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eHealth Records best practice examples

Dr. med. Ulrich Pluta Business Development Healthcare

eHealth 2007, April 18

eHealth is everywhere eHRs What for? Best practice examples Obstacles

Global e-Health projects a selection

National and regional initiatives
Sweden: Developing a National Patient Summary Denmark: New National IT-strategy to standardize EHRs Finland: National eHealhtArchives to be established Ireland: Procurement contracting has started to drive national EHR effort Netherlands: National Switch Hub Russia: 15 Diagnostic Centers project in progress. Plans being developed for national HER for 145 million people. China: Plans to develop a national EHR 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

England: EHR initiative in process, PACS project is imminent Spain: Regional initiatives are being considered France: EHR mandated by 2007. National RFP has been issued Italy: EHR regional initiatives have begun Chile: National RFP for EHR project is expected soon Brazil: National Health Card Project. Argentina: 1st adoption of a digital radiography solution- 2004

Germany: One regional deal underway. Future EHR efforts are expected to be regional

Hong Kong: Territory wide Patient Master Index Singapore: EMR system tender expected Q1 2005

Opportunity Status Current Work Planning Monitor Considering EHR Data N/A or No EHR Presence

Mexico: No EHR but aim for HL7 Integration

SEE: Bulgaria, Romania, Turkey and Serbia all developing national eHealth strategies. Malaysia: Lifetime Health Record (LRH) by 2010

Australia: HealthConnect is developing a National Information Network

South Africa: No EHR but infrastructure being developed

New Zealand: National EHR system in place (complete)

* Target opportunities identified by text in red Source: Accenture + Oracle

eHealth is everywhere eHRs What for? Best practice examples Obstacles

eHR: What for?

1 Increase Patient Satisfaction 2 Reduce Medical Errors

Contain Costs

5 Source: Commission on Systemic Interoperability, Health & Human Services, US, Jan 2005

eHR What for?

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 per physician Reduction of office visit time by 13% for physicians and one minute for pre-exam

Increase Citizen Satisfaction

Sources: HealthGrades, June 2004; DATAMONITOR, July 2006; College of Medicine, Florida State University, Feb. 2005

eHealth is everywhere eHRs What for? Best practice examples Obstacles

eHR- Functional Architecture

eHR- best practice examples


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.

Key Benefits The EHR includes all relevant information compiled Citizens have control over the information on their health history and access from regular GP visits, dental treatments, laboratory history to it at the point care and imaging tests and hospital services, such as Improved communication between Healthcare Providers, Insurers and and complicated surgery. citizens Citizens allowed to view their record and approve Significant reduction in duplicate data entry and tests access by healthcare professionals. Only health Estimated productivity gain by healthcare professionals: 74%

professionals are able to update or insert data. 2

Organisation Solution Overview

Key Benefits

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

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

eHR best practice examples

Solution Overview


Integrated standards based electronic health record framework over Oracle HTB for creating a single, up-to-date information record for the emergency up-todepartment Synchronised patient data from existing repositories using Oracle Partner Orion Healths Rhapsody with Health 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

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

Architecture for telematics applications including electronic health card, and a backend electronic health record (EHR) developed on Oracle HTB.
Key Benefits

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.

Support the modernisation of the Statutory Health Insurance System (GKV-Modernisierungsgesetz) (GKV- Modernisierungsgesetz) Reduction of healthcare costs


eHealth is everywhere eHRs What for? Best practice examples Obstacles


eHR: Obstacles
Money for Physicians

12 Source: DATAMONITOR Report, July 2006

Thank you for your attention!