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

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






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

    • 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 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 Image Source: http://en.wikipedia.org/wiki/File:Newborn_Examination_1967.jpg (Nevit Dilmen)
    • 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 Information is Everywhere in Medicine Shortliffe EH. Biomedical informatics in the education of physicians. JAMA. 2010 Sep 15;304(11):1227-8.
    • 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 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 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 Records (EHRs) Picture Archiving and Communication System (PACS)
    • 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 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-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 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, Interface = 10 N = 100, Interface = 4,950
    • 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  Timeliness  Effectiveness  Equity  Patient-Centeredness  Efficiency Why Health Information Standards?
    • 20 Levels of Interoperability Functional Semantic Syntactic
    • 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 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 Concepts & Relationships in SNOMED CT Source: http://ihtsdo.org/fileadmin/user_upload/Docs_01/Publications/SNOMED_CT/SnomedCt_Intro_20130418.pdf
    • 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 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