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Global or Glocal e-Health Approaches in Asia: What Is New or Next?
 

Global or Glocal e-Health Approaches in Asia: What Is New or Next?

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Theera-Ampornpunt N. Global or glocal e-Health approaches in Asia: what is new or next? Presented at: Globalizing Asia: Health Law, Governance, and Policy - Issues, Approaches, and Gaps!; 2012 Apr ...

Theera-Ampornpunt N. Global or glocal e-Health approaches in Asia: what is new or next? Presented at: Globalizing Asia: Health Law, Governance, and Policy - Issues, Approaches, and Gaps!; 2012 Apr 16-18; Bangkok, Thailand.

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    Global or Glocal e-Health Approaches in Asia: What Is New or Next? Global or Glocal e-Health Approaches in Asia: What Is New or Next? Presentation Transcript

    • Global or Glocal eHealth Approaches in Asia: What is New or Next?Nawanan Theera-Ampornpunt, MD, PhD
    • The Need for eHealth & Health IT “...Our recovery plan will invest in electronic health records and new technology that will reduce errors, bring down costs, ensure privacy, and save lives.” President Barack Obama Address to Joint Session of Congress February 24, 2009
    • WHO Health Systems Framework From a slide by Dr.Boonchai Kijsanayotin (2012)
    • U.S. eHealth Developments 2011 2009 2004 ONCHIT 2000-2001 HITECH Act “Meaningful Use” 1991
    • The HITECH ActBlumenthal D. Launching HITECH. N Engl J Med. 2010 Feb 4;362(5):382-5.
    • “Meaningful Use” of Health ITStage 1- Electronic capture of Betterhealth information- Information sharing Health- Data reporting Stage 3 Stage 2 Use of EHRs to Use of improve EHRs to outcomes improve processes of care Blumenthal (2010)
    • U.S. Health IT AdoptionU.S. Ambulatory Setting 100 90% of Physicians 80 70 60 50 48.3 50.7 34.8 42.0 23.9 29.2 40 30 24.9 18.2 17.3 17.3 20.8 16.9 21.8 20 9.3 10.5 11.8 10 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Year of Study Any EHR EHR with Basic Features Basic Features: Demographics, problem lists, clinical notes, test results, imaging results, order entry for medications Source: National Ambulatory Medical Care Survey (NAMCS) 2001-2010
    • U.S. Health IT Adoption U.S. Inpatient Setting 2008 2009 Basic EHRs 7.2% 9.2% Comprehensive EHRs 1.5% 2.7% Computerized 17% 34% Order Entry for MedicationsDefinitions Sources: Jha et al., 2009 & 2010
    • U.S. Health Information Exchange• Regional Health Information Organizations (RHIOs)• State eHealth Initiatives• Nationwide Health Information Network (NwHIN)
    • WHO Global Observatory for eHealth Development Model From a slide by Dr.Boonchai Kijsanayotin (2012)
    • Thailand’s eHealth StatusFoundation Policies & Strategies Uptake1. National eGovernment policy & strategy √ ICT20102. National eHealth policy & strategy X3. National eHealth governance body X3. Funding Public, No Private4. Public & Private partnership +5. Infrastructure ++ Kijsanayotin et al. (2010)
    • Thailand’s Status Summary• Widespread access to and use of ICT• Various eHealth applications but – Poorly integrated and unsystematic – Not standardized – Not interoperable• Lack of investment and groundwork for eHealth infrastructure Kijsanayotin et al. (2010)
    • Recommendations• Establish a multi-stakeholder national- level eHealth governing authority• eHealth strategy should be incorporated into other ICT frameworks• Enact laws to protect health information privacy and security• Develop national health information standards• Capacity building Kijsanayotin et al. (2010)
    • Thailand’s National eHealth Body National Health Commission National Health Information Committee National Health Information Standards Subcommittee From a slide by Dr.Boonchai Kijsanayotin (2012)
    • Thailand’s Health IT Adoption Estimate Nationwide (Partial or Complete Adoption) Basic EHR, combined inpatient & 49.8% outpatient settings Comprehensive EHR, combined 5.3% order entry of medications, combined 90.2% order entry of all orders, combined 79.4%Definitions | Estimates
    • Thailand’sHealth Information Exchange• Most exchange occurs for mandated claims and reimbursements• Limited exchange for clinical purposes in some provinces• Mostly not based on standards but rather use of the same health IT products• No push from government toward HIE Kijsanayotin et al. (2010)
    • Summary (1) United States Thailand• Decades of awareness • Relatively short period of building, advocacy, and interest & attention on research & development eHealth on eHealth• Strong national • National governance governance body body recently established• eHealth an integral part of • eHealth not yet part of national policy & agenda national policy & agenda
    • Summary (2) United States Thailand• Large funding with • Little funding and incentives and systematic incentives for eHealth efforts and no systematic approaches• Growing but still • Adoption estimates suboptimal health IT indicate an encouraging infrastructure level of infrastructure• Strong capacity building • Extremely limited high- efforts quality workforce training in health informatics
    • Summary (3)• Local contexts differ for different countries but lessons from other countries are important• National leadership, strong governance, and raising eHealth to the national policy level create a critical momentum for HIE
    • http://oilersnation.com/2011/12/28/the-long-winding-road-trip-to-a-close-team