The Healthcare Information Management Systems Society,  Global Enterprise (EHR) Task Force Findings Walter W. Wieners, MA ...
CME Objectives for this Seminar <ul><li>Identify key trends among 15 countries who are leaders in electronic health record...
Global EHRs Today’s Agenda <ul><li>HIMSS Task Force Overview </li></ul><ul><li>EHR Program Comparisons from Matrix </li></...
Task Force Charter 2007 to 2009  “ The goals of the HIMSS Global Enterprise Task Force are to identify and describe signif...
Current Objectives - Fall 2007 <ul><li>To identify and describe significant healthcare information enterprise solution eff...
Current Objectives - Fall 2007 <ul><li>To incorporate the best practices into a road map for the development of a successf...
20 Members from 9 Countries Plus Expert Advisors Selected Task Force Members:   Marion J. Ball, Ed.D, IBM George Heidenrei...
Inclusions in Matrix and White Paper January 2008 <ul><li>England </li></ul><ul><li>Wales </li></ul><ul><li>Scotland </li>...
Governance - Comparisons and Trends <ul><li>All countries and territories are different and we do not observe a pattern in...
Policy - Comparisons and Trends  <ul><li>Each jurisdiction needs to agree upon a unique patient identifier and Initiate Sy...
Technology - Comparisons and Trends  <ul><li>All countries suffer from the same issues of lack of healthcare IT standards ...
Adoption - Comparisons and Trends  <ul><li>The actual numbers of different classes of users by country vary widely dependi...
Outcomes - Comparisons and Trends  <ul><li>Research and surveys have attempted to document ROI of implementing EHRs, for e...
Key Lessons and Barriers Assessments of Canada and Australia <ul><li>Global  Perspectives   book chapter for “Aspects of t...
Key Lessons Learned and Barriers to Success  Common Across Australia and Canada  <ul><li>National EHR programs are industr...
Key Lessons Learned and Barriers to Success Common Across Australia and Canada <ul><li>Developing initial momentum among s...
Barriers Recognized - Revised Australian Approach  <ul><li>HealthConnect re-implementation announced focusing on change ma...
<ul><li>International Knowledge Transfer – New Developments </li></ul><ul><li>Significant sharing among international work...
Marion J. Ball, Ed.D., From “Around the World in Sixty Minutes: Where’s the EHR” “ No country has succeeded in fully deplo...
  Questions from Online Participants and Attendees   To participate in the Task Force, please contact: Walter W. Wieners, ...
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JHU Global EHR November 2007

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Lessons Learned from Global Health Record Programs

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  • Walter Wieners specializes in global market analyses and strategy development with expertise in electronic health records and payer systems with 20 years experience. He prepared the chapter “The Global Perspective” for “Aspects of Electronic Health Record Systems - Second Edition” edited by Dr. Marion Ball. Author, &amp;quot;Global Health Care Markets: A Comprehensive Guide to the Regions, Trends, and Opportunities Shaping the International Health Arena.&amp;quot; From 2002-2005 he was Director, Healthcare and Life Sciences Consulting, Europe, Middle East and Africa, Oracle. He previously led practice focused on investors. A HIMSS Fellow, he is Co-Chair, HIMSS Global Enterprise Task Force and serves on the National Advisory Council of The Johns Hopkins School of Nursing. Graduate, University of Chicago and Johns Hopkins University. Introduction Working toward making electronic health records (EHRs) and personal health records (PHRs) a reality in the United States, we can benefit from the experiences of other countries focused on the same goals, albeit in very different political and social environments. There is tremendous variability in the use of health information technology within countries, across regions and political jurisdictions, and among sectors (e.g., acute versus ambulatory). Despite—or perhaps because of—these differences, there are many lessons that we can learn from health informatics strategies and exemplars in other countries. To date, there have been few cross-national studies about EHR initiatives or fully developed programs. Additionally, independent, rigorous evaluation of both government and industry driven EHR projects has yet to occur. To address these limitations in global knowledge sharing, executives from leading countries conducted a collaborative observational study designed to contribute to a more in-depth understanding of the benefits of EHR innovations within the healthcare arena across borders and to offer a summary of lessons learned from selected countries. (2) After an in-depth analyses of Canada, Australia and England leading authorities from those countries found many common experiences. “ Electronic Health Records: Global Lessons,” Ball, Marion, Haux, Reinhold, Hyatt, Susan, Li, Yu-Chuan, Wieners, Walter, American Medical Informatics Association Annual Symposium , Chicago, IL, November 13, 2007. The Healthcare Information and Management Systems Society (HIMSS) is the healthcare industry&apos;s membership organization exclusively focused on providing leadership for the optimal use of healthcare information technology (IT) and management systems for the betterment of healthcare.
  • JHU Global EHR November 2007

    1. 1. The Healthcare Information Management Systems Society, Global Enterprise (EHR) Task Force Findings Walter W. Wieners, MA HIMSS, Fellow HIMSS, Co-Chair, Global Enterprise (EHR) Task Force
    2. 2. CME Objectives for this Seminar <ul><li>Identify key trends among 15 countries who are leaders in electronic health record deployment </li></ul><ul><li>Compare the EHR programs on Governance, Policy, Technology, Adoption and Outcomes </li></ul><ul><li>Articulate barriers to success in Canada and Australia </li></ul>
    3. 3. Global EHRs Today’s Agenda <ul><li>HIMSS Task Force Overview </li></ul><ul><li>EHR Program Comparisons from Matrix </li></ul><ul><li>Emerging Key Trends for White Paper </li></ul><ul><li>Barriers to Success in Two Leading Countries </li></ul><ul><li>Questions from Online Participants and Attendees </li></ul>
    4. 4. Task Force Charter 2007 to 2009 “ The goals of the HIMSS Global Enterprise Task Force are to identify and describe significant healthcare information enterprise solution efforts being pursued in one or more industrialized nations; identify those aspects of an enterprise solution that differ from one nation to another and determine, through ROI in finance and quality, those aspects that represent best practices.”
    5. 5. Current Objectives - Fall 2007 <ul><li>To identify and describe significant healthcare information enterprise solution efforts being pursued in one or more industrialized nations; </li></ul><ul><li>2. To identify those aspects of an enterprise solution that differ from one nation to another and determine, through ROI in finance and quality, those aspects that represent best practices; </li></ul><ul><li>3. To identify the common threads in national EHR adoption that have led to either failure or success, then open communications between all stakeholders; </li></ul>
    6. 6. Current Objectives - Fall 2007 <ul><li>To incorporate the best practices into a road map for the development of a successful enterprise solution in the United States and to avoid pitfalls that have had negative impact in other countries; </li></ul><ul><li>5. To understand the funding, architecture, and delivery systems of enterprise solutions in other countries such as network models and central versus local data repositories and to determine their applicability in the United States; </li></ul><ul><li>6. To join and communicate with other nations of the world to help promote common goals in the global adoption of Electronic Health Records. </li></ul>
    7. 7. 20 Members from 9 Countries Plus Expert Advisors Selected Task Force Members: Marion J. Ball, Ed.D, IBM George Heidenreich, Siemens, Germany Susan Hyatt, MBA, HYATTDIO, Inc., Canada Yu-Chaun Li, MD, Ph.D, Asia Pacific Association Dave Nurse, Technical Director, CSW Group, Ltd. Gerry Yantis, Capgemini Task Force Co-Chairs: Steve Arnold MD, President, Healthcare Consultants International Walter W. Wieners, Fellow, HIMSS
    8. 8. Inclusions in Matrix and White Paper January 2008 <ul><li>England </li></ul><ul><li>Wales </li></ul><ul><li>Scotland </li></ul><ul><li>Canada </li></ul><ul><li>Germany </li></ul><ul><li>Netherlands </li></ul><ul><li>South Africa </li></ul><ul><li>Australia </li></ul><ul><li>Singapore </li></ul><ul><li>Malaysia </li></ul><ul><li>Spain </li></ul><ul><li>Portugal </li></ul><ul><li>France </li></ul><ul><li>Finland </li></ul><ul><li>Greece </li></ul><ul><li>New Zealand </li></ul><ul><li>Sweden </li></ul><ul><li>Italy </li></ul><ul><li>Denmark </li></ul><ul><li>Hong Kong </li></ul><ul><li>France </li></ul><ul><li>USA </li></ul><ul><li>India </li></ul><ul><li>Northern Ireland </li></ul>
    9. 9. Governance - Comparisons and Trends <ul><li>All countries and territories are different and we do not observe a pattern in governing structure and financing; </li></ul><ul><li>Canada Health Infoway, an independent not-for-profit corporation, leads the national effort with all fourteen federal, provincial and territorial governments; </li></ul><ul><li>Australia’s national approach combines both centralized and decentralized components; </li></ul><ul><li>England is a worldwide leader in the development of healthcare infrastructure and its funding has been through the government-funded National Health Service (NHS). </li></ul>
    10. 10. Policy - Comparisons and Trends <ul><li>Each jurisdiction needs to agree upon a unique patient identifier and Initiate Systems is often employed; </li></ul><ul><li>Laws and regulations regarding privacy and electronic health record access vary widely but must be adopted in each jurisdiction; </li></ul><ul><li>New EU regulations offer the likelihood of standardization among European countries in the future. </li></ul>
    11. 11. Technology - Comparisons and Trends <ul><li>All countries suffer from the same issues of lack of healthcare IT standards and barriers to inter-system communication; </li></ul><ul><li>HL7 v2 and v3 are commonly being used, standards are different across different applications; </li></ul><ul><li>Germany, the Netherlands and France are attempting to do this by using a variation of the HL7 standard so that interoperability can also occur between countries; </li></ul><ul><li>South Africa is selecting of a mainstream vendor there would be considerable interoperability and utilization of industry standards such as HL7, DICOM, etc.; </li></ul><ul><li>England choose Oracle DB as the foundation upon which all applications must be built. </li></ul>
    12. 12. Adoption - Comparisons and Trends <ul><li>The actual numbers of different classes of users by country vary widely depending upon which provinces were implemented first and the number of early adapters; </li></ul><ul><li>Hong Kong implemented a system which reaches 90% plus of the population for inpatient records; </li></ul><ul><li>Israel does not have a national program but 26 different products also reach the majority of citizens; </li></ul><ul><li>In contrast, Norway has a small research program and has not implemented significant systems. </li></ul>
    13. 13. Outcomes - Comparisons and Trends <ul><li>Research and surveys have attempted to document ROI of implementing EHRs, for example, Denmark, but the studies are not recognized as providing complete answers; </li></ul><ul><li>Most jurisdictions are too early in the implementation process to be able to measure tangible savings or document the impact on healthcare quality; </li></ul><ul><li>Medical error reduction is the most commonly change researchers attempt to confirm. </li></ul>
    14. 14. Key Lessons and Barriers Assessments of Canada and Australia <ul><li>Global Perspectives book chapter for “Aspects of the Electronic Health Record Systems” Second Edition, Harold P. Lehmann, M.D., Ph.D., Marion J. Ball, Ed.D., et.al., Editors, Springer, Inc., April 2006 </li></ul><ul><li>Selected leading countries with enabling legislation, funding and implementations at Provincial levels </li></ul><ul><li>Conducted an observational study benefiting from senior EHR program executive experience </li></ul>
    15. 15. Key Lessons Learned and Barriers to Success Common Across Australia and Canada <ul><li>National EHR programs are industry-wide transformations in an immature IT environment </li></ul><ul><li>Building and maintain genuine physician/clinician involvement </li></ul><ul><li>Developing support from all stakeholders including vendors is critical </li></ul><ul><li>Adopting and adhering to data exchange standards must be achieved early </li></ul>
    16. 16. Key Lessons Learned and Barriers to Success Common Across Australia and Canada <ul><li>Developing initial momentum among stakeholders is essential for building a critical mass </li></ul><ul><li>Achievement of national legal and regulatory agreement on privacy and consent issues </li></ul><ul><li>Substantial efforts must be applied to stakeholder communication to ensure successful participation </li></ul><ul><li>Information technology investment and deployment strategies and programs must be customizable </li></ul>
    17. 17. Barriers Recognized - Revised Australian Approach <ul><li>HealthConnect re-implementation announced focusing on change management & point of care information </li></ul><ul><li>Health Ministers create National E-Health Transition Authority (NEHTA) – national health information management & information & communication technology entity (IM&ICT) to address urgent priorities </li></ul><ul><li>NEHTA – 50% funding Council of Australian Governments (COAG); 50% State funding </li></ul>
    18. 18. <ul><li>International Knowledge Transfer – New Developments </li></ul><ul><li>Significant sharing among international working groups on standards (Canada, UK, US, Australia) </li></ul><ul><li>May 2006 – first international meeting to share information on EHR systems initiatives – ONC (US), NEHTA (AU), NHS (UK) & Infoway (CAN) </li></ul><ul><li>Many international EHR study tours among Canada, UK and Australia (agencies, governments, regions) </li></ul>
    19. 19. Marion J. Ball, Ed.D., From “Around the World in Sixty Minutes: Where’s the EHR” “ No country has succeeded in fully deploying an electronic health record on a national basis; however, substantial progress has been achieved in Australia, United Kingdom and Canada. Several of these healthcare systems have developed innovative solutions to obstacles and challenges that offer constructive guidelines for the United States.”
    20. 20. Questions from Online Participants and Attendees To participate in the Task Force, please contact: Walter W. Wieners, FHIMSS Co-Chair, Global Enterprise Task Force [email_address]

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