The impact of eHealth on Healthcare Professionals and Organisations: Health Information Management Systems in Modern Health Care
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The impact of eHealth on Healthcare Professionals and Organisations: Health Information Management Systems in Modern Health Care

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The impact of eHealth on Healthcare Professionals and Organisations: Health Information Management Systems in Modern Health Care. Shemer J. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

The impact of eHealth on Healthcare Professionals and Organisations: Health Information Management Systems in Modern Health Care. Shemer J. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

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The impact of eHealth on Healthcare Professionals and Organisations: Health Information Management Systems in Modern Health Care The impact of eHealth on Healthcare Professionals and Organisations: Health Information Management Systems in Modern Health Care Presentation Transcript

  • Health Information Management Systems in Modern Health Care Prof. Joshua Shemer ICTAHC – The Israeli Center for Technology Assessment in Health Care Barcelona, March 2010
  • The Israeli Health System – National Insurance Law • National Health Insurance Law based on principles of justice, equity & solidarity • Each citizen has the right receive a standardized basket of health services • Ministry of Health responsible for health services to be supplied by the 4 Health Care Organizations • 4 non-profit HMOs – Clalit, Maccabi, Meuhedet, Leumit • Payment - capitation basis
  • Maccabi Healthcare Services • Maccabi is the 2nd largest health fund in Israel • 1.8 million members • Over 3,500 physicians • Over 3,000 clinics • 152 branches • Functions within the framework & constraints of the National Health Insurance Law
  • Maccabi’s Vision • Achieve Total Health for its members • Provide integrative and personally-tailored health care for each member • Promotes excellence in the quality of medical care, knowledge and service
  • Budgetary Efficiency Processes - (“Piston” System) NIS 1,141M NIS 409M NIS 879M NIS 435M NIS1,579M NIS 430M 30% 24% 21% 9% 7% 9% Oversight Payment Purchasing Purchasing Increased Agreements Guidelines Policy Increased Guidelines efficiency efficiency Other Hospitals Admin. Physicians Diagnostics Drugs medical
  • Health Information Technology (HIT) • H.I.T. is a TOOL not a goal • The goal = OUTCOME
  • H.M.I.S. Targets (Organizational Level) Health Management Information Services • Decision processes based on qualitative information & knowledge • Continuity of medical data • Continuity of care - integration
  • H.M.I.S. Targets (Organizational Level) • Improvement & increasing efficiency of health care processes • Increasing clinical safety & quality • Better documentation • Better customer services
  • Rationale & Feasibility of H.I.T. in Maccabi • Equal access to medical records throughout the country • On-line diagnosis • Reliable diagnosis due to digital tools • Improved quality control & assurance • Archiving capabilities • Sharing information among physicians for treatment & consultation • Lower cost • Customer Relationship Management
  • Telemedicine in Maccabi Today • E-Laboratory • E-Prescription • Tele-Diagnosis • Tele-Ophthalmology • Tele-Consultation • Remote Monitoring of Chronic Patients • Medical Support by Call Center • Patient Online Web Site
  • Maccabi’s Integrated Information System INFRASTRUCTURE Doc. Clinic Members Members Members Members Doc. Clinic Internet Medical Firewall Control Extranet Pharmacy Main Computer Clinic Intranet Backup Admin Specialist Computer Control Consultant Payment CMR ERP Control IDC Paramedic IDC IDC Reimburse-ment Control Diagnostic Drug Labs Tele Web Mgmt. of Mgmt. of Mgmt. of Center consumptio control radiology Services Service the Fund Insured n control Providers People
  • Maccabi Central Medical Record Computerized Data Available for Patient Tracking & Followup Medical Family Demographic History History parameters Lab Visits & Results Hospitalization Imaging Medications Treatments
  • Health Value Added (HVA) HVA links between: clinical indicators & budget
  • Management Through Setting Strategic Objectives & Measuring Performance - Health Value Added (HVA) Perceived Quality of Quality Clinical Member Care Satisfaction Managing the Meeting Physician Organization in Budgetary Satisfaction order to Objectives achieve Total Health Organizational Employee Processes Satisfaction (Bureaucracy)
  • Perceived Quality (Member Satisfaction) • Overall satisfaction with health plan • Growth in the number of new members • Number of members that switch to a competing plan • Satisfaction with healthcare services • Satisfaction with administrative services
  • Fiscal Responsibility Expenditures in accordance with Budget:  Expenditures on Hospital Services  Expenditures on Physician Services  Expenditures on Medications  Overall expenditures
  • HVA Principles • Measurement at all levels of the organization:  National  Regional  Local Branch  Physician • Constructive Competition at each level
  • HVA – The Tool Quality indicators Diabetes Financial Members’ indicators satisfaction
  • HVA – The Results Mammography 2002-2009 Mammography 80 71 67.7 65.3 68.4 70 63.1 60 51.9 51.3 52.7 50 40 30 20 10 0 2002 2003 2004 2005 2006 2007 2008 2009
  • Pneumovax Vaccine among 65+ 2002-2009 Pneumovax 80 73.2 68.9 70 62.6 65.5 59.3 60 51.1 50 44.4 40 35.5 30 20 10 0 2002 2003 2004 2005 2006 2007 2008 2009
  • To sum up: Health Value Added (HVA) Promoting “total health” through quality-based strategic management utilizing integrated performance measurements
  • Cardiac Heart Failure Program Model of Chronic Health Care Management
  • Information System Flowchart Family doctor Regional CI HUB Center CI Call RF Center Patient Information * Blood pressure Systems * Pulse Maccabi Weight* Healthcare IPVPN Maccabi Patient’s home Technical support Information center System M4A M4A
  • In Conclusion • I.T. is a major tool to measure clinical outcomes and control budget • It needs strong infrastructure to broadly utilize data online • Provides continuity on database & information integration • Implementation of telemedicine is required both today & in the future e.g. Chronic Congestive Heart Failure Program • HVA model controls, assesses and measures medical performance within a balanced budget • I.T. is a strong management tool
  • THANK YOU