oracle ehr
TRANSCRIPT
eHealth Records – best practice examples
Dr. med. Ulrich Pluta
Business Development HealthcareeHealth 2007, April 18
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Agenda
eHealth is everywhere
eHRs – What for?
Best practice examples
Obstacles
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* Target opportunities identified by text in red
Source: Accenture + Oracle
Monitor
Planning
CurrentWork
OpportunityStatus
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 selectionNational 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 eHealthstrategies.
Sweden: Developing a National Patient Summary
Denmark: New National IT-strategy to standardize EHR´s
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Agenda
eHealth is everywhere
eHRs – What for?
Best practice examples
Obstacles
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eHR: What for?
Increase Patient Satisfaction1 Reduce Medical Errors2
Contain Costs3
Source: Commission on Systemic Interoperability, Health & Human Services, US, Jan 2005
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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 careImprove quality of care•• Reduction in medical errors caused by inaccurate or unavailable Reduction in medical errors caused by inaccurate or unavailable patient informationpatient 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 stakeImproved communication and coordination between healthcare stakeholders in care holders in care
deliverydelivery•• Improved legal and regulator compliance with controlled and audiImproved legal and regulator compliance with controlled and auditable provider accesstable provider access•• Notes, prescriptions, orders and other data is always readable.Notes, prescriptions, orders and other data is always readable.
Reduce CostsReduce Costs•• Medical errors cost between $17 and $29 billion in US aloneMedical errors cost between $17 and $29 billion in US alone•• Savings of approx. $500 billion in unneeded duplicative careSavings 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 $300Reduced transcription costs estimates monthly between $300--$1000 per physician$1000 per physician•• Reduction of office visit time by 13% for physicians and one minReduction of office visit time by 13% for physicians and one minute for preute for pre--examexam
Increase Citizen SatisfactionIncrease Citizen Satisfaction
BenefitsBenefits
Sources: HealthGrades, June 2004; DATAMONITOR, July 2006;
College of Medicine, Florida State University, Feb. 2005
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Agenda
eHealth is everywhere
eHRs – What for?
Best practice examples
Obstacles
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eHR- Functional Architecture
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eHR- best practice examples
OrganisationOrganisation
Solution OverviewSolution Overview
Solution OverviewSolution OverviewOrganisationOrganisation
Key BenefitsKey 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.
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Key BenefitsKey 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 recordhospitals 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
managementmanagement
Citizens have control over the information on their health histoCitizens have control over the information on their health history and access ry and access
to it at the point careto it at the point care
Improved communication between Healthcare Providers, Insurers anImproved communication between Healthcare Providers, Insurers and d
citizenscitizens
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%
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eHR – best practice examples
3 OrganisationOrganisation
Solution OverviewSolution Overview
Solution OverviewSolution OverviewOrganisationOrganisation
•• 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 BenefitsKey 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,
upup--toto--date information record for the emergency date information record for the emergency
departmentdepartment
•• Synchronised patient data from existing repositories Synchronised patient data from existing repositories
using Oracle Partner Orion Healthusing Oracle Partner Orion Health’’s Rhapsody with s Rhapsody with
HTB via HL7 v3.0 messagesHTB 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 DuretaDureta and other and other
regional hospitals, and support thousands of users regional hospitals, and support thousands of users
simultaneouslysimultaneously
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Key BenefitsKey Benefits
•• Support the modernisation of the Statutory Health Support the modernisation of the Statutory Health
Insurance System (GKVInsurance System (GKV--ModernisierungsgesetzModernisierungsgesetz))
•• Reduction of healthcare costsReduction of healthcare costs
•• Architecture for Architecture for telematicstelematics applications 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. authentication, identity and access to EHR.
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Agenda
eHealth is everywhere
eHRs – What for?
Best practice examples
Obstacles
12
eHR: ObstaclesMoney for PhysiciansMoney for Physicians
Source: DATAMONITOR Report, July 2006
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Thank you for your attention!