The health care industry consists of sectors that provide medical services to treat patients. It is one of the largest industries worldwide, consuming over 10% of GDP in developed nations. The industry is divided into areas like hospitals, medical practices, and other human health services. It is further divided into health care equipment and services, and pharmaceuticals and biotechnology. The health care industry has unique characteristics like intangibility, perishability, and inseparability of services. The 7Ps of marketing - product, place, promotion, price, people, process, and physical evidence - are important factors for health care industry marketing.
The document provides an overview of different frameworks for conceptualizing health systems. It describes the World Health Organization's definition of a health system as including all organizations, people, and actions aimed at promoting, restoring, or maintaining health. It also outlines WHO's six building blocks of a health system: service delivery, health workforce, information, medical products/vaccines/technology, financing, and governance. Additionally, it summarizes key components of health systems from the perspectives of the World Bank, including financing, payment, organization of service delivery, regulation, persuasion, politics, ethics, and values.
This document discusses the key components and factors influencing health care systems. It outlines that health care systems aim to promote, restore, and maintain health for populations. The document then discusses the historical development of health care, from only being accessible to the wealthy to reforms that aimed to provide services to wider groups. Modern health care systems reflect the values of their societies, and are influenced by changing disease patterns, demographics, technology advances, and government policies. The quality of health care systems can be evaluated based on criteria like effectiveness, efficiency, accessibility, and equity of services provided.
A hospital is a residential establishment which provides short term and long term medical care consisting of observational , diagnostic , therapeutic and rehabilitative services for persons suffering or suspected to be suffering from a disease or injury and for parturients . It may or may not also provide services for ambulatory patients or an out patient basis.
Hospitals are classified into primary, secondary and tertiary based on bed capacity.
Primary hospital
Primary hospital is typically a hospital that contains less than 100 beds They are tasked withproviding preventive care, minimal health care and rehabilitation services.
They are a basic level of contact between individuals and families with the healthy system
They include general practitioners, family physicians and physiotherapist .The basic services provided by them are immunization, maternal and child health services, curative care services and prevention of diseases are provided by PHC.
The staff in PHC includes a medical officer, a staff nurse and paramedical support staff
2. Secondary hospital
Secondary hospitals are preferred with a medium size city, country or district and contain more than 100 beds but less than 500.
They are responsible for providing complete health services and medical education and also conduct research on regional basis.
These hospitals include cardiologists, urologists, dermatologists and other such specialists. The services are provided by medical specialists.
The services include acute care, short period stay in hospital emergency department for brief but serious illness.
There may be providers who remain in contact but do not work in hospitals such as psychiatrists, physiotherapists, respiratory therapists etc.
District hospitals and community health centres at the block level are the examples of secondary hospitals
3) Tertiary hospitals
These are comprehensive or general hospitals of the city at national or provincial level with the bed capacity exceeding 500.
They are responsible for providing specialist health services and play a vital role with regard to medical education and scientific research and they also serve as a medical hub providing care to multiple regions.
The Patients are admitted into these centres on a referral from primary or secondary health professionals.
They offer personnel facility as well as facilities for advanced medical investigation and treatment.
They provide advanced diagnostic support services, specialized intensive care and special services such as neurosurgery, cancer management, cardiac surgery etc that cannot be provided by primary and secondary health centres.
The examples of tertiary hospitals include 3 medical colleges and advanced medical research institutes.
The document discusses the changing role of hospitals. It notes that hospitals are evolving within a new framework of healthcare management in response to internal and external changes. Some of the challenges hospitals face include uncertainties around future patient needs due to an aging population and the progression of chronic diseases. Hospitals also have to balance emergency care with planned management of patients. The role of hospitals is gradually shifting from cure-focused to more emphasis on healthcare, community care, prevention, and public health. The changing role requires hospital management approaches to also adapt.
As a hospital administrator, their roles include planning, organizing, staffing, directing, controlling, and coordinating hospital management functions. The goal of all administrators is to maximize output through productivity and efficiency. Productivity is measured as output over input, and can be increased by boosting output while maintaining or decreasing inputs. Effectiveness means achieving objectives by focusing on outputs and outcomes. Efficiency means achieving objectives with the least amount of resources. Hospital administrators must balance roles related to patients, the hospital organization, and the surrounding community.
The health care industry consists of sectors that provide medical services to treat patients. It is one of the largest industries worldwide, consuming over 10% of GDP in developed nations. The industry is divided into areas like hospitals, medical practices, and other human health services. It is further divided into health care equipment and services, and pharmaceuticals and biotechnology. The health care industry has unique characteristics like intangibility, perishability, and inseparability of services. The 7Ps of marketing - product, place, promotion, price, people, process, and physical evidence - are important factors for health care industry marketing.
The document provides an overview of different frameworks for conceptualizing health systems. It describes the World Health Organization's definition of a health system as including all organizations, people, and actions aimed at promoting, restoring, or maintaining health. It also outlines WHO's six building blocks of a health system: service delivery, health workforce, information, medical products/vaccines/technology, financing, and governance. Additionally, it summarizes key components of health systems from the perspectives of the World Bank, including financing, payment, organization of service delivery, regulation, persuasion, politics, ethics, and values.
This document discusses the key components and factors influencing health care systems. It outlines that health care systems aim to promote, restore, and maintain health for populations. The document then discusses the historical development of health care, from only being accessible to the wealthy to reforms that aimed to provide services to wider groups. Modern health care systems reflect the values of their societies, and are influenced by changing disease patterns, demographics, technology advances, and government policies. The quality of health care systems can be evaluated based on criteria like effectiveness, efficiency, accessibility, and equity of services provided.
A hospital is a residential establishment which provides short term and long term medical care consisting of observational , diagnostic , therapeutic and rehabilitative services for persons suffering or suspected to be suffering from a disease or injury and for parturients . It may or may not also provide services for ambulatory patients or an out patient basis.
Hospitals are classified into primary, secondary and tertiary based on bed capacity.
Primary hospital
Primary hospital is typically a hospital that contains less than 100 beds They are tasked withproviding preventive care, minimal health care and rehabilitation services.
They are a basic level of contact between individuals and families with the healthy system
They include general practitioners, family physicians and physiotherapist .The basic services provided by them are immunization, maternal and child health services, curative care services and prevention of diseases are provided by PHC.
The staff in PHC includes a medical officer, a staff nurse and paramedical support staff
2. Secondary hospital
Secondary hospitals are preferred with a medium size city, country or district and contain more than 100 beds but less than 500.
They are responsible for providing complete health services and medical education and also conduct research on regional basis.
These hospitals include cardiologists, urologists, dermatologists and other such specialists. The services are provided by medical specialists.
The services include acute care, short period stay in hospital emergency department for brief but serious illness.
There may be providers who remain in contact but do not work in hospitals such as psychiatrists, physiotherapists, respiratory therapists etc.
District hospitals and community health centres at the block level are the examples of secondary hospitals
3) Tertiary hospitals
These are comprehensive or general hospitals of the city at national or provincial level with the bed capacity exceeding 500.
They are responsible for providing specialist health services and play a vital role with regard to medical education and scientific research and they also serve as a medical hub providing care to multiple regions.
The Patients are admitted into these centres on a referral from primary or secondary health professionals.
They offer personnel facility as well as facilities for advanced medical investigation and treatment.
They provide advanced diagnostic support services, specialized intensive care and special services such as neurosurgery, cancer management, cardiac surgery etc that cannot be provided by primary and secondary health centres.
The examples of tertiary hospitals include 3 medical colleges and advanced medical research institutes.
The document discusses the changing role of hospitals. It notes that hospitals are evolving within a new framework of healthcare management in response to internal and external changes. Some of the challenges hospitals face include uncertainties around future patient needs due to an aging population and the progression of chronic diseases. Hospitals also have to balance emergency care with planned management of patients. The role of hospitals is gradually shifting from cure-focused to more emphasis on healthcare, community care, prevention, and public health. The changing role requires hospital management approaches to also adapt.
As a hospital administrator, their roles include planning, organizing, staffing, directing, controlling, and coordinating hospital management functions. The goal of all administrators is to maximize output through productivity and efficiency. Productivity is measured as output over input, and can be increased by boosting output while maintaining or decreasing inputs. Effectiveness means achieving objectives by focusing on outputs and outcomes. Efficiency means achieving objectives with the least amount of resources. Hospital administrators must balance roles related to patients, the hospital organization, and the surrounding community.
This document provides a literature review on studies related to the service quality of public and private sector hospitals. It summarizes 25 studies conducted between 2004-2013 that evaluated patient perceptions and assessments of various dimensions of hospital service quality in India. The studies examined factors like infrastructure, personnel quality, clinical care processes, communication, and relationships that influence patient satisfaction. Some findings indicated private hospitals performed better than public hospitals in most quality dimensions except reliability. The review concludes that further research is needed evaluating service quality in the understudied regions of Indore and Ujjain cities in Madhya Pradesh, India.
Outsourcing Non-clinical Services in Public Hospitals: Achievements and Lesso...HFG Project
The document discusses outsourcing of non-clinical services in public hospitals in Ethiopia. It provides background on the health care financing reforms that introduced outsourcing. The key achievements are that 127 of Ethiopia's 280 hospitals have outsourced at least one non-clinical service like catering, cleaning, or security. Outsourcing has improved service quality while reducing costs. It has also increased employment and reduced the administrative burden on hospitals. The document analyzes the experiences of three hospitals that have outsourced multiple services.
Definition of Hospital by W.H.O.
History Of Hospital Development.
Factors Responsible For Development Of Hospitals.
Classification of Hospitals.
Function Of Hospitals.
Factor Affecting Distribution Of Beds.
Factors Influencing Hospital Utilization.
Administration.
Role of Administrator.
Management.
Scaler Principle.
Person reporting directly to Administrator.
The document proposes restructuring the Malaysian health system to create a unified public-private integrated health system called "1Care". Key elements of the proposed model include:
1) Universal coverage through 1Care which integrates public and private providers and services.
2) Autonomous healthcare regions and providers with more flexibility in management and performance-based payments.
3) Shift to primary care-centered system with registered primary care providers acting as gatekeepers and referrers to hospitals.
4) Harmonization of public and private human resources and incentives to address shortages and performance.
Hospitals can be classified in several ways:
1. By clinical basis such as type of patients treated (e.g. medicine, surgery, maternity).
2. By ownership (e.g. government, private trusts, religious organizations).
3. By size based on number of beds (e.g. large over 1000 beds, medium 500-1000 beds, small 100-500 beds).
4. By cost (e.g. elite/luxury hospitals with high room rates vs. budget/charitable hospitals).
5. By medical system practiced (e.g. allopathic, ayurvedic, homeopathic, unani).
The document discusses the rise of private sector participation in healthcare in India and the need for professionally trained hospital administrators. It notes an increasing demand for healthcare services, willingness to pay for services, and an entrepreneurial spirit has led to growth in the healthcare industry. However, there is currently not a large enough pool of trained hospital administrators. The document proposes strategies for developing this skills market, including promotion programs and creating administrator positions and acceptance of their roles in hospitals.
- The public healthcare sector dominates in Malaysia, with over 80% of the population preferring public hospitals for major ailments due to lower costs. However, private healthcare has seen slow growth, with only a 0.8% increase in hospitals and 3.7% increase in beds.
- Private hospitals have seen a 10% drop in inpatient admissions since the imposition of GST, while public hospitals saw a 25% increase. Private healthcare also faces pressures from a stronger currency and increasing medical costs.
- The Malaysian government has a large stake in major private healthcare conglomerates, controlling over 40% of private hospital beds. It aims to increase financing of healthcare through partnerships and investments, but this risks
The document summarizes the Malaysian health care system. It describes that the system is centralized with the Ministry of Health overseeing public health programs, medical services, dental services, pharmacy programs, and management. It provides statistics on life expectancy and leading causes of death. It outlines the organization of the Ministry of Health and flow of resources from the federal government to states. It also summarizes some of the key programs and activities under the 9th and 10th Malaysia Plans.
The document discusses several aspects of healthcare administration including the roles and responsibilities of healthcare administrators. It describes how healthcare administrators work to evaluate health problems, acquire health resources, and implement information technology systems and clinical functions to manage day-to-day operations within the healthcare industry. The goal is to improve individual wellbeing and community health by following best practices, collecting problems, providing solutions, and involving the community. Healthcare administration aims to improve processes, standards of care, and protect medical records through leadership and management.
Hospital services can be classified in various ways. They include clinical management, patient encounters, treatment, pharmacy, and social work as direct clinical services. Support services that indirectly contribute to patient care include auxiliary services like housekeeping and maintenance. Support services also facilitate the effective accomplishment of therapeutic, diagnostic, administrative, and informational services, which together aim to provide satisfactory patient care through the collective activities of all hospital departments and personnel.
This document discusses hospitals as systems. It begins by classifying hospitals according to directory, ownership, bed size, nature, and medical system. It then describes the different types of hospitals according to these classifications. The document outlines the key functions and departments of hospitals, including outpatient, inpatient, intensive care, emergency, day care, and operating theaters. It discusses the organizational structure and process flows within hospitals to deliver clinical services and achieve their overall objectives of providing healthcare.
This document provides an overview of the nurse's role in the healthcare system. It defines key terms like nursing, nurse, and nursing practice. It describes the philosophy of nursing as respecting patient dignity and treating each person as an individual. The nurse's roles include caregiving, advocacy, education, research, and management. Healthcare is organized at national, hospital, and community levels. Hospitals are organized into levels that provide different services. Community health involves health centers, posts, and organizations that work together to promote health. The nurse collaborates as part of a multidisciplinary team that includes doctors, pharmacists, and others to provide comprehensive patient care.
This document provides an overview of hospitals and the healthcare delivery system. It discusses the evolution of hospitals from places where people went to die to modern multiservice institutions. Hospitals are classified by type, ownership, size and services provided. Trends include consolidation, outpatient care replacing inpatient care, and increased partnerships between hospitals and other providers. Challenges include rising costs, physician decision making, and ensuring access to care.
1. The document defines stakeholders in the health care system as entities that affect or are affected by organizational actions. It identifies key stakeholders as government, health care providers, the public, hospital administrators, NGOs, and health insurance providers.
2. The roles and responsibilities of these stakeholders are described. The government oversees policy, funding, and administration of health services at central, state, and district levels. Health care providers deliver services. The public are beneficiaries of care. Hospital administrators and boards manage operations. NGOs supplement government work. Insurers provide coverage.
3. Effective stakeholder management involves identifying and classifying stakeholder relationships, formulating strategies, and evaluating outcomes. Stakeholder analysis
This is a presentation on the Health care and hospital management.The topic cover on this presentation is Introduction of health, Health Care provider, Components of healthcare delivery system, Levels of health care, Rural Health care system in India, Hospital management system, Type, Introduction of automation management, Problem definition, Advantages of computerized hospital management system, Requirement specification, User interface, Screen shorts of software etc.
Overview of Hospital and Clinic in the PhilippinesKyla De Chavez
Hospitals provide inpatient care and have medical staff that operate 24/7. They are funded through various sources and their primary task is providing short-term care for people with health issues. Hospitals offer services like emergency care, surgery, and testing. Clinics provide outpatient care and are smaller than hospitals. Both have various departments to care for different health needs. Hospitals are classified by ownership, either government or private, and by scope of services from general to specialized levels of care.
Organizational Structure Of A Hospital[1]jawadorak
The organizational structure of a hospital facilitates efficient management by establishing lines of authority and accountability. Larger hospitals have more complex structures than smaller facilities. Hospital departments are generally grouped into administration services, informational services, therapeutic services, diagnostic services, and support services. Administration oversees budgets, policies and public relations. Informational services handle admissions, billing, records and technology. Therapeutic services provide treatment. Diagnostic services determine causes of illness or injury. Support services maintain supplies and the facility. Understanding the organizational chart helps navigate a hospital's departments and staff.
The document discusses comprehensive primary health care in India. It proposes making primary care universal, free, and accessible close to where people live. This would include a more comprehensive package of services addressing both communicable and non-communicable diseases. Village committees would help ensure no one is excluded and services address local health priorities. Community monitoring would provide feedback on equity and quality. Comprehensive primary health care would reduce costs and the need for higher-level care compared to the selective primary care of the past.
Major stake holder in health care delivery system IndiaMandeep Gill
The document discusses major stakeholders in the health care delivery system in India. It begins by defining stakeholders as individuals or groups that affect or are affected by organizational actions. It then outlines various types of stakeholders, including primary and secondary stakeholders, external, interface, and internal stakeholders.
Major stakeholders in the Indian health care system are identified as: the government at central and state levels; the public; health care providers including community and hospital professionals; hospital administrators and governing boards; and non-governmental organizations. The relationships between these stakeholders and health care organizations are analyzed. Strategies for managing different types of stakeholder relationships are also presented.
Michael Samuelson, Keynote,Wellness at Work Conference, June 14, 2010Delaware State Chamber
This document discusses wellness and primary prevention as the keystone to transforming healthcare. It outlines that the current healthcare system focuses more on sickness and disease management rather than prevention. A shift needs to occur towards prioritizing health promotion and preventing disease. This will help lower costs by compressing morbidity. A social contract is proposed where society provides access to healthcare and supports prevention, while individuals make healthy choices and get recommended screenings. A five step strategic approach is presented for organizations to organize employees by health risk and implement wellness programs.
Michael Samuelson, Keynote,Wellness at Work Conference, June 14, 2010Delaware State Chamber
This document discusses wellness and primary prevention as the keystone to transforming healthcare. It outlines that the current healthcare system focuses more on sickness and disease management rather than prevention. A shift needs to occur towards prioritizing health promotion and preventing disease to lower costs. A five step strategic approach is proposed: 1) Organize the population by risk level, 2) Conduct a corporate health audit, 3) Adjust corporate culture, 4) Implement programs to keep low risk low and move high risk lower, 5) Evaluate, update and maintain programs. The document argues that wellness is not just an individual responsibility but a shared social contract between society and individuals with both rewards and penalties.
This document provides a literature review on studies related to the service quality of public and private sector hospitals. It summarizes 25 studies conducted between 2004-2013 that evaluated patient perceptions and assessments of various dimensions of hospital service quality in India. The studies examined factors like infrastructure, personnel quality, clinical care processes, communication, and relationships that influence patient satisfaction. Some findings indicated private hospitals performed better than public hospitals in most quality dimensions except reliability. The review concludes that further research is needed evaluating service quality in the understudied regions of Indore and Ujjain cities in Madhya Pradesh, India.
Outsourcing Non-clinical Services in Public Hospitals: Achievements and Lesso...HFG Project
The document discusses outsourcing of non-clinical services in public hospitals in Ethiopia. It provides background on the health care financing reforms that introduced outsourcing. The key achievements are that 127 of Ethiopia's 280 hospitals have outsourced at least one non-clinical service like catering, cleaning, or security. Outsourcing has improved service quality while reducing costs. It has also increased employment and reduced the administrative burden on hospitals. The document analyzes the experiences of three hospitals that have outsourced multiple services.
Definition of Hospital by W.H.O.
History Of Hospital Development.
Factors Responsible For Development Of Hospitals.
Classification of Hospitals.
Function Of Hospitals.
Factor Affecting Distribution Of Beds.
Factors Influencing Hospital Utilization.
Administration.
Role of Administrator.
Management.
Scaler Principle.
Person reporting directly to Administrator.
The document proposes restructuring the Malaysian health system to create a unified public-private integrated health system called "1Care". Key elements of the proposed model include:
1) Universal coverage through 1Care which integrates public and private providers and services.
2) Autonomous healthcare regions and providers with more flexibility in management and performance-based payments.
3) Shift to primary care-centered system with registered primary care providers acting as gatekeepers and referrers to hospitals.
4) Harmonization of public and private human resources and incentives to address shortages and performance.
Hospitals can be classified in several ways:
1. By clinical basis such as type of patients treated (e.g. medicine, surgery, maternity).
2. By ownership (e.g. government, private trusts, religious organizations).
3. By size based on number of beds (e.g. large over 1000 beds, medium 500-1000 beds, small 100-500 beds).
4. By cost (e.g. elite/luxury hospitals with high room rates vs. budget/charitable hospitals).
5. By medical system practiced (e.g. allopathic, ayurvedic, homeopathic, unani).
The document discusses the rise of private sector participation in healthcare in India and the need for professionally trained hospital administrators. It notes an increasing demand for healthcare services, willingness to pay for services, and an entrepreneurial spirit has led to growth in the healthcare industry. However, there is currently not a large enough pool of trained hospital administrators. The document proposes strategies for developing this skills market, including promotion programs and creating administrator positions and acceptance of their roles in hospitals.
- The public healthcare sector dominates in Malaysia, with over 80% of the population preferring public hospitals for major ailments due to lower costs. However, private healthcare has seen slow growth, with only a 0.8% increase in hospitals and 3.7% increase in beds.
- Private hospitals have seen a 10% drop in inpatient admissions since the imposition of GST, while public hospitals saw a 25% increase. Private healthcare also faces pressures from a stronger currency and increasing medical costs.
- The Malaysian government has a large stake in major private healthcare conglomerates, controlling over 40% of private hospital beds. It aims to increase financing of healthcare through partnerships and investments, but this risks
The document summarizes the Malaysian health care system. It describes that the system is centralized with the Ministry of Health overseeing public health programs, medical services, dental services, pharmacy programs, and management. It provides statistics on life expectancy and leading causes of death. It outlines the organization of the Ministry of Health and flow of resources from the federal government to states. It also summarizes some of the key programs and activities under the 9th and 10th Malaysia Plans.
The document discusses several aspects of healthcare administration including the roles and responsibilities of healthcare administrators. It describes how healthcare administrators work to evaluate health problems, acquire health resources, and implement information technology systems and clinical functions to manage day-to-day operations within the healthcare industry. The goal is to improve individual wellbeing and community health by following best practices, collecting problems, providing solutions, and involving the community. Healthcare administration aims to improve processes, standards of care, and protect medical records through leadership and management.
Hospital services can be classified in various ways. They include clinical management, patient encounters, treatment, pharmacy, and social work as direct clinical services. Support services that indirectly contribute to patient care include auxiliary services like housekeeping and maintenance. Support services also facilitate the effective accomplishment of therapeutic, diagnostic, administrative, and informational services, which together aim to provide satisfactory patient care through the collective activities of all hospital departments and personnel.
This document discusses hospitals as systems. It begins by classifying hospitals according to directory, ownership, bed size, nature, and medical system. It then describes the different types of hospitals according to these classifications. The document outlines the key functions and departments of hospitals, including outpatient, inpatient, intensive care, emergency, day care, and operating theaters. It discusses the organizational structure and process flows within hospitals to deliver clinical services and achieve their overall objectives of providing healthcare.
This document provides an overview of the nurse's role in the healthcare system. It defines key terms like nursing, nurse, and nursing practice. It describes the philosophy of nursing as respecting patient dignity and treating each person as an individual. The nurse's roles include caregiving, advocacy, education, research, and management. Healthcare is organized at national, hospital, and community levels. Hospitals are organized into levels that provide different services. Community health involves health centers, posts, and organizations that work together to promote health. The nurse collaborates as part of a multidisciplinary team that includes doctors, pharmacists, and others to provide comprehensive patient care.
This document provides an overview of hospitals and the healthcare delivery system. It discusses the evolution of hospitals from places where people went to die to modern multiservice institutions. Hospitals are classified by type, ownership, size and services provided. Trends include consolidation, outpatient care replacing inpatient care, and increased partnerships between hospitals and other providers. Challenges include rising costs, physician decision making, and ensuring access to care.
1. The document defines stakeholders in the health care system as entities that affect or are affected by organizational actions. It identifies key stakeholders as government, health care providers, the public, hospital administrators, NGOs, and health insurance providers.
2. The roles and responsibilities of these stakeholders are described. The government oversees policy, funding, and administration of health services at central, state, and district levels. Health care providers deliver services. The public are beneficiaries of care. Hospital administrators and boards manage operations. NGOs supplement government work. Insurers provide coverage.
3. Effective stakeholder management involves identifying and classifying stakeholder relationships, formulating strategies, and evaluating outcomes. Stakeholder analysis
This is a presentation on the Health care and hospital management.The topic cover on this presentation is Introduction of health, Health Care provider, Components of healthcare delivery system, Levels of health care, Rural Health care system in India, Hospital management system, Type, Introduction of automation management, Problem definition, Advantages of computerized hospital management system, Requirement specification, User interface, Screen shorts of software etc.
Overview of Hospital and Clinic in the PhilippinesKyla De Chavez
Hospitals provide inpatient care and have medical staff that operate 24/7. They are funded through various sources and their primary task is providing short-term care for people with health issues. Hospitals offer services like emergency care, surgery, and testing. Clinics provide outpatient care and are smaller than hospitals. Both have various departments to care for different health needs. Hospitals are classified by ownership, either government or private, and by scope of services from general to specialized levels of care.
Organizational Structure Of A Hospital[1]jawadorak
The organizational structure of a hospital facilitates efficient management by establishing lines of authority and accountability. Larger hospitals have more complex structures than smaller facilities. Hospital departments are generally grouped into administration services, informational services, therapeutic services, diagnostic services, and support services. Administration oversees budgets, policies and public relations. Informational services handle admissions, billing, records and technology. Therapeutic services provide treatment. Diagnostic services determine causes of illness or injury. Support services maintain supplies and the facility. Understanding the organizational chart helps navigate a hospital's departments and staff.
The document discusses comprehensive primary health care in India. It proposes making primary care universal, free, and accessible close to where people live. This would include a more comprehensive package of services addressing both communicable and non-communicable diseases. Village committees would help ensure no one is excluded and services address local health priorities. Community monitoring would provide feedback on equity and quality. Comprehensive primary health care would reduce costs and the need for higher-level care compared to the selective primary care of the past.
Major stake holder in health care delivery system IndiaMandeep Gill
The document discusses major stakeholders in the health care delivery system in India. It begins by defining stakeholders as individuals or groups that affect or are affected by organizational actions. It then outlines various types of stakeholders, including primary and secondary stakeholders, external, interface, and internal stakeholders.
Major stakeholders in the Indian health care system are identified as: the government at central and state levels; the public; health care providers including community and hospital professionals; hospital administrators and governing boards; and non-governmental organizations. The relationships between these stakeholders and health care organizations are analyzed. Strategies for managing different types of stakeholder relationships are also presented.
Michael Samuelson, Keynote,Wellness at Work Conference, June 14, 2010Delaware State Chamber
This document discusses wellness and primary prevention as the keystone to transforming healthcare. It outlines that the current healthcare system focuses more on sickness and disease management rather than prevention. A shift needs to occur towards prioritizing health promotion and preventing disease. This will help lower costs by compressing morbidity. A social contract is proposed where society provides access to healthcare and supports prevention, while individuals make healthy choices and get recommended screenings. A five step strategic approach is presented for organizations to organize employees by health risk and implement wellness programs.
Michael Samuelson, Keynote,Wellness at Work Conference, June 14, 2010Delaware State Chamber
This document discusses wellness and primary prevention as the keystone to transforming healthcare. It outlines that the current healthcare system focuses more on sickness and disease management rather than prevention. A shift needs to occur towards prioritizing health promotion and preventing disease to lower costs. A five step strategic approach is proposed: 1) Organize the population by risk level, 2) Conduct a corporate health audit, 3) Adjust corporate culture, 4) Implement programs to keep low risk low and move high risk lower, 5) Evaluate, update and maintain programs. The document argues that wellness is not just an individual responsibility but a shared social contract between society and individuals with both rewards and penalties.
The document outlines objectives for a nursing fundamentals course focusing on health care delivery and professional nursing. It discusses the current U.S. health care delivery system, the role of nursing within it, and different levels of health care providers. It also covers primary, secondary, and tertiary health care services; diversity in health care; trends in health care delivery systems; and examples of health care institutions and practitioners.
The document discusses the potential of personal health systems and mobile health (mHealth) technologies to support behavior change and chronic disease management. It makes three key points:
1) Chronic disease prevention and management is a major challenge that requires behavioral changes supported by tools like personal health systems.
2) Citizens are key co-producers of their own health, and their behaviors strongly influence health outcomes. Technologies can help promote healthier behaviors.
3) Personal health systems using mobile technologies, connected devices, self-monitoring, and persuasive feedback techniques can help catalyze behavioral changes needed to improve health and reduce healthcare costs.
This document proposes redefining preventative care to focus on constantly improving basic health measures for all individuals, regardless of current health status. It notes that the US currently spends over $2 trillion annually on healthcare, with two-thirds going towards treating chronic conditions for 45% of the population. While 65% have no chronic conditions currently, focusing only on these "healthy" individuals misses an opportunity to reduce costs. The document advocates continuously addressing the top causes of chronic illness - diet, exercise, alcohol, smoking, nutrition and lack of exercise - for all. This could improve outcomes and reduce unnecessary future healthcare spending, even for those with existing conditions. It proposes regularly monitoring and prescribing basic health measures like sleep, water intake, exercise and
The document discusses the role of registered dietitians in primary health care. It begins by explaining that primary health care focuses on wellness promotion rather than just illness treatment. It also notes that nutrition is important for health but access to nutrition services is limited. The document then describes key elements of primary health care, including using a population health approach, comprehensive services, coordination of care, interdisciplinary teams, and cost-effectiveness. It outlines the practice of registered dietitians in primary health care, including their skills in health promotion, education, and working with communities. Examples are provided of how dietitians contribute to quality of life, health outcomes, and cost containment through various strategies and actions.
This document discusses the challenges of improving population health outcomes for children through children's healthcare services. It argues that the focus needs to shift from caring for individual children with health problems to implementing proactive strategies that improve outcomes across entire populations of children. Programs aimed at populations are more effective when they address key social determinants of health through high-coverage interventions early in life. The document examines differences between individual care and population care, and emphasizes the importance of understanding determinants like poverty, parenting programs, and early childhood development to achieve meaningful improvements in outcomes for all children.
STATUS OF HEALTH TECHNOLOGY ASSESSMENT IN INDIA (2010)Ruby Med Plus
Research is well-established on a national level, especially essential national Health research (ENHR), with the Indian Council of Medical Research identifying the priority areas. However, the main users of these research findings are academics and researchers. In India, for commissioned research, there is a direct channel of communication between Health care researchers and policymakers. For non-commissioned research the channels of dissemination to policymakers are less clear and more varied, as dissemination of noncommissioned research is limited to academic channels (e.g. papers in peer-reviewed journals or presentations at conferences). The direct dissemination of noncommissioned research at central government level is available to a range of policymakers by distribution of a research report or inviting key policymakers and other stakeholders to a dissemination workshop often less intensively. Another Major constraint, policymakers may not fully understand how to use research to support policy formation as policymakers may not have the ability to evaluate the quality of a research study, difference between qualitative and quantitative research or to interpret research findings, thus experience difficulties in incorporating research findings into policy development for health care programs, which may lead to the failure to translate research into policy or to extraneous conclusions drawn from research results.
Social medicine is concerned with how social and economic factors impact health and disease. It aims to understand these relationships and create conditions for a healthier society. Socialized medicine describes universal healthcare systems funded through taxation where medical care is available to all at low cost. Pros include affordability, uniform access to care regardless of income, and healthcare for all citizens. Cons can include potentially lower quality care, decreased medical innovation, and increased tax burden. Some countries with socialized medicine systems are described. In India, various state-run health insurance schemes have been launched to provide socialized care.
The document provides an overview of India's health care delivery system. It defines key terms and outlines the various sectors that make up India's system, including public, private, voluntary, and indigenous medicine. It describes the organization of health services in India at the central, state, and district levels. Primary health care is discussed as the cornerstone of rural health services in India, with principles of equitable distribution, community participation, and preventive focus. Comparative infrastructure statistics are also provided for the states of India and Karnataka.
The document discusses key concepts in US healthcare including:
1. US healthcare follows a medical model focused on treating illness rather than wellness and prevention.
2. Both social and medical factors influence health outcomes and disparities exist.
3. A holistic approach addressing social determinants through policies, community programs, and individual behaviors is needed to significantly improve population health.
The document discusses key concepts in US healthcare including:
1. US healthcare follows a medical model focused on treating illness rather than wellness and prevention.
2. Both social and medical factors influence health outcomes and disparities exist.
3. A holistic approach addressing social determinants through policies, community programs, and individual behaviors is needed to significantly improve population health.
This document discusses strategies to promote population health in the United States. It provides data showing poor control of health conditions like high blood pressure and cholesterol. It also discusses how employers can play a key role in wellness since most Americans get health insurance through work. The document proposes several strategic directions for a National Prevention Strategy including promoting active lifestyles, healthy eating, strong public health infrastructure, and making clinical preventive services more accessible. It seeks input on draft strategic directions to guide federal prevention activities.
This document provides information about consumer health, including health information, products, and services. It discusses reliable and unreliable sources of health information, examples of health products and services, and different types of healthcare providers like hospitals, health professionals, and health insurance. PhilHealth, the public health insurance in the Philippines, is described. The document warns about quackery and provides examples of different forms of fraudulent health claims. Overall, it aims to educate about making informed choices regarding health.
Community medicine is defined in 3 sentences. It is the art and science of applying technical knowledge and skills to deliver comprehensive healthcare to a community. The goal is to improve the health of the community through a health team's delivery of services in collaboration with related professions and the community. Public health refers to organized community efforts to prevent disease, prolong life, and promote physical and mental health through activities like sanitation, medical services, and social support.
The document discusses primary health care and different types of health insurance. It states that primary health care is essential health care that is accessible to communities based on their needs and affordable costs. The document also outlines different types of health insurance plans including HMOs, PPOs, HDHPs, and catastrophic plans. HMOs and EPOs provide coverage only within their networks while PPOs and POS plans allow for some out-of-network coverage at a higher cost. HDHPs have lower premiums but higher deductibles while catastrophic plans only cover major medical expenses.
The healthcare industry in India covers hospitals, health insurances, medical software, equipment and pharmacies. It has grown substantially over time due to improvements in medical science and technology. Major components include hospitals, medical insurance, software, and equipment. Healthcare services combine tangible aspects like beds and decor with intangible services like medical consultations. The industry is large and growing, but remains underdeveloped compared to international standards. Government plans aim to improve access and quality of healthcare across India.
The document discusses the healthcare and hospital industry in India. It provides an overview of the industry, noting that it covers hospitals, health insurance, medical software, equipment and pharmacies. It also outlines the major components of the industry including hospitals, medical insurance, software and equipment. Additionally, it discusses the growth of the corporate hospital sector in India and factors that are attracting corporates to the healthcare space such as recognition as an industry, socio-economic changes, brand development, and the opening of the insurance sector.
as new voluntary requirements such as iso45001/jisc45001 and health score report are implemented in 2nd half of 2018, any business entities operating in Japan will conform to these requirements. Integrating operation with both already implementing management systems and financially connected health insurance services are challenging.
Health IT actions in japansese public sector 2013-2017Yasuji Suda
summary of 5 years healthcare it related programs in Japanese public sector using text analysis to visualize relation among reports describing healthcare IT.
This document discusses the evolution of healthcare services from traditional models to more digital approaches. It argues that early digital health focused on efficiency through digitization but did not fully leverage data, while modern e-health aims to create new health-related solutions by unlocking more value from data. However, the market remains fragmented. The document proposes that combining user-generated data from different life domains could enable more personalized and meaningful feedback and recommendations through a product-service system approach. This may help revitalize traditional services and create new service models.
Plan Data Health is a framework for Japanese health insurance organizations to implement data-driven managed health services based on analysis of member health checkup and medical receipt data. The goal is to improve preventive health management and outcomes using a business management cycle approach. Health insurance organizations will use outsourced experts and collaborate with employers to provide tailored health promotion programs and monitor their effectiveness over time through continuous data analysis and review.
Fueling AI with Great Data with Airbyte WebinarZilliz
This talk will focus on how to collect data from a variety of sources, leveraging this data for RAG and other GenAI use cases, and finally charting your course to productionalization.
Building Production Ready Search Pipelines with Spark and MilvusZilliz
Spark is the widely used ETL tool for processing, indexing and ingesting data to serving stack for search. Milvus is the production-ready open-source vector database. In this talk we will show how to use Spark to process unstructured data to extract vector representations, and push the vectors to Milvus vector database for search serving.
Monitoring and Managing Anomaly Detection on OpenShift.pdfTosin Akinosho
Monitoring and Managing Anomaly Detection on OpenShift
Overview
Dive into the world of anomaly detection on edge devices with our comprehensive hands-on tutorial. This SlideShare presentation will guide you through the entire process, from data collection and model training to edge deployment and real-time monitoring. Perfect for those looking to implement robust anomaly detection systems on resource-constrained IoT/edge devices.
Key Topics Covered
1. Introduction to Anomaly Detection
- Understand the fundamentals of anomaly detection and its importance in identifying unusual behavior or failures in systems.
2. Understanding Edge (IoT)
- Learn about edge computing and IoT, and how they enable real-time data processing and decision-making at the source.
3. What is ArgoCD?
- Discover ArgoCD, a declarative, GitOps continuous delivery tool for Kubernetes, and its role in deploying applications on edge devices.
4. Deployment Using ArgoCD for Edge Devices
- Step-by-step guide on deploying anomaly detection models on edge devices using ArgoCD.
5. Introduction to Apache Kafka and S3
- Explore Apache Kafka for real-time data streaming and Amazon S3 for scalable storage solutions.
6. Viewing Kafka Messages in the Data Lake
- Learn how to view and analyze Kafka messages stored in a data lake for better insights.
7. What is Prometheus?
- Get to know Prometheus, an open-source monitoring and alerting toolkit, and its application in monitoring edge devices.
8. Monitoring Application Metrics with Prometheus
- Detailed instructions on setting up Prometheus to monitor the performance and health of your anomaly detection system.
9. What is Camel K?
- Introduction to Camel K, a lightweight integration framework built on Apache Camel, designed for Kubernetes.
10. Configuring Camel K Integrations for Data Pipelines
- Learn how to configure Camel K for seamless data pipeline integrations in your anomaly detection workflow.
11. What is a Jupyter Notebook?
- Overview of Jupyter Notebooks, an open-source web application for creating and sharing documents with live code, equations, visualizations, and narrative text.
12. Jupyter Notebooks with Code Examples
- Hands-on examples and code snippets in Jupyter Notebooks to help you implement and test anomaly detection models.
Your One-Stop Shop for Python Success: Top 10 US Python Development Providersakankshawande
Simplify your search for a reliable Python development partner! This list presents the top 10 trusted US providers offering comprehensive Python development services, ensuring your project's success from conception to completion.
Skybuffer SAM4U tool for SAP license adoptionTatiana Kojar
Manage and optimize your license adoption and consumption with SAM4U, an SAP free customer software asset management tool.
SAM4U, an SAP complimentary software asset management tool for customers, delivers a detailed and well-structured overview of license inventory and usage with a user-friendly interface. We offer a hosted, cost-effective, and performance-optimized SAM4U setup in the Skybuffer Cloud environment. You retain ownership of the system and data, while we manage the ABAP 7.58 infrastructure, ensuring fixed Total Cost of Ownership (TCO) and exceptional services through the SAP Fiori interface.
Programming Foundation Models with DSPy - Meetup SlidesZilliz
Prompting language models is hard, while programming language models is easy. In this talk, I will discuss the state-of-the-art framework DSPy for programming foundation models with its powerful optimizers and runtime constraint system.
How to Get CNIC Information System with Paksim Ga.pptxdanishmna97
Pakdata Cf is a groundbreaking system designed to streamline and facilitate access to CNIC information. This innovative platform leverages advanced technology to provide users with efficient and secure access to their CNIC details.
How to Interpret Trends in the Kalyan Rajdhani Mix Chart.pdfChart Kalyan
A Mix Chart displays historical data of numbers in a graphical or tabular form. The Kalyan Rajdhani Mix Chart specifically shows the results of a sequence of numbers over different periods.
Ivanti’s Patch Tuesday breakdown goes beyond patching your applications and brings you the intelligence and guidance needed to prioritize where to focus your attention first. Catch early analysis on our Ivanti blog, then join industry expert Chris Goettl for the Patch Tuesday Webinar Event. There we’ll do a deep dive into each of the bulletins and give guidance on the risks associated with the newly-identified vulnerabilities.
HCL Notes and Domino License Cost Reduction in the World of DLAUpanagenda
Webinar Recording: https://www.panagenda.com/webinars/hcl-notes-and-domino-license-cost-reduction-in-the-world-of-dlau/
The introduction of DLAU and the CCB & CCX licensing model caused quite a stir in the HCL community. As a Notes and Domino customer, you may have faced challenges with unexpected user counts and license costs. You probably have questions on how this new licensing approach works and how to benefit from it. Most importantly, you likely have budget constraints and want to save money where possible. Don’t worry, we can help with all of this!
We’ll show you how to fix common misconfigurations that cause higher-than-expected user counts, and how to identify accounts which you can deactivate to save money. There are also frequent patterns that can cause unnecessary cost, like using a person document instead of a mail-in for shared mailboxes. We’ll provide examples and solutions for those as well. And naturally we’ll explain the new licensing model.
Join HCL Ambassador Marc Thomas in this webinar with a special guest appearance from Franz Walder. It will give you the tools and know-how to stay on top of what is going on with Domino licensing. You will be able lower your cost through an optimized configuration and keep it low going forward.
These topics will be covered
- Reducing license cost by finding and fixing misconfigurations and superfluous accounts
- How do CCB and CCX licenses really work?
- Understanding the DLAU tool and how to best utilize it
- Tips for common problem areas, like team mailboxes, functional/test users, etc
- Practical examples and best practices to implement right away
Unlock the Future of Search with MongoDB Atlas_ Vector Search Unleashed.pdfMalak Abu Hammad
Discover how MongoDB Atlas and vector search technology can revolutionize your application's search capabilities. This comprehensive presentation covers:
* What is Vector Search?
* Importance and benefits of vector search
* Practical use cases across various industries
* Step-by-step implementation guide
* Live demos with code snippets
* Enhancing LLM capabilities with vector search
* Best practices and optimization strategies
Perfect for developers, AI enthusiasts, and tech leaders. Learn how to leverage MongoDB Atlas to deliver highly relevant, context-aware search results, transforming your data retrieval process. Stay ahead in tech innovation and maximize the potential of your applications.
#MongoDB #VectorSearch #AI #SemanticSearch #TechInnovation #DataScience #LLM #MachineLearning #SearchTechnology
Threats to mobile devices are more prevalent and increasing in scope and complexity. Users of mobile devices desire to take full advantage of the features
available on those devices, but many of the features provide convenience and capability but sacrifice security. This best practices guide outlines steps the users can take to better protect personal devices and information.
Main news related to the CCS TSI 2023 (2023/1695)Jakub Marek
An English 🇬🇧 translation of a presentation to the speech I gave about the main changes brought by CCS TSI 2023 at the biggest Czech conference on Communications and signalling systems on Railways, which was held in Clarion Hotel Olomouc from 7th to 9th November 2023 (konferenceszt.cz). Attended by around 500 participants and 200 on-line followers.
The original Czech 🇨🇿 version of the presentation can be found here: https://www.slideshare.net/slideshow/hlavni-novinky-souvisejici-s-ccs-tsi-2023-2023-1695/269688092 .
The videorecording (in Czech) from the presentation is available here: https://youtu.be/WzjJWm4IyPk?si=SImb06tuXGb30BEH .
Introduction of Cybersecurity with OSS at Code Europe 2024Hiroshi SHIBATA
I develop the Ruby programming language, RubyGems, and Bundler, which are package managers for Ruby. Today, I will introduce how to enhance the security of your application using open-source software (OSS) examples from Ruby and RubyGems.
The first topic is CVE (Common Vulnerabilities and Exposures). I have published CVEs many times. But what exactly is a CVE? I'll provide a basic understanding of CVEs and explain how to detect and handle vulnerabilities in OSS.
Next, let's discuss package managers. Package managers play a critical role in the OSS ecosystem. I'll explain how to manage library dependencies in your application.
I'll share insights into how the Ruby and RubyGems core team works to keep our ecosystem safe. By the end of this talk, you'll have a better understanding of how to safeguard your code.
20240609 QFM020 Irresponsible AI Reading List May 2024
Ehealth in japan
1. Business Opportunities
with Healthcare ICT
~ viewpoint from big data and service ~
■characteristics of healthcare industry
■healthcare policy trends in Japan
■healthcare policy trends in EU and
pan-pacific countries
■healthcare ICT trends in private sector
■healthcare as services
2011.11(J⇒E translation in 2012.3)
Yasuji Suda sudays17@gmail.com
2. Expectations and policy trends about healthcare industry
■Characteristics of Healthcare
Industry■
3. 0 What is health?
◆◆Definition of WHO◆◆
Health is a state of complete physical, mental and social well-being
and not merely the absence of disease or infirmity.
The Definition has not been amended since 1948.
source:WHO charter
Are these definitions
◆◆Health in Japanese Laws◆◆ conformant with Health
【Medical Care Act Article 1-2 】 This Act・・・aims to contribute maintaining
that consumer think or
our citizens health by Protecting Interest of medical care recipient and trying to
conscious nowadays?
keep hold system that provide better quality and appropriate care efficiently
【Medical Care Act Article 1】 Medical Care・・・should be consisted not only
from Disease Care but also from preventive care and rehabilitative care with
better quality and appropriateness
【Health Promotion Act Article 2】 Citizen should pay more
attention and understanding to importance of healthy life
styles, and also percept own health conditions and try
health promotion through their life This is not formal translation
※ Describe Health as Wellness
source:
http://www.definitionofwellness.com
Wellness is a multidimensional state of being
describing the existence of positive health in
an individual as exemplified by QOL and a
sense of well-being Charles B. Corbin
Distributed by Suda Yasuji, 2011
4. 1 Healthcare Field(1)
Healthcare means・・・ By Someone’s Care
Health is contributed
By Self-Care
Concept of healthcare field
Politically Publicly Personally
Concerned Covered Consuming
Health Health Care
Public Private Consumer Goods
Social Security
Partnership & services
Insured Health Health maintenance
& self-care
There is no universally accepted policy to determine how
medical care should be provided as a part of publicly
funded healthcare.
Distributed by Suda Yasuji, 2011
5. 1 Healthcare Field(2)
As socio-economy matured, bi-
polarization of healthcare needs happens
Service is picked by
user Health
Personally
【Service provided in Self- ? Maintenance
Market】 Actualization & Self-care Consuming
Value For Life
Specialty
Life Design Esteem
Publicly
Love/Belonging Covered
Service is Necessity Safety Insured
? H e a l t h
【Service provided as Politically
SS】 Physiologically
Quality Of Life Concerned
Commodity
Life Support
Maslow’s Hierarchy
Distributed by Suda Yasuji, 2011
6. 1 Healthcare Field(3)
■ Mapping Healthcare Categories
Reactive Elective Elective Care
Acute Procedure
Rehabilitation indicate need
Emergency Chronic of coordination among
Care care settings
Disease Mng.
Assisted Elevated Risk
Living Factors
Home care & Wellness mng.
Active
Independent Health Fitness
Proactive Living
Care
Self-care
By Professionals
source:Technical Research Center of Finland ” Ecosystem of PHR based products and
services”2009
Connected by Home
Health Maintenance
Insured Health Appliances
& Self-care
(Health Data
Available) ?
Distributed by Suda Yasuji, 2011
7. 2 Healthcare Market Review
( 1 )
It is not generally speaking that increasing effect of medical cost
of Advancing New Medical Technology is Higher than that of
Population Aging.
Medical Expenditure is Most Highest in age group of 75-79
and a share of Total medical cost per person over age 80 is
about 25% in Japan. (National Statistic of 2009)
●Disease Onset will Avoidable
through Prevention ? A
Go Severe
Onset ●Disease Advance will Preventive
Diseases through Early Intervention ?
B
Pre-Onset C
Healthy
Superior
Healthy
time
-Relation among Health, Prevention &Medicine-
■Using new technology including drug are very expensive
■Even if medicine advances, still, disease will have chances to surviv
■Think as social cost;patient & family satisfaction (process or outco
Distributed by Suda Yasuji, 2011
8. 2 Healthcare Market Review
( 2 )
P a r a d o x i c a l M e c h a n i s m
Assuming Healthcare has Intrinsic Motivation to develop
Potentially High Growth & New Medical Technology
Revenue Chances “something new for love/someone”
New Tech. based products &
services are usually costly &
uncovered by insurance
Socialization of Medicine
(Black Hole) User may avoid using them if
But providing healthcare though they can get high utility
services as Public Service may
leads to increase SS cost
Insurance coverage alleviate high
Containing SS budget growth user cost & facilitate its use
through effective & efficient services
Cutting Managed Care Transferring cost to People are Econs ?
Payment ・High Cost User Think & Act with
Price to ・Duplicate ・Increase OOP Payment economic rationality,
Providers ・Redundant ・Delist from Coverage without emotions
Distributed by Suda Yasuji, 2011
9. 2 Healthcare Market Review
( ●Studying Individual Behavior, )
3 Information &Monetary Flow in
Healthcare Services are Needed
●Non-Profitability is Required but it is also an Economic Activity
1 2 3 4
expectation
Health Focal Point Info. Choice
Daily Life Consideration
Nudges From Think Collection & Use
to Act
Account Account
expectation Info. Collection &
Back
Account Consideration
Repeated process are often
Keep Rule Use
Outcome Outcome Usage cyclic
Based Eat/Drink Purchase
Actions Stables Occurs /Spread
Account
Self Medication Account
Worsening Own Health Save Use
4 3
by Self-Care Health Keep
Conscious 4 3
・Low adherence to medical Instructions Behavior Daily Life
Account
・Inappropriate Usage
Outcome Prescribing Admin. Clinical Admin. Visit Curative Healthcare
Occurs Work Work Work Work
Repeated Use Account
Default
expectation
Distributed by Suda Yasuji, 2011
10. 2 Healthcare Market Review
( ■ Points of Coordinated/Seamless Care
4 )
Ex. Wagner’s Chronic Diseases Care Model
Community
Health System
Medical Facilities (Providing Care Services)
Policy & Resources
Self- Delivery Decision Clinical
Management System Support Information
Support Design Systems
Informed, Prepared,
Activated Productive Interactions Proactive
Patient Practice Team
Improved Outcomes
http://clearinghouse.adma.org.au/home/evaluation-tool-framework/microsoft-word-the-wagner-chronic-care-model-with-an-equity-lens/view.html
Distributed by Suda Yasuji, 2011
11. 2 Healthcare Market Review
( ■ Coordinated/Seamless Care & ICT )
5
◆Healthcare paradigm shift is enable to
select sophisticating services in Cure &
Care by User rather than moves from Cure ICT
to Care Implementing
◆Bridging Cure & Care needs creation of Opportunity
system which User & Provider can select
either without any hassle
Selective
ICT
(Data
Driven)
Palliative
Cure Care Supportive
Less
invasive
Responsive
service in Sophisticating Go Ambient
critical
times
Distributed by Suda Yasuji, 2011
12. 2 Healthcare Market Review
( ■ Coordinated &6 Seamless Care Modeling
)
- Accountable Care Organization(ACO) -
●Same Concept of Medical Home, providing integrated and
customized care service experiences to patients.
●Scheduled to start in 2012 as an initiative of Medicare Service
Reform Activities
ACO
Incentives
Participation for 3 year generated by patient(5,000~/
in a row reduching expenses year)
Hospitals Patientt
Doctor P
Nursing
Facilities High Safety
Efficient and P + Family
Care Health Effective Care
Facilities Center
EHR Tele Health P
Clinics P
Remote Monitoring
Providing Quality
Referenced HealthIT.gov, public
And Price Info. comment for ACO et al.
Managed Free Access Is Necessary or Achievable in Japan?
Distributed by Suda Yasuji, 2011
13. 3 Health ICT(1)
■ Framework of HIT adaptation HIT:Healthcare Information
Technology
D i g i t i z a t i o n i n(HICT means same)
M e d i c i n e
Clinical Administrative
Front Stage Tasks Related H I E
HIE Back Stage Tasks Related
to Clinical Procedure to Medical Claims
(Diagnose, Test , Care Processing(Check &
& Operation) EMR, e-claims Pay)
E-Health, Tele-Health
Health 2.0, m-Health
Digital Health
Digitization in Healthcare
Daily Life have so many touch points that can lead to
good opportunities for healthcare intervention ?
●Reform Priorities
discussions
●Reform Approaches -Top-down
-Bottom-up
-Module
-Building-blocks
Distributed by Suda Yasuji, 2011
14. 3 Health ICT(2)
■ Types of Digitized Health Info.
EMR
Coordination among
Care Settings
(Cure)
EHR
EMR EMR
Connected Health
Managing Health
Risks in daily life
PHR
Distributed by Suda Yasuji, 2011
16. 4 Health System Reform Trends in Japan(1)
■Aspect of Social Security Reform
Integrated Reform of SS & Taxation
●Reform service provisioning systems to improve efficiency &
effectiveness in accordance with character of each Local
community introducing needed legislations
・Rearrange hospital functions & create
coordinated NW. among them Long term un-dissolved issue
・Reduce community & subjective clinical without effective solutions
gaps
・Improve home care services
Need to set theme for Big
・Strength outpatient visit management Data analysis
・Reduce duplicate/avoidable visits, test, and 【evolution of openlabs.go.jp】
over prescribing using ICT
● Reform health & long-term care insurance systems as
safety net through strengthen payer’s roles
Formally proposed as
・Study about introducing a fixed amount OOP
exemption of a fixed amount
payment including low income households
・Promote generic drug use
・Separation of drug coverage?
・Increase OOP payment for prescribed drug
(Medicare part D in Japan)
・Reform senior health insurance system, a sub
・Reference price/price capping
system of national health insurance system
Source:SS Reform HQ(2011/6/30)
Distributed by Suda Yasuji, 2011 This is not formal translation
17. 4 Health System Reform Trends in Japan(2)
■How to Assess Quality of Medical Care
Data Collection is too little to use statistic analysis.
Tragic Episodes tend to overwhelm statistical facts.
●Japan Council for Quality Healthcare Released “Medical Accidents Annual Report 2010”
No. of Reported Accidents:2,182(Death182) of Participating Facilities: 850 (20
No.
No. of Reported Incidents : 25,305 No. of Participating Facilities: 1,015 (20
≪Total No. of Facilities is over
100k≫
●Many Medical Accidents are broadcasting
A Medical malpractice caused
brain death A Medical Sponge had been left into
Patient body for 22 years.
Representivenes
http://www.med-safe.jp/ A Patient died after mis-diagnosis
s
Systematic problems though, ?
? ?
tend to consider as
personal or
organization’s partial Source:Fresheye News Clip
Distributed by Suda Yasuji, 2011
18. 4 Health System Reform Trends in Japan(3)
■Aspect of Economic Policy-①
New Growth Strategy⇒⇒Realizing New Growth Strategy in 2011
●Make medical, health & long term
Green Innovation care industry driver of economic ●Medical & Care
growth Market 78billion
●Promote R&D for Japan origin Employment
Life Innovation 201million
innovative drug & care tech. ●Health Related Services
●Progressive export to abroad Market 25billion
New Approaches Employment
to Asian Economy ●Promote barrier-free housing 0.8million
●Strength care service infrastructure
Inbound Tourism coupling to support Healthy Long Life
with Regional Vitalization
●Achieve safe senior life in local
Advancing Science, community Matter of
Tech. & ICT deregulation
【National Policy Unit’s
Employment & HR Focus】
・Facilitate use of new medical
technologies & services
New Businesses?
Finance ・Promote inbound medical & health Price
tourism competition?
(Commoditization
Source:New Growth Strategy )
This is not formal translation
Distributed by Suda Yasuji, 2011
19. 4 Health System Reform Trends in Japan(4)
■Aspect of Economic Policy-②
Report about Deregulation
(2011/7)
-now- -future-
Life Innovation WG Adding User’s
Points of deregulation Provider’s View
View・・・
●Dissolving man power inappropriate allocation Good service
Quantity is key for
& shortage, increase number of students
better quality encounter and
constantly with projection of needed man power efficient back end
●Redefine area of coverage which public Financial constraint process are key
Evidence of
insurance should cover including preventive allow prevention with
prevention are able
care little evidence?
to accumulate ?
●Improve quality and efficiency of medical care Networking of Co-creation process
through information sharing & applying new providers is essential with User is
technology in clinical setting important
Financial constraint
Service process
●Promote & support consensus for self- health shift cost &
innovation is key
management through empowerment responsibility to one
●Facilitate combination and coordination of Med/Health tourism Creation of high
medical care & non medical care services to is easy to make and User friendly
create New Business Opportunities grow well ? interface is key
Secondary Use & Big Data
may be Drivers to
Innovation
Source:Cabinet Office, Sub Committee about
Deregulation
Distributed by Suda Yasuji, 2011 This is not formal translation
20. 4 Health System Reform Trends in Japan(5)
■Aspect of Economic Policy-③ ●Will economic growth and job creation be
promised success in New Special Zone?
Healthcare related Projects under Special Zone Healthcare Related Project Proposals in New Special
Since 2004 Zone from 2011
Leading Edge Medical Industry Promotion Intl. Strategic Special Zone/Tsukuba City
/ Kobe City TeleMedicine Special Zone/Iwate Pref.
→Continued Under Kobe Medical Industry Medical Care Service Community/Hinoemata Villiage
Vision
Active Health Special Zone/Kamogawa City
Clinical Internship Promotion/Odawara City
& Rumoi City Smart Wellness City /Niigata City, Gifu City et al.
→Continued Naturing Wellness Special Zone/Myoko City
Medical & Welfare Industry Promotion Leading Edge Medicine Special Zone/Shizuoka Pref.
/Ootawara City Lifetime Health Record Special Zone/Nagahama City
→Further Deregulation has executed to
Intl. Medical Exchange Special Zone/Izumisano City
enable this promotion nationally
Genesis of Medical Valley/Tsu City Healthy Long-Life Special Zone/Okayama City
→Continued Under Medical Valley Project Regionally Coordinated Care Special Zone
Bio-Me Industry Promotion/Kanagawa Pref. /Onomichi City
→Continued 1 Clinic to Provide Advancing Integrated Regional Medical Service/Tokushima Pref.
Cosmetic Surgery
Medical & Wellness Service Special Zone
/Kagawa Pref.
Source:Special Zone for Structural Reform
Health Promotion Town /Matsuyama City
Many Bio-venture Companies are far below Medical Valley Special Zone/Ooita & Miyazaki Pref.
from expectations. Success? Failure?
Source:Cabinet Office. List of Special Zone
(2011/10) This is not formal translation
Distributed by Suda Yasuji, 2011
21. 5 Digital Health Approaches in Japan
( ■HIT Policy Movements 1 ●So many initiatives but little advancement in
)
health info. digitizing strategies for 5 years.
Abe Regime
-IT New Revolution Strategy ・Lifetime Health Management by
-Innovation25 oneself
・Citizens ID Number
Fukuda Regime ・Citizens e-Private Box
-IT Policy Road Maps ・Unique Number for
・Social Security Card SS & Taxation
Aso Regime
i-Japan Strategy Japan Service Tourism
EHR Intl. Medical Partnership
/Inbound Med & Sightseeing
Health Related Healthy Long Life
Services
Hatoyama・Kan Regimes
-New Development Strategy “Life Innovation”
ICT supported Tele Medicine System
MIC Ubiquitous Special Zone
Local Info. Platform Initiatives Japan EHR Facilitation Program
(Residents Health Portals)
Projects for
Haraguchi vision (EHR for All by 2015)
Infrastructure
METI A Study Group of New Health Services applying PHR ⇒ ⇒ ⇒ of Health
Info. Grand Voyage ⇒ ⇒ The Consortium for the Promotion Related Info.
of Next Generation Personal Services ⇒ ⇒ Usage
Standardization and Pilot Projects for Infrastructure ⇒⇒⇒
of Health Related Info. Usage
Distributed by Suda Yasuji, 2011
22. 5 Digital Health Approaches in Japan
( ■4 Major Categories of 2
HIT )
IT HQ’s IT Strategy in Medicine is consisted in 4 Categories
But it lacks user (patient) perspective
Individually participating
disease
Completing Vision of ○Studying Architecture of Virtual still
management services are My Hospital
1 conceptual.
“Virtually Replicated My Clinical Setting” ○Facilitating medical/health Info. digitization
There are No descriptions what
value patient get Drug e-Hand Book
& What value
co-creation process between
patient
Completing Vision of Seamless Coordinated ○Model and provider are required.
Network Development, Execution
2
Medical Care in Regions and Assessment
Toward More Efficient Medical Care ○Trial Use of providing data to 3rd Parties
3
Analyzing Claim Data ○Development of Data Use Technologies
○Advancing Medical Database Infrastructure
Facilitating Safer Medication
4
By Using Drug DB Development Program 10million Patients
Source:IT HQ・Healthcare TF
This is not formal translation
Distributed by Suda Yasuji, 2011
23. 5 Digital Health Approaches in Japan
( IT HQ:The New Strategy in Info. & Communications Technology
2 ) a Road Maps
(Updated)
Implementing Virtually replicated My Clinical Setting (Dokodemo My Hospital)
Use Case pilot test
Cab. Office MHLW METI MIC Drug e-hand book & Opt in Type
Disease Management Service are
Virtually
Newly Added in Updated Road
Replicated
My Clinical Maps.
Setting Former Planned Services are
METI MIC
giving patients more clinical &
MIC administrative info. to Empower.
Use Case MHLW Use Case pilot test
pilot test METI
METI
New
Drug
In case that clinically duplicate/ Phase1
Info. redundant medical tests but patient still want Drug e-hand book
to
Schedule
Specific do them, Whether Withdraw or Execute those
Changed
Claim Info.
Phase2-2
Discharge
Summary
tests lead to better healthcare service
New
e-Discharge Summary
e-image report
Health Check for patient?
Info. changed
Test Result Phase2-1
Opt-in type Disease
METI MHLW Mgmt. Service
Daily Health
Data Exchange
Info.
Standardization
Distributed by Suda Yasuji, 2011 Source:IT HQ(2011/8) is not formal translation
This
24. 5 Digital Health Approaches in Japan
( IT HQ:The New Strategy in Info. & Communications Technology
2 ) b Road Maps
(Updated)
Establishing Seamless, Coordinated Community Based Medical Care
Cab. Office Cab. Office Cab. Office
Establishing
Regional Use Case pilot test ・Coordinated Medical Care Models
Medical METI MHLW MIC for Targeted Diseases
Care NW Cab. Office MHLW ・Seamless, Coordinated Community
METI MIC Based Medical Care NW
Studying Disaster Proof Health Info.NW
MIC
Inter-
Regional
Use Case pilot test
Medical
Care NW Cab. Office MHLW METI MIC
Incentives Cab. Office MHLW
MIC Implement MHLW METI MIC
METI
MHLW
Use Case pilot test Establishing Coordinated Medical
& Long-term Home Care Model
Cab. Office MHLW MIC MHLW METI
E-Care METI MIC
MHLW METI MIC
Use Case pilot test MHLW METI
MIC Cab. Office
Tele
Medicine Studying E-Prescription MHLW MIC Dissemination of Tele Medicine
MHLW
Developing
Autopsy Guideline MHLW
Continuing Financial Support
Imaging
Financial Support MHLW
Distributed by Suda Yasuji, 2011 Source:IT HQ(2011/8) This is not formal translation
25. 5 Digital Health Approaches in Japan
( IT HQ:The New Strategy in Info. & Communications Technology
2 ) c Road Maps
(Updated)
Improving Efficiency of Medical Care Using Medical Claims Data etc.
•Claim Data Hospital& DPC Data Other Valuable
Types of Info. •Health Check Payer Pharmaco Data
•Coding Data Data Epidemic Data
Provision MHLW MHLW
Expertise Panel
Claims ・Use Case Pilot Testing Use for Improving Efficiency
Data ・Business Model Exam. Including
Legal aspects Clinical & Admin. Efficiency
MHLW MHLW ・Provider Use
・Payer Use
DPC
MHLW
ここを変更する!
National average data of Insurers
Hospital
expenses & clinical data of
Clinical Exam. About medical facilities are added in
Info. & Providing of national
Added average data
updated road maps. On the other,
Medical
expense integrated usage among
MHLW
secondary Data Base is deleted.
・Studying Published Data Anonymization
・Reviewing Data Security Technology
・Developing Analytic Technology for Big Data
Usage METI MHLW
Research & Study about Medical
Claim Data Use for improving
Medical Care Efficiency
MHLW METI Cab. Office
Source:IT HQ(2011/8) is not formal translation
This
Distributed by Suda Yasuji, 2011
26. 5 Digital Health Approaches in Japan
( IT HQ:The New Strategy in Info. & Communications Technology
2 ) d Road Maps
(Updated)
Promotion of Medical Drug & Device Safety Assurance Initiatives Using Drug Info. DB
E-Clinical Data Other valuable
Types of Info. Claim Data
DPC Data Data
Study of Provision Framework ・Tohoku Univ. Hospital
MHLW ・Chiba Univ. Hospital
MHLW
・Tokyo Univ. Hospital
・Hamamatsu Med. Univ.
Provision Hospital
MHLW MHLW
・Kagawa Univ. Hospital
Rules for use of e-clinical data
MHLW ・Kyushu Univ. Hospital
Drug Drug Adverse Info. Collection & Review ・Saga Univ. Hospital
Research MHLW ・Kitasato Univ. Hospitals
MHLW ・NTT Hospitals
Platform Development Project for DB ・Tokushukai Hospitals
Creation of Network
of Medical Info. Accumulating
Phase 1 Phase 2 High Volume Data 10 million Patient
MHLW MHLW MHLW Info. Repository
Exam. For DB Architecture
MHLW Cab. Office
Usage
Drug
MHLW
Research
Research on usage by pharmaceutical companies
MHLW
Distributed by Suda Yasuji, 2011 Source:IT HQ(2011/8) is not formal translation
This
27. 5 Digital Health Approaches in Japan
( ■Pilot Programs for Inter-Regional HIEー①
3 )
A National Approach about “Network of networks”
was to set at last !
Network of networks
standards based
interoperable
network
Local Network A Local Network B Local Network C
separated from each other
Applications Development
on Exclusive Health Info.
NW Check Clinical Long term Care
Source:IT HQ Healthcare TF (2011.5)
Health
DB DB DB
●Adding to IT HQ’s Open Network ? Community based Health Info. Platform
Record, Store & Retrieve Broad Band
Initiative, MIC is planning to develop Applications Development
Community Based Local-Hub
Japan EHR Network as Closed
Network Initiative. onCoordinated Gov. Info. NW Tele-consul.
Local Hospital Home
Care Unit
Medical
⇒Will they interact effectively? Care
Pharmacy Clinic Univ.
Specialist Hospital
Source:MIC, Action Plan 2012 Nursing Care Municipal Other Communities
Facility patient health staff in same Prefecture
Health Coaching
Distributed by Suda Yasuji, 2011
28. 5 Digital Health Approaches in Japan
( ■Pilot Programs for Inter-Regional HIEー②
4 )
Japan EHR Developing Program(a part of health info. Coordination Infrastructure
Deployment) Open Patient Card & Emergency
Care Coordination
Whether These 3 Applications
Should 1:Shimane Pref.
Region Run on One Common
Platform orOota & Hikawa) is not
(Izumo, Multi-Platforms
Prescribed Info. Coordination Clear Medical & Nursing Care
Coordination
Region 2:Kagawa Pref. Region 3:Hiroshima Pref.
(Takamatsu, Miki & Sanuki) (Onomichi. Fukuyama &
Mihara)
Source:MIC Outline of Japan EHR
Distributed by Suda Yasuji, 2011
29. 5 Digital Health Approaches in Japan
( ■Concerns about HIT Business Model
5 )
●Issue 3:Incentives to slow disease advancement using HIT
Past pilot HIT programs to create regional coordinated care
often failed because they can’t get sound finance after government
Requiring non-profitable
grants period ended. insured care but vague,
Therefore, it may be necessary to provide service providers with
financial incentives for continuing business. abstractive words on
Issue3:Incentives to slow disease advancement using HIT legislation & rules
implement cost running cost actions for budget
Specify Benefits of Information Sharing
assigned budget
required budget
Measure & Analyze ROI
Year 1 Year 2 Year 3 Year 4
pilot project phase
In case of operation stops by financial shortage
Source:IT Strategic HQ・Healthcare TF
●METI・Interim Report (2011/6)
Financial Incentives such as Long-term care insurance premium
discount & point programs might effective to motivate Patients/
Users purchasing preventive care services.
This is not formal translation
Distributed by Suda Yasuji, 2011
30. 5 Digital Health Approaches in Japan
( ■Fragile Insist of “Implementation of HIT should Do”
6 )
2011.3.11 Catastrophic Disaster in East Coast Japan
Paper based Patient Information are heavily Lost as well as
Hurricane Katrina, Great Earthquake in Haiti and so on.
Same Phenomenon already happened in 2004 Chuetsu Earthquake .
Proposals for Digitized Medical Information such as EHR and PHR
could be useful in case of these urgent situations.
☆IT Strategic HQ・Healthcare TF
☆EHR enterprise facilitation committee
Switch & Execute
Alternative Logistic Ex. Tohoku Medical Megabank
Health Mgmt. for Victims
Systems Smoothly to Alliance Tohoku Region
Local Reconstruct Medical Care Systems
Supply Medical StuffNational Tohoku Univ. Companies
centers Create New Medical Businesses
& Staff in EmergencyNational Medical Mega Bank Local
Univ. ・digital health
Colleges
Is further importantetc. ・tele medicine Contribute to develop
solutions for scarce
・health info. NW
Than Digitizing Patient medical resources
interaction
Information. Next Gen. Next Gen.
Medical Innovation
facilitating disaster
medical research Bio-med informatics recovery
Source:medical innovation council
http://www.kantei.go.jp/jp/singi/iryou/dai2/siryou5.pdf
This is not formal translation
Distributed by Suda Yasuji, 2011
31. 6 Healthcare Service Policy Frame in Japan
( ■Services as Life-Medical Industry
1 )
Life-Medical Industry will be emerging as domination of
chronic diseases advance.
This service industry should facilitate by redefining health/
medical service field, especially public health insurance .
③Services for
prevention of Insured
Healthy
①Services for readmission & Clinical Care
health maintenance disease advance time
Normal
Condition
Applying to the chart of P5
④Services for
Terminal care
Operation& in home
Rehabilitation
Disease ②Customized Services
Onset Insured responding Personal Go A
Clinical Care Disease Severe ④
needs
Onset
source:METI B
this isn’t formal translation
Pre-onset C ②
① ③
Healthy
Superior
Healthy
Distributed by Suda Yasuji, 2011
32. 6 Healthcare Service Policy Frame in Japan
( ■Services as Smart System 2 )
Strategy for Smart Convergence
Leading Edge Medical Smart Healthcare (System)
Create Offshore COE Services for
Inbound foreign patients Revitalize healthcare industry
• coordination with Inbound
• Health Information Exchange through developing international
• Tele-Medicine seamless medical care NW.
Combination pulling patient to Japan
and pushing out Japanese medical
Export Medical Care System service system to abroad
(facility, equipment, ICT)
Outbound
Be Cautious !
source:METI
this isn’t formal translation
●OECD’s Medical Tourism:Treatments, Markets and “During the 20th century, wealthy
Health System Implications:A scoping review(2011) people from less developed areas of
pointed. the world travelled to developed
nations to access better facilities and
●Vague strategy for Medical/Health tourism highly trained medics”
Japanese Government has no numerical targets.
http:www.oecd.org/dataoecd/51/11/48723982.pdf
Instead, Development Bank of Japan’s estimation of
inbound medical tourist in 2020. ※both potential
-Total Number of tourists:0.425 millions
-Total Revenue :¥168 billions
http://www.dbj.jp/ja/topics/report/2010/files/0000004549_file2.pdf
Distributed by Suda Yasuji, 2011
33. 6 Healthcare Service Policy Frame in Japan
( 3
【Point】 CSF of Medical Tourism is Low Price. )
source:OECD Medical Tourism:Treatments, Markets and Health
System Implications:A scoping review(2011)
Can Japan Create New Niche Market?
Distributed by Suda Yasuji, 2011
34. Expectations and policy trends about healthcare industry
■Healthcare Policy Trends in English
Spoken Countries■
United States
United Kingdom(England & Scotland)
Australia
New Zealand
Distributed by Suda Yasuji, 2011
35. 7 Digital Health Approaches in US(1)
■ Nationwide Health Information Network:NHIN
●2004.4 “EHR for All Americans by 2014”
E.O.13335 :
- On Going Effort to create Health Data distribution system -
NHIN・Direct Push Type
If Provider A have Data of Patient X, He/She
can encrypt data and send it Directly to
Provider B who know each other and keep
trusted condition.
Alternative to FAX, mail and e-mail. Pilot Testing in 9 Areas
NHIN・Exchange Pull Type
VLER:Virtual Lifetime
Reference from Provider A to Provider B. Electric Record
If Provider B have referenced Data of ( DoD & VA )
Patient X is confirmed, Provider A can Patient Summary
Retrieve the Data ( SSA )
20 Organizations Joined ( 2011/10 ) Bio Surveillance
( CDC )
NHIN・Connect
Open Source initiative to develop and
provide Direct Exchange Software.
Ver. 3.2.1 is publishing ( 2011/10 )
Distributed by Suda Yasuji, 2011
36. 7 Digital Health Approaches in US(2)
■ Federal HIT Strategy Map
(1
)
(2
)
Disseminatio
(3
n of EHR
)
(4
)
(5
)
●Coined New Phrase to get More
Toward “The learning health system” Consumer Attraction and Involvement
Huge Volume of digitized Health Related Data
⇒ Collect and Analyze
⇒ Create New Clinical Knowledge & Insight
⇒ Apply them in Clinical Setting
source:Federal HIT Strategic Plan 2011-
ASAP
Distributed by Suda Yasuji, 2011 2015
37. 7 Digital Health Approaches in US(3)
■ Empowering People Providing Rich Info. 【Blue Button
● Using Blue Button, Medicare beneficiaries of DoD
Initiative】
and VA can easily Down Load Own Medical Record for A Condition to get
Self Control/Management of them Meaningful Use Bonus
● Over 430,000 beneficiaries use Blue Button
since 2010/10 against projected number of 25,000.
http://medgadget.com/2011/09/why-blue-button-data-is-a-big-deal.html
http://www.ihealthbeat.org/articles/2011/10/11/hhs-more-than-430k-vets-using-blue-button-to-access-health-d
Medicare MS・Healthvault
VA・myheatlhevet Relayhealth・
PHR
ASCII Text Format
DoD・TRICARE Aetna・PHR
For iphone
and ipod use Iatric
Systems・
Patient
Portal
●PR Portal Site has opened
(http://www.bluebuttondata.org/)
Distributed by Suda Yasuji, 2011
38. 7 Digital Health Approaches in US(4)
■ Empowering People Providing Rich Info. 【MedlinePlus
Connect】
●Specified disease related information is provided from
MedlinePlus Library .
●Implementation is mandatory condition to get Meaningful
Use Bonus.
●A Type of Push Media to omit patient burdensome process
to get assured information.
Service Provider(including IT)
Clinical Code response Data
Patient Portal(EHR/PHR)
③Repository
①Input Code ④
・Clinical Reference
・Drug ② Pick up and
・Test Send Automatically
http://medlineplus.gov/connect
Generally, Patient have to Patient
MedlinePlus
search information by oneself
Drug Code response Data
Test Code response Data
Distributed by Suda Yasuji, 2011
39. 7 Digital Health Approaches in US(5)
■ Modeling Coordinated Healthcare Services
- Accountable Care Organization(ACO) -
●Same Concept of Medical Home, providing integrated and customized
care service experiences to patients.
●Scheduled to start in 2012 as an initiative of Medicare Service Reform
Activities
ACO
Incentives
Participation for 3 year generated by patient(5,000~/
in a row reduching expenses year)
Hospitals Patientt
Doctor P
Nursing
Facilities High Safety
Efficient and P + Family
Care Health Effective Care
Facilities Center
EHR Tele Health P
Clinics P
Remote Monitoring
Providing Quality
Referenced HealthIT.gov, public
And Price Info. comment for ACO et al.
Managed Free Access Is Necessary or Achievable in Japan?
Distributed by Suda Yasuji, 2011
40. 8 Digital Health Approaches in UK(1)
England
●Reviewing National Program for IT(NPfIT), Program
scheme will be changed to more local NHS has responsibility
and budget control aiming to improve efficiency of the program.
●DOH will develop strategy for HIT market expansion allied
with industrial society, Intellect.
●Pilot testing Personal Health Budget in 42 areas aiming to
improve VFM through visualizing medical expense per person
and active choice of services.
Opt-in is required to use.
●NHS Evidence, a web portal of
evidence information about health and
medical care, is introduced to support
more informed choice.
http://www.evidebce.nhs.uk/
Distributed by Suda Yasuji, 2011
41. 8 Digital Health Approaches in UK(2)
Scotland
● As following 3-year Strategy(2008-2011), Developed 6-year
Strategy(2011-2017) targeted to digitize multiple data set .
・CHI :Unique Patient ID, already applied
・PCR(Pharmacy Care Record):Pharmacist use to support
appropriate medication for Chronic Patient who need medication for a
long period.
・ECS(Emergency Care Summary):Prescribed medicine and
allergy information. 2010, 2.5 million summary are used.
・PCS(Palliative Care Summary):Palliative Care related
scheduled to
information accessible while out of business hour are
start in 2014
added as new version of ECS.
・KIS(Key Information Summary):Information consisted
from ECS, PCS and Care Plans are accessible
in any case.
Quality assured general portal
about health and medical info.
http://www.nhsinform.co.uk/
Portal about self-care info.
http://www.nhs24.com/
⇒Access via DirectScot, a Scottish
Government Portal, is plannned.
Distributed by Suda Yasuji, 2011
42. 9 Digital Health Approaches in Oceanic Countries
Australia
●Patient Unique ID(14 digit)which is
necessary for HIE started 2010/7.
Total number of annual DL is over 24
millions and more than 1,180,000 are
activated.
●12 e-health pilot areas are selected.
● PCEHR(user must opt-in)will set to
start 2012/7.
● PCEHR Bill was introduced.
New Zealand
● Clinical Challenge, request ideas and concepts about
health ICT and select items to develop by IT vender, was held.
【finalist in 2011】
- Early warning scoring system
- Language interpreter for simple communication
- e-Referral to medical officers of health
Distributed by Suda Yasuji, 2011
43. Expectations and policy trends about healthcare industry
■Healthcare ICT Trends in Private Sector■
~Information Design and Big Data~
44. 10 PHR/PHI Market Movements(1)
Microsoft Growing its ecosystem through PC to mobile.
・Health Vault Shift its focus to Home Care Market ?
Recommended transfer alternative
Google Challenged to establish health info. sharing, but
・GoogleHealth
will stop it by the end of 2011(data transition
available through 2012)
Reasons ●Only few innovative customer used (not scale out)
●Accumulation⇒Big data⇒Value creation is hard to
achieve
●Hospital review on Google map looks same situation (a few
posted )
Dossia Consortium growth is very slow and number of
implementation of this service in consortium member
looks stagnant.
Allied with Near Field Communication Forum and EU
Continua
Number of Consortium member is 264 as of 2011/10.
Microsoft joined at last.
Distributed by Suda Yasuji, 2011
45. 10 PHR/PHI Market Movements(2)
■ Quest for Data Driven Healthcare
PHR/PHI
Digitally Archived Personal Health,
Beauty
and Wellness Data
≪not Data accumulation
Claims Data chasm interoperable≫ grows though valuable
outcome generation
stumbles.
input process outcome Value chain
Service Industry innovation is needed.
(2006)
Almost same projects
Government pilot projects (Japan) continued
with different names
Local Community
Health Industry Platform
Health ServiceRevitalize(2008) Deregulation(2010~) (2011~)
Industry (2004)
Regional health integrated
service industry(2009) Failure will
● Any Lessons from Past (Failed) Projects? replicate
● Small Investment isn’t cause of Failure ? Still there will any
chances for success
● Vast Invested US Health ICT initiatives are really
Successful ? Or alternative ?
Distributed by Suda Yasuji, 2011
46. 10 PHR/PHI Market Movements(3)
■ Designing information-①
●Technological solution (Single Sign On) has 1st priority?
User Provider
“I want (want to “User must want
see) these info.” (want to see)
these info.”
really matched?
Traditional Research
based conclusion
may・・・
almost
Easy
accessibility
is a key
http://www.karada.ft.nttcloud.net/
partly
But it may not good
in User’s Emotional
& Instinct Level
never
Alternative User Research Methods
such as Ethnographic approach are
Distributed by Suda Yasuji,
Required
2011
47. 10 PHR/PHI Market Movements(4)
■ Designing informationー②
●Even local government sites change their
design , much of healthcare service sites
keep almost same looking (user interface)
Lack of design thinking
more than a year.
※a veryUnchanged Design &cloud
few sites introduced tag
2010.7 Continuity is most
important CSF ?
2011.10
Could you find any
effort improving
GUI?
namely user Experience
Distributed by Suda Yasuji, 2011
48. 10 PHR/PHI Market Movements(5)
■ Designing informationー③ ●This leads to business model shift in Keas
Tried to provide PHR to consumer・・・ 2010
■ select suitable health & prevention plans,
set the goals, then execute
■ results are e-mailed weekly
■ applying wisdom of crowd(user feedback)
Shift to gamified healthcare 2011
solution for company use
■measuring health data will not create good
market(people don’t want to measure their
health) is the answer through 2010 trial.
■gamification will the CSF and company on the
target
■improving employee’s health status(phisycally
and mentally) leads to high productivity and high
ES
■Free to end user
Population
Social
approach per × ICT ×
http://info.keas.com/employee-wellness-tin game
company
Distributed by Suda Yasuji, 2011
49. 10 PHR/PHI Market Movements(6)
■ Quest for healthcare ecosystem“From Parasite to Co-creation”
Withings
Data link with digital TV
(Panasonic)
is available in north American
region
Distributed by Suda Yasuji, 2011
50. 10 PHR/PHI Market Movements(7)
●Health ICT ecosystem such as Withigs and healthvault are
Discussions not created in Japan. Is this a strategic decision ?
●Is it able to scale out in fragmented healthcare field ?
pedometer Activity monitor pedometer Blood pressure monitor
Player
Provider of measure
devices
【case A】 【case B】
Omron Healthcare Tanita
Platform Owner
BMI scale
Publish API
【case C】
Of Health Planet
NTT docomo
Weight/BMI scale Blood pressure
monitor
synergy?
Data link with digital TV
(Sony) is available in Japan
Publishing Real Magazine
Link with
“eatsmart”
source:companies HP
Distributed by Suda Yasuji, 2011
51. 10 PHR/PHI Market Movements(8)
Adding to LM,
Chronic disease management,
Cardio vascular diseases prevention,
Screening tests and Early diagnosis
Are focused categories.
Lifestyle management programs are process of
co-creation toward individual well-being
Improving program
Deep communication
adherence both short
(coaching ・・・)
& long term
source:Philips European Affairs Office”Active and Healthy Ageing – a Long-term View uo to 2050”
(2011/1/31) P7
Distributed by Suda Yasuji, 2011
52. 11 Healthcare Big Data approach(1)
Actions for sophisticated use of digital data are accelerating
Info.
use Info. use Info. use
Info. use
Accumulated Accumulated Accumulated Accumulated
To the
Info. Info. Info.
Info. letter
Big Data
Open Innovation comes popular in
Healthcare ICT apps. development as well
as product development.
Many Governments start to support Open data Big
initiatives. (Digi
tal)
Data
Advanced analytical technologies with low
cost computing power (cloud) bring
opportunities to analyze larger data set
and get valuable insights.
Distributed by Suda Yasuji, 2011
53. 11 Healthcare Big Data approach(2)
Advancing Open Innovation-1
【US・HHS】
●Open Government Data Initiatives related to health &
medicine “liberate data and catalyze innovation”
●“HHS Open Government Plan ver.1.1” an explanation
material
【focused area】 http://www.hhs.gov/open/
mHealth initiative
Health Data Initiative
Startup America
HHSinnovates
Challenges & Competitions
http://www.data.gov/health
Since 2009, HHS has been providing
searchable Flu vaccination information on
google map (mashed up)
⇒MHLW of Japan doesn’t do this service
⇒What is the Reason? Little demands?
http://www.flu.go
Distributed by Suda Yasuji, 2011 v/
54. 11 Healthcare Big Data approach(3)
Advancing Open Innovation-2
【US・HHS(continue)】
【UK・DOH】 http://mapsandapps.dh.gov.uk/
http://challenge.gov/search?cat=25&org=5
イギリス・HHS
Healthcare Web Application
Developer Online Community
was held for 6weeks
from2011/8/22
・Ready-made apps assessment
・New apps idea contest
<Total Number of posted>
http://departmentofhealth.ideascale.com/
Distributed by Suda Yasuji, 2011
55. 11 Healthcare Big Data approach(4)
Advancing Open Innovation-3
●Some applications picked up in Health Data Initiative Forum (2011.6)
Asthmapolis:http://asthmapolis.com
Enabling real/time monitoring of asthma
patients who use inhaler with sensors.
Analyzing monitoring data then send info.
about self-care to patients’ mobile devices.
Community Commons:
Providing free supportive tools of healthcare services
use combining GIS data & free portal as learning &
exchanging place.
http://profiles.communitycommons.org/sit
e/#
Daily Feats:http://www.dailyfeats.com SleepBot:
/
Providing health related tips useful Mobile application for recording
for better quality of life. sleep time & providing insufficient
User can get points making actions sleep related hazardous data.
through using tips as they combined
with point program.
My Dietary Supplements: IMPAct:
Mobile application for recording, managing & Providing health check information based on
Cecking Information about Using Supplements. age & sex. Enabling appointment of health
Providing English version & Spanish version. check on Google Calendar.
http://ods.od.nih.gov/about/mobile/aboutmyds
.aspx
source:http://www.iom.edu/~/media/Files/Activity%20Files/PublicHealth/HealthData/List%20of%20Featured%20App
Distributed by Suda Yasuji, 2011
56. 11 Healthcare Big Data approach(5)
Advancing Open Innovation-4 ● Japan is still in experimental phase compared
to other governments.
http://openlabs.go.jp/
● Furthermore, activity are temporally stalled.
(accessed 11/7/2011)
Resume date is unreleased
Applying Cloud Source
in Medical Field High
New Strategy for Innovation of Information & Security
Payer Research Institute
Economy (2010/6) Anonymization
Claim Epidemiology
People Seems to have great interesting about Data Mega Data Pharmacology
Open Government Movement(128p) Provider 1.8B/year
We will develop platform based on Idea Box (above) Health
Record Strict Use
to collect & share citizen’s voices then combining them Management Anonymized ID
with policy making & executing processes(129p)
Source:METI Medical Claims Data Processing Infrastructure
Developing Project(2011)
Distributed by Suda Yasuji, 2011
57. 11 Healthcare Big Data approach(6)
R e c a p 1 1
Open Innovation comes popular in
Healthcare IT application development
as well as product development
Big
Many governments start to support
(Digi
open data initiatives tal)
Data
Advanced analytical technologies with low
cost computing power (cloud) make
opportunities to analyze larger data set
and get valuable insights
In Japan,Consensus about non-profitability of
health/medical care is essential. Worldwide
dissemination of FREE health ICT applications
is critical as well
What can be connected to application
X?
Distributed by
Who pay the bill? When and How ?
Suda Yasuji, 2011
59. 12 Healthcare as services ( 1)
Many sectors of society become somewhat Healthy.
Medicalization of Society will be stimulated.
Medicine Exercise & Play
healthy/
medical XX
healthy/
medical XX
Supplement PHR Occupation
healthy/ healthy/
medical XX medical XX
Diet Fashion
healthy/
medical XX
Though, many business players stick in
enclosing information as value source.
Closed System
~stumbling information sharing~
or Open System
~product prior to service~
Distributed by Suda Yasuji, 2011
60. 12 Healthcare as services ( 2)
Healthcare ICT Service Ecosystem Agreed in Meta-
Concept
Implementations are source:smart personal health final repot ,deliverable 6.1 (2011
http://sph.continuaalliance.org/docs/SPH_D6.1_Final_Report.
varied
Distributed by Suda Yasuji, 2011
61. 12 Healthcare as services ( 3)
【Case Study】 Digitizing personal exercise and health
data is already in place in Sports and Food Industry, but
there are no data platform across industry.
Own products user only
https://www.polarpersonaltrainer.com/
11 posted from user in 2011
http://www.movescount.com/
http://www.kao.co.jp/healthya/
https://www.polarpersonaltrainer.com/
Community Approach
Without Digital Health https://www.polarpersonaltrainer.com/
Data Handling Ability
Distributed by Suda Yasuji, 2011