 2014 Som Mittal - Managing risks in an interdependent economy risks rela...
WCIT 2014 Som Mittal - Managing risks in an interdependent economy risks rela...
 
WCIT 2014 Peter Elkin - Human computer interaction, evaluation, usability tes...
WCIT 2014 Peter Elkin - Human computer interaction, evaluation, usability tes...WCIT 2014 Peter Elkin - Human computer interaction, evaluation, usability tes...
WCIT 2014 Peter Elkin - Human computer interaction, evaluation, usability tes...
 
WCIT 2014 Matt Stamper - Information Assurance in a Global Context
WCIT 2014 Matt Stamper - Information Assurance in a Global ContextWCIT 2014 Matt Stamper - Information Assurance in a Global Context
WCIT 2014 Matt Stamper - Information Assurance in a Global Context
 
WCIT 2014 Jaime Reyes - Innovation & entrepreneurship ecosystem in Jalisco
WCIT 2014 Jaime Reyes - Innovation & entrepreneurship ecosystem in JaliscoWCIT 2014 Jaime Reyes - Innovation & entrepreneurship ecosystem in Jalisco
WCIT 2014 Jaime Reyes - Innovation & entrepreneurship ecosystem in Jalisco
 
WCIT 2014 Gail Breslow - Creativity, Collaboration, and Community: Inspiring ...
WCIT 2014 Gail Breslow - Creativity, Collaboration, and Community: Inspiring ...WCIT 2014 Gail Breslow - Creativity, Collaboration, and Community: Inspiring ...
WCIT 2014 Gail Breslow - Creativity, Collaboration, and Community: Inspiring ...
 
WCIT 2014 Andrew Stott - Implementing a successful government open data program
WCIT 2014 Andrew Stott - Implementing a successful government open data programWCIT 2014 Andrew Stott - Implementing a successful government open data program
WCIT 2014 Andrew Stott - Implementing a successful government open data program
 
WCIT 2014 Rohit Tandon - Big Data to Drive Business Results: HP HAVEn
WCIT 2014 Rohit Tandon - Big Data to Drive Business Results: HP HAVEnWCIT 2014 Rohit Tandon - Big Data to Drive Business Results: HP HAVEn
WCIT 2014 Rohit Tandon - Big Data to Drive Business Results: HP HAVEn
 
WCIT 2014 Laura García Vitoria - Living Labs: the World Transforms into a Lab...
WCIT 2014 Laura García Vitoria - Living Labs: the World Transforms into a Lab...WCIT 2014 Laura García Vitoria - Living Labs: the World Transforms into a Lab...
WCIT 2014 Laura García Vitoria - Living Labs: the World Transforms into a Lab...
 
WCIT 2014 Brian Cheng - Unleashing enterprise transformation through mobile &...
WCIT 2014 Brian Cheng - Unleashing enterprise transformation through mobile &...WCIT 2014 Brian Cheng - Unleashing enterprise transformation through mobile &...
WCIT 2014 Brian Cheng - Unleashing enterprise transformation through mobile &...
 
WCIT 2014 Robert Kahn - The Evolution of the Internet
WCIT 2014 Robert Kahn - The Evolution of the InternetWCIT 2014 Robert Kahn - The Evolution of the Internet
WCIT 2014 Robert Kahn - The Evolution of the Internet
 
WCIT 2014 Ricardo del Olmo - Colaboración Público-Privada para el Desarrollo ...
WCIT 2014 Ricardo del Olmo - Colaboración Público-Privada para el Desarrollo ...WCIT 2014 Ricardo del Olmo - Colaboración Público-Privada para el Desarrollo ...
WCIT 2014 Ricardo del Olmo - Colaboración Público-Privada para el Desarrollo ...
 

Recently uploaded

CT GUIDED LUNG BIOPSY.pptx,lung mass is malignant (cancerous) or benign
CT GUIDED LUNG BIOPSY.pptx,lung mass is malignant (cancerous) or benignCT GUIDED LUNG BIOPSY.pptx,lung mass is malignant (cancerous) or benign
CT GUIDED LUNG BIOPSY.pptx,lung mass is malignant (cancerous) or benignRukamaneeYadav
 
INTERVENTIONAL RADIOLOGY.pptxChronic stable angina . Valvular heart disease ...
INTERVENTIONAL RADIOLOGY.pptxChronic stable angina . Valvular heart disease  ...INTERVENTIONAL RADIOLOGY.pptxChronic stable angina . Valvular heart disease  ...
INTERVENTIONAL RADIOLOGY.pptxChronic stable angina . Valvular heart disease ...RukamaneeYadav
 
Sadhya Asadhya including upadrava SGB.pptx
Sadhya Asadhya including  upadrava SGB.pptxSadhya Asadhya including  upadrava SGB.pptx
Sadhya Asadhya including upadrava SGB.pptxShivaniBorele1
 
The 3 Undeniable Truths About Consuming Alcohol During Pregnancy. Prevention ...
The 3 Undeniable Truths About Consuming Alcohol During Pregnancy. Prevention ...The 3 Undeniable Truths About Consuming Alcohol During Pregnancy. Prevention ...
The 3 Undeniable Truths About Consuming Alcohol During Pregnancy. Prevention ...Q.M. Sami
 
The Goals of Inova’s Heart and Vascular Programs
The Goals of Inova’s Heart and Vascular ProgramsThe Goals of Inova’s Heart and Vascular Programs
The Goals of Inova’s Heart and Vascular ProgramsDwight Schar
 
FLAIR,STIR,FLASH,PDW Sequences presented by waseem javid
FLAIR,STIR,FLASH,PDW Sequences presented by waseem javidFLAIR,STIR,FLASH,PDW Sequences presented by waseem javid
FLAIR,STIR,FLASH,PDW Sequences presented by waseem javidwaseemjavid2004
 
FORMATION OF EMBRYO and FETAL DEVELOPMENT.pdf
FORMATION OF EMBRYO and FETAL DEVELOPMENT.pdfFORMATION OF EMBRYO and FETAL DEVELOPMENT.pdf
FORMATION OF EMBRYO and FETAL DEVELOPMENT.pdfDolisha Warbi
 
SHOCK/TYPES OF SHOCK AND ITS MANAGEMENT.pdf
SHOCK/TYPES OF SHOCK AND ITS MANAGEMENT.pdfSHOCK/TYPES OF SHOCK AND ITS MANAGEMENT.pdf
SHOCK/TYPES OF SHOCK AND ITS MANAGEMENT.pdfDolisha Warbi
 
Magnetic Resonance Imaging Brain (MRA).pptx,umour, Metastases Cranial nerv...
Magnetic Resonance Imaging Brain (MRA).pptx,umour,  Metastases   Cranial nerv...Magnetic Resonance Imaging Brain (MRA).pptx,umour,  Metastases   Cranial nerv...
Magnetic Resonance Imaging Brain (MRA).pptx,umour, Metastases Cranial nerv...RukamaneeYadav
 
The Sound of Better Hearing: Ear Wax Removal
The Sound of Better Hearing: Ear Wax RemovalThe Sound of Better Hearing: Ear Wax Removal
The Sound of Better Hearing: Ear Wax RemovalEuropean Best Care
 
Hospital HEALTHCARE WASTE Management MANUAL.pdf
Hospital HEALTHCARE WASTE Management MANUAL.pdfHospital HEALTHCARE WASTE Management MANUAL.pdf
Hospital HEALTHCARE WASTE Management MANUAL.pdfMimiGT
 
UNIT-9 NURSING MANAGEMENT OF PATIENT IN CRITICAL CARE.pptx
UNIT-9 NURSING MANAGEMENT OF PATIENT IN CRITICAL CARE.pptxUNIT-9 NURSING MANAGEMENT OF PATIENT IN CRITICAL CARE.pptx
UNIT-9 NURSING MANAGEMENT OF PATIENT IN CRITICAL CARE.pptxNirmal Vaghela
 
Separation Anxiety in Children with causes, symptoms
Separation Anxiety in Children with causes, symptomsSeparation Anxiety in Children with causes, symptoms
Separation Anxiety in Children with causes, symptomsNidhiBalhera
 
CT Neck angiography.pptx,nodal disease. Tumor, lymphoma and metastases. Thyr...
CT  Neck angiography.pptx,nodal disease. Tumor, lymphoma and metastases. Thyr...CT  Neck angiography.pptx,nodal disease. Tumor, lymphoma and metastases. Thyr...
CT Neck angiography.pptx,nodal disease. Tumor, lymphoma and metastases. Thyr...RukamaneeYadav
 
Oral Cavity:Common problem associated with teeth and gums.
Oral Cavity:Common problem associated with teeth and gums.Oral Cavity:Common problem associated with teeth and gums.
Oral Cavity:Common problem associated with teeth and gums.kunjanlanjewar2002
 
TARGET DELINEATION OF THORACIC NODAL. STATION
TARGET DELINEATION OF THORACIC NODAL. STATIONTARGET DELINEATION OF THORACIC NODAL. STATION
TARGET DELINEATION OF THORACIC NODAL. STATIONKanhu Charan
 
PPT-Administration-of-Subcutaneous-Injection-.pptx.ppt
PPT-Administration-of-Subcutaneous-Injection-.pptx.pptPPT-Administration-of-Subcutaneous-Injection-.pptx.ppt
PPT-Administration-of-Subcutaneous-Injection-.pptx.pptrahmatullahnazari7411
 
BLS ( Basic Life Support/ Cardiopulmonary Resuscitation )
BLS ( Basic Life Support/  Cardiopulmonary Resuscitation )BLS ( Basic Life Support/  Cardiopulmonary Resuscitation )
BLS ( Basic Life Support/ Cardiopulmonary Resuscitation )gemergencycare
 
Acoustic Neuroma causing hearing loss.pptx
Acoustic Neuroma causing hearing loss.pptxAcoustic Neuroma causing hearing loss.pptx
Acoustic Neuroma causing hearing loss.pptximranamc1231
 

Recently uploaded (20)

CT GUIDED LUNG BIOPSY.pptx,lung mass is malignant (cancerous) or benign
CT GUIDED LUNG BIOPSY.pptx,lung mass is malignant (cancerous) or benignCT GUIDED LUNG BIOPSY.pptx,lung mass is malignant (cancerous) or benign
CT GUIDED LUNG BIOPSY.pptx,lung mass is malignant (cancerous) or benign
 
INTERVENTIONAL RADIOLOGY.pptxChronic stable angina . Valvular heart disease ...
INTERVENTIONAL RADIOLOGY.pptxChronic stable angina . Valvular heart disease  ...INTERVENTIONAL RADIOLOGY.pptxChronic stable angina . Valvular heart disease  ...
INTERVENTIONAL RADIOLOGY.pptxChronic stable angina . Valvular heart disease ...
 
Sadhya Asadhya including upadrava SGB.pptx
Sadhya Asadhya including  upadrava SGB.pptxSadhya Asadhya including  upadrava SGB.pptx
Sadhya Asadhya including upadrava SGB.pptx
 
The 3 Undeniable Truths About Consuming Alcohol During Pregnancy. Prevention ...
The 3 Undeniable Truths About Consuming Alcohol During Pregnancy. Prevention ...The 3 Undeniable Truths About Consuming Alcohol During Pregnancy. Prevention ...
The 3 Undeniable Truths About Consuming Alcohol During Pregnancy. Prevention ...
 
The Goals of Inova’s Heart and Vascular Programs
The Goals of Inova’s Heart and Vascular ProgramsThe Goals of Inova’s Heart and Vascular Programs
The Goals of Inova’s Heart and Vascular Programs
 
FLAIR,STIR,FLASH,PDW Sequences presented by waseem javid
FLAIR,STIR,FLASH,PDW Sequences presented by waseem javidFLAIR,STIR,FLASH,PDW Sequences presented by waseem javid
FLAIR,STIR,FLASH,PDW Sequences presented by waseem javid
 
FORMATION OF EMBRYO and FETAL DEVELOPMENT.pdf
FORMATION OF EMBRYO and FETAL DEVELOPMENT.pdfFORMATION OF EMBRYO and FETAL DEVELOPMENT.pdf
FORMATION OF EMBRYO and FETAL DEVELOPMENT.pdf
 
SHOCK/TYPES OF SHOCK AND ITS MANAGEMENT.pdf
SHOCK/TYPES OF SHOCK AND ITS MANAGEMENT.pdfSHOCK/TYPES OF SHOCK AND ITS MANAGEMENT.pdf
SHOCK/TYPES OF SHOCK AND ITS MANAGEMENT.pdf
 
Magnetic Resonance Imaging Brain (MRA).pptx,umour, Metastases Cranial nerv...
Magnetic Resonance Imaging Brain (MRA).pptx,umour,  Metastases   Cranial nerv...Magnetic Resonance Imaging Brain (MRA).pptx,umour,  Metastases   Cranial nerv...
Magnetic Resonance Imaging Brain (MRA).pptx,umour, Metastases Cranial nerv...
 
The Sound of Better Hearing: Ear Wax Removal
The Sound of Better Hearing: Ear Wax RemovalThe Sound of Better Hearing: Ear Wax Removal
The Sound of Better Hearing: Ear Wax Removal
 
Hospital HEALTHCARE WASTE Management MANUAL.pdf
Hospital HEALTHCARE WASTE Management MANUAL.pdfHospital HEALTHCARE WASTE Management MANUAL.pdf
Hospital HEALTHCARE WASTE Management MANUAL.pdf
 
UNIT-9 NURSING MANAGEMENT OF PATIENT IN CRITICAL CARE.pptx
UNIT-9 NURSING MANAGEMENT OF PATIENT IN CRITICAL CARE.pptxUNIT-9 NURSING MANAGEMENT OF PATIENT IN CRITICAL CARE.pptx
UNIT-9 NURSING MANAGEMENT OF PATIENT IN CRITICAL CARE.pptx
 
Separation Anxiety in Children with causes, symptoms
Separation Anxiety in Children with causes, symptomsSeparation Anxiety in Children with causes, symptoms
Separation Anxiety in Children with causes, symptoms
 
CT Neck angiography.pptx,nodal disease. Tumor, lymphoma and metastases. Thyr...
CT  Neck angiography.pptx,nodal disease. Tumor, lymphoma and metastases. Thyr...CT  Neck angiography.pptx,nodal disease. Tumor, lymphoma and metastases. Thyr...
CT Neck angiography.pptx,nodal disease. Tumor, lymphoma and metastases. Thyr...
 
Oral Cavity:Common problem associated with teeth and gums.
Oral Cavity:Common problem associated with teeth and gums.Oral Cavity:Common problem associated with teeth and gums.
Oral Cavity:Common problem associated with teeth and gums.
 
TARGET DELINEATION OF THORACIC NODAL. STATION
TARGET DELINEATION OF THORACIC NODAL. STATIONTARGET DELINEATION OF THORACIC NODAL. STATION
TARGET DELINEATION OF THORACIC NODAL. STATION
 
Overview of Models, Frames of Reference and Approaches.pptx
Overview of Models, Frames of Reference and Approaches.pptxOverview of Models, Frames of Reference and Approaches.pptx
Overview of Models, Frames of Reference and Approaches.pptx
 
PPT-Administration-of-Subcutaneous-Injection-.pptx.ppt
PPT-Administration-of-Subcutaneous-Injection-.pptx.pptPPT-Administration-of-Subcutaneous-Injection-.pptx.ppt
PPT-Administration-of-Subcutaneous-Injection-.pptx.ppt
 
BLS ( Basic Life Support/ Cardiopulmonary Resuscitation )
BLS ( Basic Life Support/  Cardiopulmonary Resuscitation )BLS ( Basic Life Support/  Cardiopulmonary Resuscitation )
BLS ( Basic Life Support/ Cardiopulmonary Resuscitation )
 
Acoustic Neuroma causing hearing loss.pptx
Acoustic Neuroma causing hearing loss.pptxAcoustic Neuroma causing hearing loss.pptx
Acoustic Neuroma causing hearing loss.pptx
 

Health Record Banks are Essential for Effective Health Information Infrastructure

  • 1. Health Record Banks are Essential for Effective Health Information Infrastructure William A. Yasnoff, MD, PhD, FACMI CEO, Health Record Banking Alliance Adjunct Professor, Health Science Informatics, Johns Hopkins University WCIT Guadalajara, Mexico September 30, 2014 © 2014
  • 2. 2 © 2014 Outline  Goals of Health Information Infrastructure (HII)  Comprehensive Electronic Patient Records  Population Health and Prevention  The Health and Prevention Promotion Initiative (HAPPI): A Self-Funding Organization for Prevention, Population Health, and Electronic Records  Next Steps
  • 3. 3 © 2014 HII Goals Support the Triple Aim  Better Health  Better Care  Lower Costs Challenges Prevention Population Health Consumer Tools Better Decisions Consumer Tools Avoid Errors Avoid Duplication Prevention Prevention & Population Health Comprehensive Electronic Patient Records
  • 5. 5 © 2014 HII Goal 1: Individual Records  Comprehensive electronic patient records when & where needed  Individual (patient care)  Aggregate (research, public health)  Basic Requirements  All information must be electronic  all providers must use EHRs  Mechanism to bring together scattered information for each person (“Health Information Exchange” or HIE)
  • 6. 6 © 2014 Current Efforts are Failing  HHS: Current efforts “alone will not be enough to achieve the widespread interoperability and electronic exchange of information necessary for delivery reform where information will routinely follow the patient regardless of where they receive care.” -- ONC/CMS RFI 3/7/13, p. 5  PCAST: HIE efforts through the states “will not solve the fundamental need for data to be universally accessed, integrated, and understood while also being protected.” – Dec 2010, p. 40
  • 7. 7 © 2014  Adler-Milstein et al HIE Survey (Annals of Internal Medicine, May 2011)  179 HIEs surveyed  Only 13 met Meaningful Use Stage 1 – 3% of hospitals, 0.9% of physicians  Only 6 of 13 self-reported as sustainable  None of 179 met expert panel definition of comprehensive system, calling “into question whether RHIOs* in their current form can be self-sustaining and effective.” (abstract) *Regional Health Information Organizations Current Efforts are Failing (continued)
  • 8. 8 © 2014  Multiple HIEs have already failed  Washington, DC  Kansas  Tennessee  CalRHIO  CareSpark (Kingsport, TN) – Long touted as national leader  No patients currently receive care with guaranteed availability of comprehensive records from all sources Current Efforts are Failing (continued)
  • 9. 9 © 2014  Why are HIEs failing?  Substantial resources: $564 million Federal funds allocated March 2010  Challenges well known – Privacy – Stakeholder Cooperation – Sustainability Current Efforts are Failing (continued)
  • 10. 10 © 2014  Wrong Path  Trying to replicate manual process of contacting other providers directly for records Current Efforts are Failing (continued) HIE Index Other EHRs Assembly Clinician EHR Patient Encounter 5 4 3 1 2 Diagram © Health Record Banking Alliance, 2013. Used by permission.
  • 11. 11 © 2014  Complex and Expensive  All EHRs must be online 24/7 to respond to queries  Real-time reconciliation of records  Requires unique patient identifier – Politically impractical – Privacy threat  Must have expensive 24/7 network operations center to monitor all contributing EHRs Current Efforts Can’t Work
  • 12. 12 © 2014  Increasing Errors with More Data Sources Current Efforts Can’t Work (continued) Source: Lapsia V, Lamb K, Yasnoff WA: Where should electronic records for patients be stored? Int J Med Informatics 81:821-827, 2012.
  • 13. 13 © 2014  Increased Liability  Patients cannot review or annotate data  Providers and HIE responsible for correctness  No propagation of corrections Current Efforts Can’t Work (continued)
  • 14. 14 © 2014  Not Financially Sustainable Current Efforts Can’t Work (continued) 0 10 20 30 40 50 60 70 80 90 100 0 20 40 60 80 100 Value of Info (%) Completeness of Information (%) Value vs. Completeness of Health Information Source: Yasnoff WA: Health Information Infrastructure. In Biomedical Informatics: Computer Applications in Healthcare and Medicine, Fourth Edition (Shortliffe & Cimino, eds.). New York: Springer-Verlag, 2014, pp. 423-441.
  • 15. 15 © 2014  Unable to Protect Privacy  Where can consumers indicate their privacy preferences?  If data left at sources, consumers must set and maintain their preferences at every source  too complex and inconvenient Current Efforts Can’t Work (continued)
  • 16. 16 © 2014  Unable to Ensure Stakeholder Provision of Patient Information  Stakeholder participation in HIE is voluntary – Difficult to get cooperation – Difficult to maintain cooperation  Only patient requests for information must be honored by all stakeholders Current Efforts Can’t Work (continued)
  • 17. 17 © 2014  Unable to Facilitate Robust Data Searching  Distributed records  sequential search  Sequential search is too slow to be practical Current Efforts Can’t Work (continued)
  • 18. 18 © 2014 Consequences for Stakeholders Stakeholder Problems Health Plans/Insurers 1. Continually escalating costs 2. No comprehensive patient records Hospitals/ACO s 1. Inadequate/incomplete patient information on admission and in ER 2. Uncontrollable financial risk (e.g. from readmissions) 3. Ineffective/inefficient prevention activities Physicians 1. EHRs just “electronify” existing silo of patient records 2. No comprehensive patient records  better care 3. Ineffective/inefficient prevention activities Patients 1. Preventable errors 2. Preventable adverse events 3. Unnecessary repeat tests/procedures 4. Continually escalating costs Government/C ommunity 1. Continually escalating costs 2. Prevention efforts ineffective/underfunded 3. Data unavailable for policy & research
  • 19. 19 © 2014 HIT Architecture Choices  Distributed architecture – does not work  Leave information in place; retrieve in real time when needed  Problems – Inefficient – Error prone – Does not scale – Hard to protect privacy – Impractical to search data  Centralized architecture (health record banks)
  • 20. 20 © 2014 Solution: Health Record Bank (HRB)  Secure community-based repository of complete health records  Access to records completely controlled by patients (or designee)  “Electronic safe deposit boxes”  Information about care deposited once when created  Required by HIPAA (in U.S.)  Allows EHR incentives to physicians to make outpatient records electronic  Operation simple and inexpensive
  • 21. 21 © 2014 http://www.healthbanking.org/video1.html What is a Health Record Bank?
  • 22. 22 © 2014 HRB Architecture Patient Records Clinician EHR Patient Encounter HRB 1 3 2 Diagram © Health Record Banking Alliance, 2013. Used by permission.
  • 23. 23 © 2014 HRB Rationale  Operationally simple  Records immediately available  Deposit new records when created  Enables value-added services  Enables research queries  Patient control  Trust & privacy  Stakeholder cooperation (HIPAA)  Low cost facilitates business model  Creates EHR incentive options  Pay for deposits  Provide Internet-accessible EHRs
  • 25. 25 © 2014 How HRBs Create Value Health Record Bank including free/subsidized EHRs for physicians More complete electronic health Enables delivery of record information optional services with compelling value Patients sign up for HRB accounts (recommended by physicians) Enables physicians to provide better patient care $
  • 26. 26 © 2014 HRB Business Model  Costs (with 1,000,000 subscribers)  Operations: $6/person/year  EHR incentives: $10/person/year  Revenue  Advertising: ~$3/person/year (option to opt out for small fee)  Reminders & Alerts: >= $18/person/year – “Peace of mind” alerts – Preventive care reminders – Medication reminders  Queries: >$3/person/year  No need to assume/capture any health care cost savings (!!)
  • 27. 27 © 2014 Pro Forma Example (Houston) ($1,000) $0 $1,000 $2,000 $3,000 $4,000 $5,000 $6,000 $7,000 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 "Expenses ($K)" "Revenue ($K)" "Net ($K)" Month Initial Capital: $4.4 MM Breakeven: 16 months EBITDA Year 4: $41 MM+
  • 28. 28 © 2014 HII Goal 2: Prevention & Population Health  Definition – Improving the health outcomes of a group of individuals  U.S. not doing this well  Per capita health care spending >2x other industrialized nations  But outcomes poor – U.S. ranks 24th of 30 OECD countries in life expectancy  Only 3% of spending on prevention while 75% of medical costs relate to preventable chronic conditions  How can we improve?
  • 29. 29 © 2014 Prevention & Population Health  Challenges  New activity – Providers do not do this now – Must hire staff & establish procedures  Inefficient for each provider – More costly per capita to focus on limited populations  Benefit externalities – Member “churn” limits ROI for prevention – No incentive for long-term prevention investments
  • 30. 30 © 2014 Prevention & Population Health  Potential Solution: Collaborative Community Prevention Organization  All providers pool resources  Community organization does prevention & population health for all  Issues  Ongoing funding  Continuous provider cooperation – Initial capitalization – Annual operational funding  Incentives good but not compelling  Need comprehensive patient info
  • 32. 32 © 2014 Health and Prevention Promotion Initiative (HAPPI)  Combine Community Prevention Organization with Health Record Bank  Health Record Bank  Provides needed information Ensures all-electronic records  Generates revenue (apps, ads, data)  Provides funds for itself and more  Excess funds from HRB Pay for Prevention and Population Health
  • 33. 33 © 2014 How does a HAPPI work? PATIENT CONTROL CENTRAL REPOSITORY Stakeholder Cooperation ensures Electronic Patient Data provides Benefits 1. Clinical: Quality,Costs 2. Reminders/Alerts 3. Research produces pay for enables Prevention (stakeholder need) empowers Privacy protects Financial Incentives ensure Key Design Decisions Initial Steps: 1. Free/subsidized EHRs for physicians 2. Physicians recruit patients for free HRB accounts
  • 34. 34 © 2014 All Stakeholders Benefit Stakeholder Benefits Health Plans/Insurers 1. Lower care costs (better info) 2. Prevention lowers future costs 3. Sustainable after initial investment *** Hospitals/ACOs 1. Prevention services 2. Better info/tools for care 3. Patient portal 4. Sustainable after initial investment *** Physicians 1. Free/subsidized EHRs 2. Better info/tools for care 3. Prevention services Patients 1. Better care 2. Tools for health and prevention 3. Control over own records 4. Basic accounts free Government/Commu nity 1. Lower costs 2. Prevention 3. Information for policy & research *** key benefit
  • 35. 35 © 2014 The Triple Aim  Better Health  Better Care  Lower Costs Challenges Prevention Population Health Consumer Tools Better Decisions Consumer Tools Avoid Errors Avoid Duplication Prevention Prevention & Population Health Comprehensive Electronic Patient Records HAPPI
  • 36. 36 © 2014 Next Steps  Implement HAPPI Pilots  Looking for candidate communities  Need outside funding to reduce risk  Disseminate Lessons Learned  Organize HAPPI Projects in Multiple Communities
  • 37. 37 © 2014 SUMMARY  HII Goals Include Prevention & Population Health  Health Record Banks Can Provide Comprehensive Electronic Patient Records Needed  Incentives for EHR Adoption  Excess Revenue  Combine Community Prevention with HRB  Health and Prevention Promotion Initiative (HAPPI)  HAPPI  Successful HII & Achieving the Triple Aim
  • 38. 38 © 2014 Questions? William A. Yasnoff, MD, PhD, FACMI william.yasnoff@nhiiadvisors.com 703/527-5678