Presented to the Subcommittee on Science, Technology, Research and Innovation to Drive the Country of the Science, Technology, Research and Innovation Committee, The House of Representatives, Bangkok, Thailand on July 29, 2020
Presented at the Health Informatics and Health Information Technology Course, Doctor of Philosophy and Master of Science Programs in Data Science for Health Care (International Program), Faculty of Medicine Ramathibodi Hospital, Mahidol University on October 24, 2017
Presented at the Thai Medical Informatics Association Annual Conference and The National Conference on Medical Informatics (TMI-NCMedInfo 2016) on November 25, 2016.
Presented at the Thai Medical Informatics Association Annual Conference and The National Conference on Medical Informatics (TMI-NCMedInfo 2016) on November 25, 2016.
Presented at The Seventh National Conference on Medical Informatics and The Annual Meeting of the Thai Medical Informatics Association (TMI-NCMedInfo 2018), Bangkok, Thailand on November 23, 2018
Presented at The Fifth National Conference on Medical Informatics and The Annual Meeting of The Thai Medical informatics Association (TMI-NCMedInfo 2017) on November 24, 2017. Copyrighted by Boonchai Kijsanayotin, reproduced and shared with permission.
Presented at the Ramathibodi Hospital Administration School, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on November 19, 2018
Presented at the 11th Healthcare CIO Certificate Program, School of Hospital Management, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on March 24, 2021
Presented at the RACM 302 Community Medicine Course, Doctor of Philosophy Curriculum, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on December 3, 2018
Presented at the Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on December 4, 2017.
An introductory lecture for 3rd year medical students, (RACM302: Community Medicine), Faculty of Medicine Ramathibodi Hospital, Mahidol Univeristy, 2017.11.29
Health Information Exchange & Interoperability for Better Health Outcomes, an...Nawanan Theera-Ampornpunt
Presented at the Second Growing e-Health Expertise, Knowledge and Skills (GEEKS) Program, Department of Disease Control, Ministry of Public Health, Bangkok, Thailand on August 7, 2019
Presented to the Subcommittee on Science, Technology, Research and Innovation to Drive the Country of the Science, Technology, Research and Innovation Committee, The House of Representatives, Bangkok, Thailand on July 29, 2020
Presented at the Health Informatics and Health Information Technology Course, Doctor of Philosophy and Master of Science Programs in Data Science for Health Care (International Program), Faculty of Medicine Ramathibodi Hospital, Mahidol University on October 24, 2017
Presented at the Thai Medical Informatics Association Annual Conference and The National Conference on Medical Informatics (TMI-NCMedInfo 2016) on November 25, 2016.
Presented at the Thai Medical Informatics Association Annual Conference and The National Conference on Medical Informatics (TMI-NCMedInfo 2016) on November 25, 2016.
Presented at The Seventh National Conference on Medical Informatics and The Annual Meeting of the Thai Medical Informatics Association (TMI-NCMedInfo 2018), Bangkok, Thailand on November 23, 2018
Presented at The Fifth National Conference on Medical Informatics and The Annual Meeting of The Thai Medical informatics Association (TMI-NCMedInfo 2017) on November 24, 2017. Copyrighted by Boonchai Kijsanayotin, reproduced and shared with permission.
Presented at the Ramathibodi Hospital Administration School, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on November 19, 2018
Presented at the 11th Healthcare CIO Certificate Program, School of Hospital Management, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on March 24, 2021
Presented at the RACM 302 Community Medicine Course, Doctor of Philosophy Curriculum, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on December 3, 2018
Presented at the Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on December 4, 2017.
An introductory lecture for 3rd year medical students, (RACM302: Community Medicine), Faculty of Medicine Ramathibodi Hospital, Mahidol Univeristy, 2017.11.29
Health Information Exchange & Interoperability for Better Health Outcomes, an...Nawanan Theera-Ampornpunt
Presented at the Second Growing e-Health Expertise, Knowledge and Skills (GEEKS) Program, Department of Disease Control, Ministry of Public Health, Bangkok, Thailand on August 7, 2019
The Future of Thai Health Systems: Healthcare Quality Management and Control ...Borwornsom Leerapan
Panel discussion on the future of Thai health systems: healthcare quality management and control according to the Statute on the National Health System B.E. 2552
สถานการณ์ระบบบริการสุขภาพและการควบคุมคุณภาพตามธรรมนูญว่าด้วยระบบสุขภาพแห่งชาติ พ.ศ. 2552", การอภิปราย “อนาคตระบบสุขภาพไทย สุขภาพคนไทยดีขึ้นหรือแย่ลง”, ประชุมวิชาการ การวิจัยระบบสาธารณสุข ครั้งที่ 3
Presented at the Executive Breakfast Forum EP.4 : The Future of Healthcare is Data, Digital User Group Association, Bangkok, Thailand on March 10, 2021
Presented at the Life Sci. Level Up Challenge 2020, a Project to Promote and Incubate New Medical and Health Technology Researchers and Startups Promot 2020 by Thailand Center of Excellence for Life Sciences (Public Organization) (TCELS) and Srinakharinwirot University, Ministry of Higher Education, Science, Research and Innovation, Bangkok, Thailand on August 1, 2020.
An introductory lecture for 3rd year medical students, (RACM302: Community Medicine), Faculty of Medicine Ramathibodi Hospital, Mahidol Univeristy, 2017.11.28
Presented at the BDMS Golden Jubilee Scientific Conference 2022 "BDMS Beyond 50 years: Looking towards the centennial," Bangkok Dusit Medical Services Public Company Limited (BDMS), Bangkok, Thailand on October 19, 2022
Presented at The Thai Medical Informatics Association Annual Conference and The National Conference on Medical Informatics (TMI-NCMedInfo) 2021, Bangkok, Thailand on November 26, 2021
Presented at the Master of Science Program in Medical Epidemiology and the Doctor of Philosophy Program in Clinical Epidemiology, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on November 25, 2021
Presented at the Master of Science and Doctor of Philosophy Programs in Data Science for Healthcare and Clinical Informatics, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on November 15, 2021
Consumer Health Informatics, Mobile Health, and Social Media for Health: Part...Nawanan Theera-Ampornpunt
Presented at the Master of Science and Doctor of Philosophy Programs in Data Science for Healthcare and Clinical Informatics, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on November 10, 2021
Consumer Health Informatics, Mobile Health, and Social Media for Health: Part...Nawanan Theera-Ampornpunt
Presented at the Master of Science and Doctor of Philosophy Programs in Data Science for Healthcare and Clinical Informatics, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on November 10, 2021
Presented at the Master of Science and Doctor of Philosophy Programs in Data Science for Healthcare and Clinical Informatics, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on November 8, 2021
26. 26
• “Don’t implement technology just for
technology’s sake.”
• “Don’t make use of excellent technology.
Make excellent use of technology.”
(Tangwongsan, Supachai. Personal communication, 2005.)
• “Health care IT is not a panacea for all that ails
medicine.” (Hersh, 2004)
Some “Smart” Quotes
34. 34
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)
What Clinicians Want
36. 36
A safe, effective care that
focus on us, the patients,
and our needs
What Patients Want
37. 37
• Safe (ปลอดภัย)
• Timely (ทันเวลา)
• Effective (มีประสิทธิผล)
• Patient-Centered
(ยึดผู้ป่วยเป็นศูนย์กลาง)
• Efficient (มีประสิทธิภาพ)
• Equitable (เป็นธรรม)
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.
Quality of Care
41. 41
• Safe
–Drug allergies
–Medication Reconciliation
• Timely
–Complete information at point of care
• Effective
–Better clinical decision-making
Being “Smart” in Healthcare
42. 42
• Patient-Centered
–Empowerment & better self-care
• Efficient
–Faster care
–Time & cost savings
–Reducing unnecessary tests
• Equitable
–Access to providers & knowledge
Being “Smart” in Healthcare
43. 43
• Guideline adherence
• Better documentation
• Practitioner decision making or
process of care
• Medication safety
• Patient surveillance & monitoring
• Patient education/reminder
Documented Values of Health IT
46. 46
Hospital Information System (HIS) Computerized Physician Order Entry (CPOE)
Electronic
Health
Records
(EHRs)
Picture Archiving and
Communication System
(PACS)
Various Forms of Health IT
57. 57
Electronic Health Records (EHRs) &
Electronic Medical Records (EMRs)
Hersh (2009)
• EMRs: “Computerized health records of an individual”
• EHRs: “Longitudinal collection of computerized
health information about a patient”
Emphasis in the definitions added by the presenter.
58. 58
Electronic Health Records (EHRs) &
Electronic Medical Records (EMRs)
The National Alliance for Health Information
Technology (Report to ONC in 2008)
• EMR: “An electronic record of health-related
information on an individual that can be created,
gathered, managed, and consulted by authorized
clinicians and staff within one health care organization”
Emphasis in the definitions added by the presenter.
59. 59
Electronic Health Records (EHRs) &
Electronic Medical Records (EMRs)
The National Alliance for Health Information
Technology (Report to ONC in 2008)
• EHR: “An electronic record of health-related
information on an individual that conforms to
nationally recognized interoperability standards and
that can be created, gathered, managed, and
consulted by authorized clinicians and staff across
more than one health care organization”
Emphasis in the definitions added by the presenter.
60. 60
Personal Health Records (PHRs)
The National Alliance for Health Information
Technology (Report to ONC in 2008)
• PHR: “An electronic record of health-related
information on an individual that conforms to
nationally recognized interoperability standards and
that can be drawn from multiple sources while being
managed, shared, and controlled by the individual”
Emphasis in the definitions added by the presenter.
61. 61
Personal Health Records (PHRs)
Hersh (2009)
• PHR: “Patient-controlled aspect of the health record, which
may or may not be tethered to one or more EHRs from
health care delivery organizations”
Markle Foundation’s Connecting for Health (2003)
• PHR: “An electronic application through which individuals
can access, manage and share their health information, and
that of others for whom they are authorized, in a private,
secure, and confidential environment”
Emphasis in the definitions added by the presenter.
62. 62
Personal Health Records (PHRs)
Tang et al. (2006)
• PHR: “A PHR includes health information managed by
the individual”
• “...Contrasted with the clinician’s record of patient
encounter-related information (a paperchart or
EHR...), which is managed by the clinician and/or
health care institution”
Emphasis in the definitions added by the presenter.
65. 65
Health Information Exchange
The National Alliance for Health Information Technology
(Report to ONC in 2008)
• HIE: “The electronic movement of health-related
information among organizations according to nationally
recognized standards”
Hersh (2009)
• HIE: “The exchange of health information for patient care
across traditional business boundaries in health care”
Emphasis in the definitions added by the presenter.
66. 66
EMRs, EHRs, PHRs & HIE
Electronic Medical Records (EMRs) (เวชระเบียนอิเล็กทรอนิกส์)
Electronic Health Records (EHRs) (ระเบียนสุขภาพอิเล็กทรอนิกส์)
เวชระเบียนที่มีข้อมูลประวัติสุขภาพของผู้ป่วยในรูปแบบอิเล็กทรอนิกส์
ที่สถานพยาบาลเก็บบันทึกและใช้ในการดูแลผู้ป่วย ซึ่งมีประวัติผู้ป่วยในระยะยาว
Personal Health Records (PHRs) (ระเบียนสุขภาพส่วนบุคคล)
ข้อมูลสุขภาพของผู้ป่วยในรูปแบบอิเล็กทรอนิกส์ ที่ผู้ป่วยเข้าถึงได้ และผู้ป่วย
สามารถควบคุมดูแล จัดการ และแลกเปลี่ยนข้อมูลกับผู้อื่นได้
ไม่ว่าจะมีแหล่งที่มาจากข้อมูลในระบบสารสนเทศ (EHRs) ของสถานพยาบาล
โดยตรง ข้อมูลจากการบันทึกของผู้ป่วยเอง หรือจากแหล่งอื่นก็ตาม
ทั้งนี้ รวมถึงกรณีที่ผู้แทนโดยชอบธรรมเป็นผู้ใช้งานแทนผู้ป่วยด้วย
เสนอความหมายโดย นพ.นวนรรน ธีระอัมพรพันธุ์ เพื่อประโยชน์ในการขับเคลื่อนงานด้าน eHealth ของกระทรวงสาธารณสุข
67. 67
EMRs, EHRs, PHRs & HIE
Health Information Exchange (HIE)
(การแลกเปลี่ยนข้อมูลสุขภาพระหว่างหน่วยงาน)
การแลกเปลี่ยนข้อมูลสุขภาพของผู้ป่วยระหว่างหน่วยงานในระบบ
สุขภาพ (เช่น ระหว่างสถานพยาบาลด้วยกัน หรือระหว่าง
สถานพยาบาลกับหน่วยงานที่กากับดูแล) เพื่อการดูแลผู้ป่วยและการ
จัดการระบบสุขภาพ
เสนอความหมายโดย นพ.นวนรรน ธีระอัมพรพันธุ์ เพื่อประโยชน์ในการขับเคลื่อนงานด้าน eHealth ของกระทรวงสาธารณสุข
76. 76
• The Large N Interfaces Problem
N = 2, Interface = 1
# Interfaces = N(N-1)/2
N = 3, Interface = 3
N = 5, Interface = 10
N = 100, Interface = 4,950
Standards: Why?
77. 77
นวนรรน ธีระอัมพรพันธุ์. ตำนำนควำมเชื่อและข้อเท็จจริงเกี่ยวกับมำตรฐำนสำรสนเทศทำงสุขภำพ. ใน: Health
Data Standards Expo: From Reimbursement to Clinical Excellence; 2011 Aug 8-9; Bangkok,
Thailand. Bangkok (Thailand): Mahidol University, Faculty of Medicine Ramathibodi Hospital;
2011 Aug.
http://www.slideshare.net/nawanan/myths-and-truths-on-health-information-standards
Myths and Truths on Standards
78. 78
Myths
• We don’t need standards
• Standards are IT people’s jobs
• We should exclude vendors from this
• We need the same software to share data
• We need to always adopt international standards
• We need to always use local standards
Theera-Ampornpunt (2011)
Myths and Truths on Standards
79. 79
Tip #4: Go for Systems that
Use Standards, Not a Unified,
Conquer-the-World System
Image Source: http://www.denofgeek.com/movies/avengers/37236/why-loki-was-cut-from-avengers-age-of-ultron
84. 84
จับตาดู...
• การปฏิรูปของรัฐบาล: โครงการ PHRs (HIE?), Long Term
Care, หมอครอบครัว
• การผลักดัน eHealth Strategy ระดับชาติ
• นโยบาย Digital Economy ของรัฐบาล
• ภัยคุกคามด้าน privacy ใน healthcare ไทย
85. 85
Calling All Dreamers...
Toward Healthcare 4.0 & “ATM in Healthcare”
“Dreamers need to stick together...
It's not programming, it's personal.”
-- Tomorrowland
86. 86
References
• Connecting for Health. The personal health working group final report [Internet]. New York:
The Markle Foundation; 2003 Jul 1 [cited 2016 Mar 6]. 58 p. Available from:
http://www.markle.org/sites/default/files/final_phwg_report1.pdf
• Hersh W. A stimulus to define informatics and health information technology. BMC Med
Inform Decis Mak. 2009 May 15;9:24.
• Kaelber DC, Jha AK, Johnston D, Middleton B, Bates DW. A research agenda for personal
health records (PHRs). J Am Med Inform Assoc. 2008 Nov-Dec;15(6):729-36.
• Tang PC, Ash JS, Bates DW, Overhage JM, Sands DZ. Personal health records: definitions,
benefits, and strategies for overcoming barriers to adoption. J Am Med Inform Assoc. 2006
Mar-Apr;13(2):121-6.
• The National Alliance for Health Information Technology report to the Office of the National
Coordinator for Health Information Technology on defining key health information
technology terms [Internet]. Bethesda (MD): The National Alliance for Health Information
Technology; 2008 Apr 28 [cited 2016 Mar 6]. 40 p. Available from:
https://www.nachc.com/client/Key%20HIT%20Terms%20Definitions%20Final_April_2008.pdf