H. Stephen Lieber President & CEO Healthcare Information and Management Systems Society (HIMSS) Electronic Health Records Global Perspectives

H. Stephen Lieber

President & CEO

Healthcare Information and Management Systems Society (HIMSS)

HIMSS International not-for-profit, membership based organisation Offices in US, Belgium and Singapore Offer educational programs in North America, Europe, Asia and Middle East Over 23,000 HIT professionals, physicians, nurses, other healthcare executive members Primary source of education, professional development, tools and resources on e-Health, HIT Recognises best practices, leading hospitals and physician practices for adoption and use of HIT More at www.himss.org

International not-for-profit, membership based organisation

Offices in US, Belgium and Singapore

Offer educational programs in North America, Europe, Asia and Middle East

Over 23,000 HIT professionals, physicians, nurses, other healthcare executive members

Primary source of education, professional development, tools and resources on e-Health, HIT

Recognises best practices, leading hospitals and physician practices for adoption and use of HIT

More at www.himss.org

Sound Familiar? The situation and challenges in ( fill in the blank ) are similar to other ( fill in the continent ) countries: limited budget rising demand for healthcare services chronic disease management quality below expectations people in countryside with limited access to health care services

The situation and challenges in ( fill in the blank ) are similar to other ( fill in the continent ) countries:

limited budget

rising demand for healthcare services

chronic disease management

quality below expectations

people in countryside with limited access to health care services

Core Comparisons Overview of each country examined National EHR Program - National IT/ICT status and strategy - National/Regional EHR Approach EHR Governance - Legal/Regulatory - Healthcare policy - EHR Financing

Overview of each country examined

National EHR Program

- National IT/ICT status and strategy

- National/Regional EHR Approach

EHR Governance

- Legal/Regulatory

- Healthcare policy

- EHR Financing

Core Comparisons (cont.) Technology Adoption Outcomes - Benefits - Implementation Experiences Next steps for each country

Technology

Adoption

Outcomes

- Benefits

- Implementation Experiences

Next steps for each country

Funding Central Government Private Sector Central, Local and Private Central and Local - England, Germany, France, Netherlands, Sweden, South Africa, Denmark, New Zealand. -India, Israel, Japan, Singapore -Canada, Hong Kong, USA. -Australia

Central Government

Private Sector

Central, Local and Private

Central and Local

- England, Germany,

France, Netherlands,

Sweden, South Africa,

Denmark, New Zealand.

-India, Israel, Japan, Singapore

-Canada, Hong Kong, USA.

-Australia

Governance Models England, New Zealand Centralised United States Private Sector Germany, Denmark, Hong Kong, Singapore Distributed Countries Governance Model

Standards and Interoperability United States, Israel Multiple Systems England, United States, Singapore, New Zealand, Australia Interoperability-Driven England, South Africa, Singapore, Malaysia, New Zealand, Australia International (such as HL7)‏ France, Sweden, Netherlands, Denmark, New Zealand, Australia Parochial Standards

United Kingdom Regional and local organizations vary in their IT maturity and adoption of EHR/EMR systems Primary care has been, and continues to be, a leader in the adoption of EHR due to policy requirements and financial incentives Successful adoption has also been attributed to leadership by highly committed physician champions and carefully targeted communication, regulation, assistance and incentives on the part of the NHS

Regional and local organizations vary in their IT maturity and adoption of EHR/EMR systems

Primary care has been, and continues to be, a leader in the adoption of EHR due to policy requirements and financial incentives

Successful adoption has also been attributed to leadership by highly committed physician champions and carefully targeted communication, regulation, assistance and incentives on the part of the NHS

France Classic obstacles still being experienced lack of interoperability, incomplete standardization, insufficient training and inadequate provider support Start with clinical documents in use rather than fully structured data Need collaborative involvement of all stakeholders (patients, providers, vendors and government agencies) from beginning Need framework for national EHR early in the implementation process

Classic obstacles still being experienced

lack of interoperability, incomplete standardization, insufficient training and inadequate provider support

Start with clinical documents in use rather than fully structured data

Need collaborative involvement of all stakeholders (patients, providers, vendors and government agencies) from beginning

Need framework for national EHR early in the implementation process

Greece Goal: allow the unimpeded flow of health information within the healthcare system in an absolutely secure manner, following the citizen in his/her interactions and contacts with the system The national EHR will include a subset of medical data for every citizen, easily accessible from various health care units Twister Project: implement eHealth services in remote areas using a hybrid network with wireless, satellite, and terrestrial broadband segments

Goal: allow the unimpeded flow of health information within the healthcare system in an absolutely secure manner, following the citizen in his/her interactions and contacts with the system

The national EHR will include a subset of medical data for every citizen, easily accessible from various health care units

Twister Project: implement eHealth services in remote areas using a hybrid network with wireless, satellite, and terrestrial broadband segments

Turkey Significant benefits have been realized: National Health Information Standards have been developed Agreements governing health data types and collection methods at the national and regional levels Agreements on data interchange standards between different health information systems Telemedicine programs implemented in selected rural and poor regional hospitals Decision Support System (DSS) has been added

Significant benefits have been realized:

National Health Information Standards have been developed

Agreements governing health data types and collection methods at the national and regional levels

Agreements on data interchange standards between different health information systems

Telemedicine programs implemented in selected rural and poor regional hospitals

Decision Support System (DSS) has been added

Algeria In 2007, 66 of 69 countries in e-Readiness 10% of the population is considered to be internet users In 2006, 1.1 PCs per 100 person System aims to manage patient records, verify patient benefits, and simplify administration by reducing paperwork Designed to have three major applications: teleconsultation, remote assistance of surgical acts and the sharing of health information

In 2007, 66 of 69 countries in e-Readiness

10% of the population is considered to be internet users

In 2006, 1.1 PCs per 100 person

System aims to manage patient records, verify patient benefits, and simplify administration by reducing paperwork

Designed to have three major applications: teleconsultation, remote assistance of surgical acts and the sharing of health information

Estonia Service oriented nation-wide Health Information system All health service providers have own information systems and these connect to central Health Information System Document sending/receiving, Case beginning/closing messages, Summary queries, Document queries, Duplicate handling, Access services, Patient demographics, related person handling ID card system

Service oriented nation-wide Health Information system

All health service providers have own information systems and these connect to central Health Information System

Document sending/receiving, Case beginning/closing messages, Summary queries, Document queries, Duplicate handling, Access services, Patient demographics, related person handling

ID card system

Mongolia 10% of population PC users Pilots focused on distance treatment, diagnostic, monitoring Online system to allow medical professionals in remote areas to share patient information with medical professionals in urban centers and make internet-based diagnosis Bring together the best cardiological expertise in Mongolia, through a telemedicine network and website, for diagnostic purposes Health Sciences University of Mongolia and the University of Basel linkage to allow for remote pre-op, post-op diagnosis, therapy and knowledge sharing

10% of population PC users

Pilots focused on distance treatment, diagnostic, monitoring

Online system to allow medical professionals in remote areas to share patient information with medical professionals in urban centers and make internet-based diagnosis

Bring together the best cardiological expertise in Mongolia, through a telemedicine network and website, for diagnostic purposes

Health Sciences University of Mongolia and the University of Basel linkage to allow for remote pre-op, post-op diagnosis, therapy and knowledge sharing

Key Lessons Requires a commitment from high levels of government and private sector. Continuous communications at all levels. Data standards for Interoperability needs to be implemented. Physicians must be involved. Training is a essential piece that must be funded.

Requires a commitment from high levels of government and private sector.

Continuous communications at all levels.

Data standards for Interoperability needs to be implemented.

Physicians must be involved.

Training is a essential piece that must be funded.