Paul Woolman Green ShootsOr Blue Sky ?. 1935 2013.

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Presentation transcript:

Paul Woolman Green ShootsOr Blue Sky ?

1935

2013

1935

2013

Challenges in Scotland Environment Cancer Cardio Vascular disease Long Term Conditions Deprivation Obesity Ageing population Escalating costs

The Power of Information

National Strategies

William Gibson

National Programme in England “The aim is to implement integrated care records services (ICRS) records which are: integrated across all health and social care settings; designed around the patient, and not around individual institutions; therefore able to support the implementation of care pathways as part of National Service Frameworks. Delivering 21st Century IT National Specification for Integrated Care Records Service July 2002

Successes of NPFIT National network N3 PACS rollout GP2GP record transfer rollout

Failures of NPFIT “The aim is to implement integrated care records services (ICRS) records which are: integrated across all health and social care settings; designed around the patient, and not around individual institutions; therefore able to support the implementation of care pathways as part of National Service Frameworks. Delivering 21st Century IT National Specification for Integrated Care Records Service July 2002

14 Reasons for failure 23 (of 245) 26 June 07 Doctor, 20 Feb 07 Hospital Doctor, 08 Feb 07

Bill Gates

16 Spain (Andalucia)

Population Growth:1.6 % > 65 years:14.6 % Life expectancy Women:82.17 Men:75.24 Birth rate:11.94 ‰ Standardized mortality rate Women:4.83 ‰ Men:8.70 ‰ Child mortality: 4.74 ‰ 8 million inhabitants Andalucía 87,579 Km2 91 inhabitants/Km % of Spanish population

Integrate the healthcare information of every citizen Andalusia’s eHealth objective A SINGLE HEALTH RECORD A SINGLE HEALTH RECORD

1 A SINGLE Health record for each citizen 2 Unified access to all services 3 All relevant information structured Diraya’s key elements Developed by the practitioners/users 4

H.C. CENTRAL RECORD Record Browser Problems Sheet Allergic/Contraindications Personal Background Current prescription Sheet Medical Disability Notes Diagnostics Test Medical Referrals LOCAL RECORD H.C. Citizen Register

Lessons learned in Spain Involve professionals in the inception of the system in order to create useful tools for the clinical practice. Feedback of information. Provide support to management level information systems. Staff involvement. Political support. Internal and external communications

US – Veteran’s Administration Every VA Medical Center has Electronic Health Records and Computerized Order Entry!

Veterans Health Administration Basic stats ~ 1,400 Sites-of-Care Including 154 medical centers, ~ 875 clinics, 198,500 Employees > $30 Billion budget 5.3 million patients

Critical Success Factors at the VA Top management support Clinical informatics leadership Institutional commitment and culture National networking Excellent infrastructure and resources Inpatient/outpatient care can be documented by same system

Sweden

In 1995, the northern region of Norrbotten mandated that everyone – including all PHC centers and hospitals - would use a single common system. One of the justifications was to eliminate the problems surrounding the electronic transmission of records between sectors and different computer systems. This approach has become widespread in all Sweden with adoption of standards.

Critical success factors in Sweden Local autonomy National EHR standards Clinical leadership Advanced IT infrastructure

Patient Summaries transfer Emergency care summary Scotland EPSOS Europe

Emergency Care Summary – a taster of the successes Present value of total annual costsPresent value of annual benefits

EPSOS Transfer of patient summaries across EU countries Developed Standards Legal and Governance Agreements Technical & Semantic Interoperability Open Source developments

eHealth in Chile

eHealth in Chile ?

eHealth in South Africa ? You Decide !