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1 ehealth Records best practice examples Dr. med. Ulrich Pluta Business Development Healthcare ehealth 2007, April 18

2 Agenda ehealth is everywhere ehrs What for? Best practice examples Obstacles 2

3 Opportunity Status Global e-health projects a selection National and regional initiatives Canada Infoway set up to design and procure National EHR - $1.2 billion of government backing for regional EHR projects USA Federal ONC NHIN contract underway. Multiple State initiatives for RHIOS. Still emergent national EHR by 2014 Current Work Planning Monitor Considering EHR Mexico: No EHR but aim for HL7 Integration Data N/A or No EHR Presence * Target opportunities identified by text in red Source: Accenture + Oracle Chile: National RFP for EHR project is expected soon Ireland: Procurement contracting has started to drive national EHR effort England: EHR initiative in process, PACS project is imminent Spain: Regional initiatives are being considered France: EHR mandated by National RFP has been issued Brazil: National Health Card Project. Netherlands: National Switch Hub Italy: EHR regional initiatives have begun Argentina: 1 st adoption of a digital radiography solution Sweden: Developing a National Patient Summary Denmark: New National IT-strategy to standardize EHR s Germany: One regional deal underway. Future EHR efforts are expected to be regional South Africa: No EHR but infrastructure being developed Finland: National ehealht- Archives to be established SEE: Bulgaria, Romania, Turkey and Serbia all developing national ehealth strategies. Malaysia: Lifetime Health Record (LRH) by 2010 Russia: 15 Diagnostic Centers project in progress. Plans being developed for national HER for 145 million people. China: Plans to develop a national EHR Hong Kong: Territory wide Patient Master Index Singapore: EMR system tender expected Q Australia: HealthConnect is developing a National Information Network New Zealand: National EHR system in place (complete) 3

4 Agenda ehealth is everywhere ehrs What for? Best practice examples Obstacles 4

5 ehr: What for? 1 Increase Patient Satisfaction 2 Reduce Medical Errors 3 Contain Costs Source: Commission on Systemic Interoperability, Health & Human Services, US, Jan

6 ehr What for? Benefits Implementing IT will prove to provide a wide range of benefits. Not all are easy to financially quantify. Improve quality of care Reduction in medical errors caused by inaccurate or unavailable patient information Able to track access to healthcare information more easily. Improved communication and coordination between healthcare stakeholders in care delivery Improved legal and regulator compliance with controlled and auditable provider access Notes, prescriptions, orders and other data is always readable. Reduce Costs Medical errors cost between $17 and $29 billion in US alone Savings of approx. $500 billion in unneeded duplicative care Reduced cost of recruitment by improved clinician satisfaction Reduced transcription costs estimates monthly between $300-$1000 $1000 per physician Reduction of office visit time by 13% for physicians and one minute for pre-exam exam Increase Citizen Satisfaction Sources: HealthGrades, June 2004; DATAMONITOR, July 2006; College of Medicine, Florida State University, Feb

7 Agenda ehealth is everywhere ehrs What for? Best practice examples Obstacles 7

8 ehr- Functional Architecture 8

9 1 ehr- best practice examples Organisation Key Benefits Citizens have control over the information on their health history and access to it at the point care Improved communication between Healthcare Providers, Insurers and citizens Significant reduction in duplicate data entry and tests Estimated productivity gain by healthcare professionals: 74% Solution Overview Secure, centralized electronic health record developed by IZIP and the General Health Insurance company in CZ Republic on Oracle Database and RAC available over the public network. The EHR includes all relevant information compiled from regular GP visits, dental treatments, laboratory and imaging tests and hospital services, such as complicated surgery. Citizens allowed to view their record and approve access by healthcare professionals. Only health professionals are able to update or insert data. 2 Key Benefits Organisation Reduction in duplicated or unnecessary procedures Improved patient safety, as allergy and other data is stored on the smartcard Patients can choose where they want to be treated, as all hospitals have access to their health record Solution Overview Electronic Health Card based access to centralised secure electronic health record. Essential health information available on card for quick access. Data warehouse for analysis and reporting created from the transactional electronic health record. Single window accessibility to healthcare services, appointment bookings, lab results and prescription management 9

10 ehr best practice examples 3 Organisation Key Benefits Improve the speed and quality of healthcare delivery by creating a single,universally accessible electronic health record for each patient Cut developing costs by reuse of existing clinical systems 4 Key Benefits Organisation Support the modernisation of the Statutory Health Insurance System (GKV-Modernisierungsgesetz Modernisierungsgesetz) Reduction of healthcare costs Solution Overview Integrated standards based electronic health record framework over Oracle HTB for creating a single, up-to to-date information record for the emergency department Synchronised patient data from existing repositories using Oracle Partner Orion Health s s Rhapsody with HTB via HL7 v3.0 messages Scalability of Oracle HTB to roll out electronic health records to all departments in Son Dureta and other regional hospitals, and support thousands of users simultaneously Solution Overview Architecture for telematics applications including electronic health card, and a backend electronic health record (EHR) developed on Oracle HTB. The EHR exposed as web services and accessible to patients through a user interface via Kiosks. Implementation of enterprise processes, i.e. authentication, identity and access to EHR. 10

11 Agenda ehealth is everywhere ehrs What for? Best practice examples Obstacles 11

12 ehr: Obstacles Money for Physicians Source: DATAMONITOR Report, July

13 Thank you for your attention! 13

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