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60AsiAn HospitAl & HeAltHcAre MAnAgeMent
ISSUE-12 2007
While improving computer systems would not eliminate all medical errors, researchersbelieve they will reduce them dramatically. Now is the time to share progress, challengesand best practices to enable interoperability and link the ecosystem in the delivery of betterquality care.
ifma thy Haha
ca a  hahaym
Madhav R RagamDirector - Healthcare and Life Sciences
IBM Asia Pacifc
 
ising costs, aging populations andantiquated healthcare systemshave put pressure on governments,businesses and society to make signicantchanges in the delivery o care.Tese challenges, combined with theemergence o a new environment driven by globalization, consumerism, demographicshits, increased burden o disease, expen-sive new technologies and treatments areexpected to orce undamental change onhealthcare within the coming decade.One o the great ironies o modernmedicine is that while many o us enjoy thebenets o scientic discovery and sophisti-cated equipment, many patients across theglobe do not receive adequate standards o quality care due to a variety o issues un-derpinned by the application o insucientresources and undamental technology ine-ciencies.In countries where inormation tech-nology is commonly used or services suchas banking, telecommunications and en-tertainment, many medical organisationstoday still rely on paper records or the de-livery o their service.Furthermore, most existing medicalelectronic systems don’t interact, whichmeans that important inormation is otenisolated and disconnected. While physi-cians keep their own records, they do nothave access to inormation about the caretheir patients receive outside their oces.Hospitals rarely have access to these patientrecords and emergency room doctors knowlittle about patients’ pre-existing conditions.Tis oten results in redundant tests and as-sessments, increasing the cost o care andmissed diagnoses or treatment resulting ininjury.Such disconnects across the world’shealthcare systems are causing an increasein poor health outcomes and in some caseseven death. A recent Institute o Medicine (IOM)report ound that preventable medical er-rors kill up to 98,000 people each year inthe United States alone. While improvingcomputer systems would not eliminate allmedical errors, many researchers believethey will reduce them dramatically.In addition to saving lives, we at IBMbelieve between ve and 20% o all health-care costs could be saved by eliminatingunnecessary tests. Tis view is supportedby Te Economist, which recently reportedthat redundancy and ineciency accountor between 25% and 40% o the US$3.3trillion the world spends on healthcare ev-ery year and that this could be eliminated with proper I implementation.Change must be made. Healthcaresystems that ail to address the chal-lenges o the emerging environment will “hit the wall” and require imme-diate and major orced restructuring.he choices let to stakeholders o today’s healthcare systems are when andhow. I they wait too long or do not actdecisively enough, their systems will beunable to continue on the current path.his is a rightening, but very real prospect.
 Which direction will the industry take?
Te answer is complicated. Te health-care ecosystem is extremely complex, basedon intricate relationships, oten with dier-ing motivations. Most agree the chie goalis to improve healthcare systems to providebetter quality service to more people, moreeciently and at lower cost. How to achievethat goal, however, varies widely by stake-holder. Tese complex actors create anurgent need to break down industry silos,establish partnerships and increase collabo-ration to drive progress.Tat’s why IBM has taken a leadershiprole in the global healthcare transormation.It is working with major ecosystem stake-holders—ranging rom healthcare providersand standards bodies to governments andother employers—to infuence the adoptiono a consumer-driven model.Tis emerging, patient-centric modelocuses on improved outcomes throughdisease management, prevention and well-being programs. It gives consumers greatercontrol over their healthcare, including inthe selection o primary care providers andaccess to inormation needed to make betterhealthcare decisions.Clearly, technology plays a key role in
spotlight 
 
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i n f o r m at i o n t e c h n o l o g y 
patient-centric healthcare by enabling theast, ecient and secure fow o digital inor-mation between patients and their doctors.Moreover, it provides the tools to improveclinical decision making, collaboration, e-ciency and administrative processes.Fortunately, much o the technology needed to enable patient-centric networksis available today. But the transormation toa patient-centric model will require morethan technology—it requires innovationand a shit to more open, collaborative andintegrated systems. Tere remains a greatdeal o work to be done around standards,governance and workfows, which is criticalto the easy fow o inormation within thehealthcare ecosystem.
An Asia Pacific portrait
 Asia Pacic Healthcare market is cur-rently the smallest in size out o the 3 ge-ographies—the US and Europe being theother two. However, it is exerting a tremen-dous infuence on the Global Healthcarescene, or example- Tere is an expanding interest in medicaltourism across Asia with India, Tailandand Singapore paving the way - Many o the leading pharmaceuticalcompanies are moving clinical trials romthe U.S. and Europe to India- Te Philippines is renowned as a leadingexporter o highly skilled nurses aroundthe globe- Te U.S. has turned to Indian and Aus-tralian companies or the outsourcing o radiology readingsand- Australia has enhanced the U.S.’s Diagno-sis Related Groups (DRG) system, which was subsequently adapted by Singapore,France and Germany. According to the World Health Organi-sation (WHO), the Health Systems Statis-tics vary signicantly across the world’s de-veloped and emerging countries. In the caseo Asia Pacic, WHO claims inequitablehealth systems are preventing many AsiaPacic nations rom meeting internationalgoals set on health and poverty. Further-more, the healthcare systems o many AsiaPacic countries are ailing to deliver servic-es o adequate quality, oten using resourcesineciently or inappropriately.Te graphs below—rom the WHO2005 statistics or Health Systems—high-light the healthcare acts and gures o relevance to key Asia Pacic countries andcompares them to some o the world’s mostdeveloped countries.In these graphs, India, China and Ma-laysia clearly stand out as having a signicantlow number o beds, physicians and nursesor every 10,000 people in their respectivecountries. As a result, we expect to see expo-nential growth o the healthcare industry in
SingaporeRepublic of KoreaNew ZealandMalaysiaJapanChinaAustraliaIndiaEuropeNorth America051015202530Source: WHO
Physicians per 10000
 
62AsiAn HospitAl & HeAltHcAre MAnAgeMent
ISSUE-12 2007
these three countries while the more devel-oped countries will ocus on reining in thehealthcare costs and improving quality.
Linking the healthcare ecosystem
In all o the world’s markets, theHealthcare industry unctions as an ecosys-tem, with its various constituents, rules andinteractions.Currently, that ecosystem is plaguedby a number o pervasive issues including:poor communications among constituentsresulting in ragmented patient data andpoor coordination across the continuum o care; inadequate inormation on quality andoutcomes; worrisome patient saety issues;and misaligned nancial incentives thatocus resources on episodes o care insteado preventive medicine and long-term careoutcomes.Tese ecosystem issues have resulted ina strong interest across several countries toleverage technology (healthcare interoper-ability) in order to create regional electronicpatient inormation exchanges. Te basicconcept is that these exchanges will providephysicians with the patient inormationthey need at the time treatment decisionsare made—e.g.: what prescriptions is thispatient on?, what tests has he/she received?etc.—which in turn permits a substantialincrease in the quality o care, patient saety and eciency gains.More than just data sharing utilities,these regional electronic patient inorma-tion exchanges are also envisioned as places where community constituents can experi-ment with new business models to addressthe lack o incentives or the perverse incen-tives built in the existing reimbursementsystem, both or their own benets and thegreater good o the community.o urther illustrate these points, thechart below indicates the typical stakehold-ers in a Healthcare Ecosystem, the initiativesthat are o interest to them and the types o solutions that IBM can oer. At the early stages o an initiative it iskey to careully approach planning, constit-
i n f o r m at i o n t e c h n o l o g y 
SingaporeRepublic of KoreaNew ZealandMalaysiaJapanChinaAustraliaIndiaEuropeNorth America020406080100120140160Source: WHO
Hospitals beds per 10000
SingaporeRepublic of KoreaNew ZealandMalaysiaJapanChinaAustraliaIndiaEuropeNorth America020406080100Source: WHO
Nurses per 10000
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