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EHR in Ensuring Universal Healthcare

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Plenary presentation at the first EHR Summit of the UP Manila Medical Informatics Unit and the Philippine Medical Informatics Society, 10 Nov 2019. Philippine Heart Center.

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EHR in Ensuring Universal Healthcare

  1. 1. EHR in Ensuring UHC EHR Summit 2019 Iris Thiele Isip Tan MD, MSc Professor 3, UP College of Medicine Chief, UP Medical Informatics Unit Director, UP Interactive Learning Center
  2. 2. NOTHING TO DISCLOSE I give consent for the audience to tweet this talk and give me feedback (@endocrine_witch). Feel free take pictures of my slides (though the deck will be at www.slideshare.net/isiptan).
  3. 3. Role of EHR in UHC Case Study: Taiwan UHC Act Section 36
  4. 4. WHO (2010). Monitoring the Building Blocks of Health Systems: A Handbook of Indicators and their Measurement Strategies
  5. 5. Ingun P et al. WHO Technical Brief Series 2010
  6. 6. — Ingun P et al. WHO Technical Brief Series 2010 While UHC implementation may provide the political and financial impetus for implementing a NHIS, information from the NHIS assists with decision-making and assessment to improve accessibility, quality, and efficiency of the UHC. ” “
  7. 7. Building a Health Information Infrastructure Why electronic health records? by InfowayInfoRoute https://youtu.be/Lo_3qOejQzI
  8. 8. Ingun P et al. WHO Technical Brief Series 2010
  9. 9. — Hsieh, Chang-tseh (2010) "Electronic Medical Record System: Current Status and Its Use to Support Universal Healthcare System," Communications of the IIMA: Vol. 10: Iss. 3, Article 7. Although some hospitals and physician clinics have begun using HIT, the industry as a whole is still pessimistic toward the improvement and implementation of costly HIT functions such as electronic medical records (EMR) and their interoperability in current and future healthcare systems. ” “
  10. 10. Hsieh, Chang-tseh (2010) "Electronic Medical Record System: Current Status and Its Use to Support Universal Healthcare System," Communications of the IIMA: Vol. 10: Iss. 3, Article 7. ADMINISTRATIVE Influences to EMR Adoption Need to share comparable patient data among different sites within a multi-entity healthcare delivery system. 
 Need to improve clinical documentation to support appropriate billing service levels. 
 Requirement to contain or reduce healthcare delivery costs.
  11. 11. Hsieh, Chang-tseh (2010) "Electronic Medical Record System: Current Status and Its Use to Support Universal Healthcare System," Communications of the IIMA: Vol. 10: Iss. 3, Article 7. ADMINISTRATIVE Influences to EMR Adoption Need to establish a more efficient and effective information infrastructure as a 
 competitive advantage. 
 Need to meet the requirements of legal, regulatory, or accreditation standards. 

  12. 12. CLINICAL Influences to EMR Adoption Hsieh, Chang-tseh (2010) "Electronic Medical Record System: Current Status and Its Use to Support Universal Healthcare System," Communications of the IIMA: Vol. 10: Iss. 3, Article 7. Improve ability to share patient record information among healthcare practitioners and professionals within the enterprise. 
 Improve quality of care. 
 Improve clinical processes or workflow efficiency. 
 Improve clinical data capture.
  13. 13. CLINICAL Influences to EMR Adoption Hsieh, Chang-tseh (2010) "Electronic Medical Record System: Current Status and Its Use to Support Universal Healthcare System," Communications of the IIMA: Vol. 10: Iss. 3, Article 7. Reduce medical errors. 
 Provide access to patient records at remote locations. 
 Facilitate clinical decision support. 
 Improve employee/physician satisfaction. Improve patient satisfaction.
  14. 14. CLINICAL Influences to EMR Adoption Hsieh, Chang-tseh (2010) "Electronic Medical Record System: Current Status and Its Use to Support Universal Healthcare System," Communications of the IIMA: Vol. 10: Iss. 3, Article 7. Improve efficiency via pre-visit health assessments and post-visit patient education. 
 Support and integrate patient healthcare information from Web-based personal health 
 records. 

  15. 15. — Brailer, D., & Terasawa, E. (2003). Use and adoption of computer-based patient records. California HealthCare Foundation. http://www.chcf.org Overall, the barriers to electronic medical records adoption are large … The policy challenge in many ways is not to make the benefits of electronic medical records more compelling, but to make the barriers less challenging. ” “
  16. 16. Role of EHR in UHC Case Study: Taiwan UHC Act Section 36
  17. 17. Syed-Abdul S et al. Telemed J E Health. 2015 Sep;21(9):742-7. doi: 10.1089/tmj.2014.0189. Epub 2015 Apr 28.
  18. 18. https://www.csmonitor.com/USA/2009/1014/p25s04-usgn.html
  19. 19. Syed-Abdul S et al. Telemed J E Health. 2015 Sep;21(9):742-7. doi: 10.1089/tmj.2014.0189. Epub 2015 Apr 28.
  20. 20. Syed-Abdul S et al. Telemed J E Health. 2015 Sep;21(9):742-7. doi: 10.1089/tmj.2014.0189. Epub 2015 Apr 28. Adoption of HIT on a national scale - Involves both public and private health providers Supported heavily by implementation of an e-claims system to support administration of the national health insurance
  21. 21. Role of EHR in UHC Case Study: Taiwan UHC Act Section 36
  22. 22. Rule VIII. Governance & Accountablity Sec. 36.1 All health service providers and insurers are required to maintain a health information system on enterprise resource planning, human resource information system, electronic health records and electronic prescription log including electronic health commodities logistics management information, which shall electronically be uploaded on a regular basis through interoperable systems consistent with standards set by the DOH and Philhealth in consultation with the DICT and the NPC … RA 11223 Universal Healthcare Act
  23. 23. Rule VIII. Governance & Accountablity Sec. 36.2 The DOH and PhilHealth, in consultation with the DICT and NPC, shall issue detailed guidelines on the scope and standards of electronic health records, enterprise resource planning, human resource information system and electronic prescription log including electronic health commodities logistics management information, and maintenance of said health information system … RA 11223 Universal Healthcare Act
  24. 24. Rule VIII. Governance & Accountablity Sec. 36.3 The DOH and PhilHealth shall fund and engage providers, through appropriate mechanisms, to develop and upgrade information systems, which may be availed at no cost by health care providers and insurers. RA 11223 Universal Healthcare Act
  25. 25. Rule VIII. Governance & Accountablity Sec. 36.4 The DOH, PhilHealth, health service providers and insurers, shall ensure patient privacy and confidentiality in the maintenance of health information systems, in compliance with RA 10173 (Data Privacy Act). RA 11223 Universal Healthcare Act
  26. 26. RA 11223 Universal Healthcare Act Rule VIII. Governance & Accountablity Sec. 36.5 PhilHealth shall use its contracts to incentivize the incorporation of HIS, automation of clinical information, improvement of data quality, integration and use of telemedicine, and participation in regional or national health information networks.
  27. 27. Art 4. Sec 3.3 Program Educational Objectives With additional training, graduates of the MD program may pursue any of the following careers to include: • General medical practitioner • Clinical specialist • Researcher/Medical Scientist/Innovator • Health professions teacher • Health administrator • Health information manager • Health economist • Health policy maker CHED Memorandum Order 18 Series of 2016
  28. 28. Art 5. Sec 6.3 Minimum Curricular Content The minimum curricular content regardless of the curriculum design shall include the following: • Research, evidence-based medicine and medical informatics CHED Memorandum Order 18 Series of 2016
  29. 29. EHR in Ensuring UHC EHR Summit 2019 @endocrine_witch

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