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1
Nawanan Theera-Ampornpunt, M.D., Ph.D.
Faculty of Medicine Ramathibodi Hospital
Mahidol University
October 8, 2013
Medic...
2
Let’s Start with
Something Simple
3
What Clinicians Want?
To treat & to
care for their
patients to their
best abilities,
given limited
time &
resources
Imag...
4
High Quality Care
• Safe
• Timely
• Effective
• Efficient
• Equitable
• Patient-Centered
Institute of Medicine, Committe...
5
Information is Everywhere in Medicine
Shortliffe EH. Biomedical informatics in the education of
physicians. JAMA. 2010 S...
6
Achieving Quality Care with Information
• Safe
– Drug allergies
– Medication Reconciliation
• Timely
– Complete informat...
7
Achieving Quality Care with Information
• Efficient
– Faster care
– Time & cost savings
– Reducing unnecessary tests
• E...
8
That’s Where Health IT
Plays A Role...
9
The Anatomy of Health IT
Health 
Information
Technology
Goal
Value‐Add
Means
10
Various Forms of Health IT
Hospital Information System
(HIS)
Computerized Provider Order Entry
(CPOE)
Electronic
Health...
11
Still Many Other Forms of Health IT
m-Health
Health Information
Exchange (HIE)
Biosurveillance
Information Retrieval
Te...
12
A Vision
for Health Care
13
eHealth & Health Information Exchange
Hospital A Hospital B
Clinic C
Government
Lab Patient at
Home
14
Goals of Health Information Exchange
• Deliver patient’s health information
across systems & settings
• To support high...
15
Achieving HIE
16
eHealth Components (WHO-ITU Model)
17
Standards: Why?
• The Large N Problem
N = 2, Interface = 1
# Interfaces = N(N-1)/2
N = 3, Interface = 3
N = 5, Interfac...
18
eHealth & Health Information Exchange
Hospital A Hospital B
Clinic C
Government
Lab Patient at
Home
19
Objectives
• Interoperability
• Inter-operable
systems
Ultimate Goals
• Continuity of Care
• Quality
 Safety
 Timelin...
20
Levels of Interoperability
Functional
Semantic
Syntactic
21
How Standards Support Interoperability
Technical Standards
(TCP/IP, encryption, security)
Exchange Standards
(HL7 v.2, ...
22
An Example: SNOMED CT
• A coded clinical terminology for use
in Electronic Health Records
• Currently maintained by IHT...
23
Concepts & Relationships in SNOMED CT
Source: http://ihtsdo.org/fileadmin/user_upload/Docs_01/Publications/SNOMED_CT/Sn...
24
Classification vs. Terminology
ICD-10
SNOMED
CT
25
In Real Life...
Patient
Care
Quality
of Care
Profession-
alism
ITPolicy
Limited
Time &
Resources
26
Patients Are Counting on Us...
Image Source: http://www.flickr.com/photos/childrensalliance/3191862260/
27
Summary
• Better information means quality of care
• Health IT helps clinicians care for patients
• Health Information ...
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Medical Information Exchange in ASEAN Countries: How To Achieve IT?

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Transcript of "Medical Information Exchange in ASEAN Countries: How To Achieve IT?"

  1. 1. 1 Nawanan Theera-Ampornpunt, M.D., Ph.D. Faculty of Medicine Ramathibodi Hospital Mahidol University October 8, 2013 Medical Information Exchange in ASEAN Countries: How to Achieve It? www.SlideShare.net/Nawanan
  2. 2. 2 Let’s Start with Something Simple
  3. 3. 3 What Clinicians Want? To treat & to care for their patients to their best abilities, given limited time & resources Image Source: http://en.wikipedia.org/wiki/File:Newborn_Examination_1967.jpg (Nevit Dilmen)
  4. 4. 4 High Quality Care • Safe • Timely • Effective • Efficient • Equitable • Patient-Centered Institute of Medicine, Committee on Quality of Health Care in America. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press; 2001. 337 p.
  5. 5. 5 Information is Everywhere in Medicine Shortliffe EH. Biomedical informatics in the education of physicians. JAMA. 2010 Sep 15;304(11):1227-8.
  6. 6. 6 Achieving Quality Care with Information • Safe – Drug allergies – Medication Reconciliation • Timely – Complete information at point of care • Effective – Better clinical decision-making Image Source: http://www.flickr.com/photos/childrensalliance/3191862260/
  7. 7. 7 Achieving Quality Care with Information • Efficient – Faster care – Time & cost savings – Reducing unnecessary tests • Equitable – Access to providers & knowledge • Patient-Centered – Empowerment & better self-care
  8. 8. 8 That’s Where Health IT Plays A Role...
  9. 9. 9 The Anatomy of Health IT Health  Information Technology Goal Value‐Add Means
  10. 10. 10 Various Forms of Health IT Hospital Information System (HIS) Computerized Provider Order Entry (CPOE) Electronic Health Records (EHRs) Picture Archiving and Communication System (PACS)
  11. 11. 11 Still Many Other Forms of Health IT m-Health Health Information Exchange (HIE) Biosurveillance Information Retrieval Telemedicine & Telehealth Personal Health Records (PHRs) Image Sources: Apple Inc., Geekzone.co.nz, Google, Microsoft, PubMed.gov, and American Telecare, Inc.
  12. 12. 12 A Vision for Health Care
  13. 13. 13 eHealth & Health Information Exchange Hospital A Hospital B Clinic C Government Lab Patient at Home
  14. 14. 14 Goals of Health Information Exchange • Deliver patient’s health information across systems & settings • To support high-quality health care delivery by providers • As well as facilitating other health care functions (patient’s access, reimbursements, public health operations, policy-making, education, research)
  15. 15. 15 Achieving HIE
  16. 16. 16 eHealth Components (WHO-ITU Model)
  17. 17. 17 Standards: Why? • The Large N Problem N = 2, Interface = 1 # Interfaces = N(N-1)/2 N = 3, Interface = 3 N = 5, Interface = 10 N = 100, Interface = 4,950
  18. 18. 18 eHealth & Health Information Exchange Hospital A Hospital B Clinic C Government Lab Patient at Home
  19. 19. 19 Objectives • Interoperability • Inter-operable systems Ultimate Goals • Continuity of Care • Quality  Safety  Timeliness  Effectiveness  Equity  Patient-Centeredness  Efficiency Why Health Information Standards?
  20. 20. 20 Levels of Interoperability Functional Semantic Syntactic
  21. 21. 21 How Standards Support Interoperability Technical Standards (TCP/IP, encryption, security) Exchange Standards (HL7 v.2, HL7 v.3 Messaging, HL7 CDA, DICOM) Vocabularies, Terminologies, Coding Systems (ICD-10, ICD-9, CPT, SNOMED CT, LOINC) Information Models (HL7 v.3 RIM, ASTM CCR, HL7 CCD) Standard Data Sets (12 & 18 Files) Functional Standards (HL7 EHR Functional Specifications) Some may be hybrid: e.g. HL7 v.3, HL7 CCD Unique ID (Provider, Facility, Patient) Functional Semantic Syntactic
  22. 22. 22 An Example: SNOMED CT • A coded clinical terminology for use in Electronic Health Records • Currently maintained by IHTSDO • Each concept has a code, a name (“term”) and relationships with other concepts
  23. 23. 23 Concepts & Relationships in SNOMED CT Source: http://ihtsdo.org/fileadmin/user_upload/Docs_01/Publications/SNOMED_CT/SnomedCt_Intro_20130418.pdf
  24. 24. 24 Classification vs. Terminology ICD-10 SNOMED CT
  25. 25. 25 In Real Life... Patient Care Quality of Care Profession- alism ITPolicy Limited Time & Resources
  26. 26. 26 Patients Are Counting on Us... Image Source: http://www.flickr.com/photos/childrensalliance/3191862260/
  27. 27. 27 Summary • Better information means quality of care • Health IT helps clinicians care for patients • Health Information Exchange (HIE) should be our shared VISION • Standards help us achieve HIE, and thus better care • There are many types of standards needed to achieve HIE, including SNOMED CT • Let’s walk together toward that common goal, for the benefits of patients and all stakeholders
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