eHealth Records – best practice examples
Dr. med. Ulrich Pluta
Business Development Healthcare
Agenda
eHealth is everywhere
eHRs – What for?
Best practice examples
Obstacles
3 * Target opportunities identified by text in red
Source: Accenture + Oracle
Monitor Planning Current Work Opportunity Status Data N/A or No EHR Presence Considering EHR England: EHR initiative in process, PACS project is imminent
France: EHR mandated
by 2007. National RFP has been issued
Singapore: EMR system tender expected Q1 2005 Chile: National RFP for EHR project is expected soon Argentina: 1st adoption of a digital radiography solution- 2004 South Africa: No EHR – but infrastructure being developed Australia: HealthConnect is developing a National Information Network
USA – Federal ONC NHIN
contract underway. Multiple State initiatives for RHIOS. Still emergent – national EHR by 2014
Canada – Infoway set up to
design and procure National EHR - $1.2 billion of government backing for regional EHR projects
Germany: One regional
deal underway. Future EHR efforts are expected to be regional
New Zealand: National
EHR system in place (complete)
Hong Kong: Territory
wide Patient Master Index
Brazil: National
Health Card Project.
Finland: National
eHealht-Archives to be established
Netherlands:
National Switch Hub
Malaysia: Lifetime
Health Record (LRH) by 2010
Mexico: No
EHR but aim for HL7 Integration
China: Plans to
develop a national EHR
Italy: EHR regional
initiatives have begun
Ireland: Procurement contracting has started to drive national EHR effort Spain: Regional
initiatives are being considered
Global e-Health projects – a selection
National and regional initiatives
Russia: 15 Diagnostic Centers
project in progress. Plans being developed for national HER for 145 million people.
SEE: Bulgaria,
Romania, Turkey and Serbia all developing national eHealth strategies.
Sweden: Developing a
National Patient Summary
Denmark: New National
IT-strategy to standardize EHR´s
Agenda
eHealth is everywhere
eHRs – What for?
Best practice examples
Obstacles
5
eHR: What for?
Increase Patient Satisfaction
1 2 Reduce Medical Errors
Contain Costs 3
eHR – What for?
Implementing IT will prove to provide a wide range of benefits.
Implementing IT will prove to provide a wide range of benefits. Not all are easy to
Not all are easy to
financially quantify.
financially quantify.
Improve quality of care
Improve quality of care
•
•
Reduction in medical errors caused by inaccurate or unavailable patient information
Reduction in medical errors caused by inaccurate or unavailable
patient information
•
•
Able to track access to healthcare information more easily.
Able to track access to healthcare information more easily.
•
•
Improved communication and coordination between healthcare stakeholders in care
Improved communication and coordination between healthcare stake
holders in care
delivery
delivery
•
•
Improved legal and regulator compliance with controlled and auditable provider access
Improved legal and regulator compliance with controlled and audi
table provider access
•
•
Notes, prescriptions, orders and other data is always readable.
Notes, prescriptions, orders and other data is always readable.
Reduce Costs
Reduce Costs
•
•
Medical errors cost between $17 and $29 billion in US alone
Medical errors cost between $17 and $29 billion in US alone
•
•
Savings of approx. $500 billion in unneeded duplicative care
Savings of approx. $500 billion in unneeded duplicative care
•
•
Reduced cost of recruitment by improved clinician satisfaction
Reduced cost of recruitment by improved clinician satisfaction
•
•
Reduced transcription costs estimates monthly between $300-
Reduced transcription costs estimates monthly between $300
-$1000 per physician
$1000 per physician
•
•
Reduction of office visit time by 13% for physicians and one minute for pre
Reduction of office visit time by 13% for physicians and one min
ute for pre
-exam
-
exam
Increase Citizen Satisfaction
Increase Citizen Satisfaction
Benefits
Benefits
Sources: HealthGrades, June 2004; DATAMONITOR, July 2006; College of Medicine, Florida State University, Feb. 2005
7
Agenda
eHealth is everywhere
eHRs – What for?
Best practice examples
9
eHR- best practice examples
Organisation Organisation Solution Overview Solution Overview Solution Overview Solution Overview Organisation Organisation Key Benefits Key Benefits •
• Secure, centralized electronic health record Secure, centralized electronic health record
developed by IZIP and the General Health Insurance
developed by IZIP and the General Health Insurance
company in CZ Republic on Oracle Database and
company in CZ Republic on Oracle Database and
RAC available over the public network.
RAC available over the public network.
•
• The EHR includes all relevant information compiled The EHR includes all relevant information compiled from regular GP visits, dental treatments, laboratory
from regular GP visits, dental treatments, laboratory
and imaging tests and hospital services, such as
and imaging tests and hospital services, such as
complicated surgery.
complicated surgery.
•
• Citizens allowed to view their record and approve Citizens allowed to view their record and approve access by healthcare professionals. Only health
access by healthcare professionals. Only health
professionals are able to update or insert data.
professionals are able to update or insert data.
2
Key Benefits
Key Benefits •
• Reduction in duplicated or unnecessary proceduresReduction in duplicated or unnecessary procedures •
• Improved patient safety, as allergy and other data is Improved patient safety, as allergy and other data is stored on the
stored on the smartcardsmartcard
•
• Patients can choose where they want to be treated, as all Patients can choose where they want to be treated, as all hospitals have access to their health record
hospitals have access to their health record
•
• Electronic Health Card based access to centralised Electronic Health Card based access to centralised secure electronic health record. Essential health
secure electronic health record. Essential health
information available on card for quick access.
information available on card for quick access.
•
• Data warehouse for analysis and reporting created Data warehouse for analysis and reporting created from the transactional electronic health record.
from the transactional electronic health record.
•
• Single window accessibility to healthcare services, Single window accessibility to healthcare services, appointment bookings, lab results and prescription
appointment bookings, lab results and prescription
management
management Citizens have control over the information on their health histo
Citizens have control over the information on their health history and access ry and access
to it at the point care
to it at the point care
Improved communication between Healthcare Providers, Insurers an
Improved communication between Healthcare Providers, Insurers and d
citizens
citizens
Significant reduction in duplicate data entry and tests
Significant reduction in duplicate data entry and tests
Estimated productivity gain by healthcare professionals: 74%
Estimated productivity gain by healthcare professionals: 74%
eHR – best practice examples
3 OrganisationOrganisation Solution Overview Solution Overview Solution Overview Solution Overview Organisation Organisation •• Improve the speed and quality of healthcare delivery by Improve the speed and quality of healthcare delivery by creating a single,universally accessible electronic health
creating a single,universally accessible electronic health
record for each patient
record for each patient
•
• Cut developing costs by reuse of existing clinical systemsCut developing costs by reuse of existing clinical systems
Key Benefits
Key Benefits
•
• Integrated standards based electronic health record Integrated standards based electronic health record
framework over Oracle HTB for creating a single,
framework over Oracle HTB for creating a single,
up
up--toto--date information record for the emergency date information record for the emergency department
department
•
• Synchronised patient data from existing repositories Synchronised patient data from existing repositories
using Oracle Partner Orion Health
using Oracle Partner Orion Health’’s Rhapsody with s Rhapsody with
HTB via HL7 v3.0 messages
HTB via HL7 v3.0 messages
•
• Scalability of Oracle HTB to roll out electronic health Scalability of Oracle HTB to roll out electronic health
records to all departments in Son
records to all departments in Son DuretaDuretaand other and other
regional hospitals, and support thousands of users
regional hospitals, and support thousands of users
simultaneously simultaneously 4 Key Benefits Key Benefits •
• Support the modernisation of the Statutory Health Support the modernisation of the Statutory Health Insurance System (GKV
Insurance System (GKV--ModernisierungsgesetzModernisierungsgesetz))
•
• Reduction of healthcare costsReduction of healthcare costs
•
• Architecture for Architecture for telematicstelematicsapplications including applications including
electronic health card, and a backend electronic health
electronic health card, and a backend electronic health
record (EHR) developed on Oracle HTB.
record (EHR) developed on Oracle HTB.
•
• The EHR exposed as web services and accessible to The EHR exposed as web services and accessible to patients through a user interface via Kiosks.
patients through a user interface via Kiosks.
•
• Implementation of enterprise processes, i.e. Implementation of enterprise processes, i.e. authentication, identity and access to EHR.
11
Agenda
eHealth is everywhere
eHRs – What for?
Best practice examples
eHR: Obstacles
Money for Physicians
Money for Physicians
13
