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"Healthcare Reform and IT Trends in Asia/Pacific"
By IDC Health Insights


Feb12
20

Australian Healthcare: Integration of Business and Technology

Posted by: Sash Mukherjee in Health Bytes @ 3:05 PM

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Sash Mukherjee
Australian ehealth implementation is progressing at a dynamic rate, towards the implementation of the personally controlled electronic health records (PCEHR) (PCEHR) scheduled to go live in June 2012. The Australian government has identified and confirmed its commitment to ehealth as a key part of its strategy to transform the delivery of healthcare in Australia. 

The business needs of the Australian healthcare system are: 
Chronic disease management: Investments to the tune of A$872 million has been made for preventive health programs targeted at schools, workplaces, and local communities, and the National Preventive Health Agency has been created. Super GP Clinics also bring together GPs, nurses, specialists, and allied health professionals to provide integrated care for chronic diseases at a single point of care.
Healthcare funds maximization: To ensure future sustainability, the government has been tapping private insurance funds to supplement the expenditure on healthcare by the public system. Recent measures by the Federal Government to take majority funding responsibility of the public hospitals, GP clinics, and primary healthcare, as well as the introduction of activity-based funding at the local hospital network level, are both positive steps towards the maximisation of healthcare funds. 
National healthcare standards: The health infrastructure and availability of medical personnel in the rural and underserved regions is still vastly different from the urban counterparts. There have been initiatives to generate effective national standards, and transparent reporting system.   

These business trends require a technological strategy that will help Australia achieve better chronic disease management by focusing on the individual, improve financial outcomes by avoiding overlap of resources, and create a universal healthcare system across the country that can be evaluated and improved on constantly.  Health record digitization is the foundation on which these can be based. The Australian Government has identified and confirmed its commitment to ehealth as a key part of its strategy to transform the delivery of healthcare in Australia.

The Australian health industry and government agencies involved in its delivery, now need to focus on ensuring that the very significant investments that have been made so far to build the foundation, can start to deliver greater efficiencies, as well as productivity improvements that will ultimately reduce the cost of healthcare delivery in Australia. 

In the wake of citizen-centric focus, there is a need for governments to justify to its citizens the investments they make in all areas, including healthcare. There has been expressed scepticism about the benefits of the ehealth implementations from several angles in Australia. To be able to answer these sceptics, the government needs to use analytics to evaluate and justify the costs that they are incurring, and dynamically update its compliance regulations regarding security, privacy and access, as the PCEHR is implemented to its full potential.

Health Insights Country Report for Australia ( http://www.idc-hi.com/getdoc.jsp?containerId=AP9296301U ) speaks about the Australian healthcare in greater details.

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Nov11
23

Collaboration and Security: A Critical Balance

Posted by: Sash Mukherjee in Health Bytes @ 2:43 PM

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Sash Mukherjee
A recent healthcare records breach at the Sutter Medical Foundation in California, USA has been widely reported (http://www.informationweek.com/news/security/attacks/231903336). The desktop computer theft from the healthcare organization is said to have potentially exposed personal records of about 4 million patients visiting the organization since 1995. Ironically the theft of the machine containing unencrypted data occurred in the midst of an encryption roll-out.
 
While the media continues to actively cover such instances in the USA, such incidents may well go unreported in the Asia/Pacific region. In the USA, under the American Recovery and Reinvestment Act (ARRA), privacy breach notification, minimum use, and disclosure reporting requirements have become more stringent. Most countries, including some of the matured economies, in the Asia/Pacific region do not have national data protection laws. In some countries there are legislative and administrative guidelines that create data privacy obligations, especially for specific industries like banking and telecommunications. Many of these guidelines came into place with ecommerce.  A national level data protection law, and specific regulations and Codes of Practices for specific industries, including healthcare, are required to counter the threat of data breach.  

To gauge the IT investment priorities across industries in the region, IDC Asia/Pacific conducts an annual poll. When the healthcare industry results of this year's poll are compared to the results of a similar poll conducted the previous year, the surprise entrant in the top 3 priorities list is security; this has moved up considerably from 8.5% to 15%. This is a step in the right direction. With the increase in healthcare digitization and point-of-care access of records, it is important for healthcare organizations to actively consider security, access and privacy issues. Over 46% of the 80-odd IT executives polled have responded that they will increase or newly deploy security software in the organization. Only 6% respondents said that they would reduce deployment of security software.

Interestingly, the healthcare sector also stands out significantly in its concerns regarding internal threats. Over 64% of respondents indicated that they have little to very little confidence in their security coverage because of people with access to the internal resources and information. Both accidental losses of sensitive information and privacy concerns rank high as the reasons for their lack of confidence.

As more patient information is moved into EHRs and made accessible both internally and externally by an organization, via a range of devices, including mobile devices, the risk of privacy breach rises. Healthcare IT systems are becoming increasingly complex as the volume of data is increasing and mobility takes information out of hospitals and other traditional and controlled settings. The need to build an ethos of collaboration in a secure and compliant atmosphere will be main driver for security investments.

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Oct11
24

Singapore's Healthcare Revolution

Posted by: Sash Mukherjee in Health Bytes @ 10:00 AM

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Sash Mukherjee

If you are living in Singapore it would be hard to avoid the buzz around healthcare reforms. The rising costs of healthcare due to a fast ageing population and the change in disease burden are issues being faced by many developed nations in the world.   The Singapore government seems to be tackling it through a many-pronged approach.

Singapore's public healthcare system is organized in clusters, each cluster anchored by a regional hospital working with a variety of primary providers, the intermediate and long-term care sector and support services to create an ecosystem for patient-centric care delivery. The Agency for Integrated Care (AIC) makes the transition of patients from one care setting to another smoother.


Prevention of diseases, especially chronic diseases has evolved as another key focus for the Ministry of Health. The Health Promotion Board is implementing a S$116 million program aimed at chronic disease management. GPs and Polyclinics are being empowered to provide this care.


The National Electronic Healthcare Records (NEHR) rolled out earlier this year has the capability of supporting these strategies. The NEHR is a key enabler of Singapore’s vision of “one patient, one record” which allows patients to move seamlessly within the entire healthcare ecosystem. It is targeted to be used, not only within the walls of the hospital but also over the entire care continuum. It aims to collect all medical data on a person and use it to support clinical decision making, at all points of care.Phase 1 aimed to compile key medical information including patient demographics, allergies, clinical diagnoses, medication history, X-ray reports, laboratory investigations and discharge summaries, which will be fully exchangeable. The foundations have been laid to enable leverage to implement advanced functionalities like clinical analytics. As the system evolves to its full potential, it should have the capacity to perform a wide range of other functions like clinical analytics, quality assurance, and research.

 

Singapore has clearly envisaged this as a business and clinical transformation project, and not merely an ICT project. If you wish to learn more about Singapore's healthcare revolution, please contact me on smukherjee@idc.com 

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Aug11
04

'Broad Spectrum' Mobile Health

Posted by: Sash Mukherjee in Health Bytes @ 3:27 PM

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Sash Mukherjee
Mobile health has a very broad definition, especially in the Asia/Pacific. From point-of-care devices used to access and enter data, to SMS appointment reminders, there are multiple areas that mobility assists in healthcare service. It has a role in providing essential medical help in remote and underserved areas as it has in home monitoring the chronically ill in urban areas. The IDC Asia/Pacific CIO Summit, held in Singapore on the 28 - 29 July 2011 showcased two such varied solutions, differing vastly in their sophistication level and aimed at solving different problems. 
The RIM presentation used the Oklahoma Heart Hospital's (OHH)  search for a solution to improve their remote patient monitoring system as a case study. The alert on an alphanumeric pager with a text message and low-quality waveform had no way of evaluating the criticality of the reading or registering the individual nurse's acknowledgement of responsibility. OHH's answer was the Connexall solution (http://www.connexall.com/) in conjunction with Drager (manufacturer of vital signs monitor) and Blackberry devices. Whenever the monitor reached a specific threshold, all assigned nurses received the waveform, displayed on Blackberry's high-resolution display, a text message and the patient's vital signs, enabling them to monitor the criticality. The nurses could also acknowledge responsibility using the Blackberry.

On the other side of the world, the International Specialist Eye Centre (ISEC) in Malaysia recognized the need for a system that would solve the problem of appointment over-booking and no-shows. Their solution was SendQuick Entera (http://www.talariax.com/) which uses Microsoft's Open Database Connectivity (ODBC) to ISEC Patient Information System to retrieve patient details and sends SMS reminders before the appointment. The data never leaves the ISEC office, maintaining information confidentiality. 

On the same day, there was an interesting example of the advancement in mobile health in the news -- the iPad app, Drchrono, which is being advertised as the cheapest EHR in the market.  It is the only app of its kind to be named a certified EHR technology making its user eligible for subsidies under the the Hitech Act in the US.

The Asia/Pacific region, with its increased focus on health digitalization, will witness more and more sophistication in its mobile health solutions. With the increasing popularity of mobile devices, driven largely by the high uptake rate of mobile phones and tablet devices, healthcare organizations should consider mobile technology initiatives to boost their existing or upcoming service transformation efforts, both in areas of hospital process streamlining and wellness outreach programs beyond hospital walls.
But, I envisage that extensive application of mobile health in the region still has a long way to go. The question remains whether it will be the indifference of healthcare organizations towards these helpful solutions, or individual apathy to participate in these wellness programs, that will be the main deterrent.

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Nov10
30

Patient Centricity for Singapore’s Healthcare Providers

Posted by: Janet A Chiew in Health Bytes @ 4:44 PM

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Janet A Chiew

In the first Singapore IDC Health Insights roundtable held on 20th October, participants from seven healthcare provider organizations were actively engaged on the topic of 'Patient Centricity'. One participant, interestingly, drew an analogy of healthcare services to the airline industry. No doubt customer centricity is the major focus for the airline industry. What can the healthcare providers learn from airlines, and does every consumer require 'business class' healthcare service?

The business model of the airline industry has transformed in the past decade with the introduction of personalized services made available via technology. Travelers are provided with basic flight information and services which allows meals and seats selections to be customized based on personal preferences.

In similar ways, the healthcare industry is on the same path as the airline industry in the journey towards patient centricity. The vision for healthcare providers is to be able to provide valued services to the patients beyond basic meal and ward stay preferences. Essential guidance and directions on treatments options could be provided and further engagement with patients' family on potential treatment outcomes will drastically improve quality of care to the patients.

Economics, however, warrants a discussion on the balance of cost and value. Do all patients require business class healthcare services and can they afford them? We cannot assume so, and need to be mindful of the costs overheads in the bid to improve the healthcare services to the masses. Whilst it may be not a straightforward matter segregating frill and no-frills services, the healthcare industry, both care and technology providers, will need to jointly study the cost and viable business models for patient–centric healthcare.

Personal Health Management (PHM) is an area that Singapore's healthcare sector is actively looking into right now, and that is just one aspect of patient centricity. We will expect more activities lining up for hospitals and care providers in this area in 2011.
 
Do you have any stories on patient centricity/personal health management to share?

We've received overwhelming interest from you regarding the proceedings report of the roundtable. The report is now available from IDC Health Insights! Contact me at jchiew@idc.com  for more information.

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Oct10
27

Revolution in Healthcare Delivery Underway in the Asia/Pacific region

Posted by: Gerald Wang in Health Bytes @ 5:17 PM

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Gerald Wang

Recent developments in eHealth are moving in several key fronts — toward an evidence-based practice of medicine in a connected environment, the digitization of health information for interoperable electronic health records (EHRs), web-based communications solutions for a seamless transfer of patient information from one institution in one region to another in a different region, integration of existing systems for a cost-effective way of implementing eHealth, and increased consumer participation in healthcare.

According to IDC Health Insights, the following are the key drivers of eHealth in the Asia/Pacific region:

  • Improving IT and business alignment
    - Ambitious IT transformation plans focus on achieving greater responsiveness in sustainable and market-aligned initiatives
  • Realizing patient-centric market responsiveness
    - Focus on cost-effective delivery of health services, and increase consumer expectation and participation in healthcare
  • Achieving seamless operations
    - Evidence-based practice of medicine in a connected environment, the digitization of health information for interoperable EHRs, and web-based communications solutions that provides for a seamless transfer of patient information

At the IDC Health Insights’ first Singapore eHealth roundtable last Wednesday, the topic of eHealth transformation was high on the agenda for the delegates. Analysts from IDC Health Insights Asia/Pacific actively engaged with invited C-level healthcare IT practitioners in in-depth discussions relating to strengthening business-IT alignment strategies and shared anecdotal best practices in ICT implementations for the Asia/Pacific healthcare sector.

We will be publishing the event's proceedings in our IDC Health Insights report series, the “Asia/Pacific Healthcare Country Profile Service” soon.  If you would like to get hold of this report, please contact me at geraldwang@idc.com or my colleague Janet Chiew at jchiew@idc.com.

An overview of the Asia/Pacific healthcare landscape

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May09
06

Are You Ready to Catch the Wave of Healthcare Reform in Asia/Pacific?

Posted by: Alex Kim in Health Bytes @ 7:47 PM

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Alex Kim

Healthcare reform across Asia/Pacific will gain a much-needed infusion of cash, catching the spirit of the U.S. ARRA stimulus funding.

Australia's New South Wales (NSW) government finally committed electronic medical record (EMR) funding of $100 million over the next two years to cover 188 hospitals across the state. Earlier in April, the NSW government promised $485 million over four years to deliver better healthcare, including the creation of a Bureau of Health Information to collect, analyze and report on the safety and quality of patient care in public hospitals. At the federal level, we expect much more. The anticipated June 2009 report from last year's established National Health and Hospitals Reform Commission (NHHRC) should outline Australia's reform plan, including its concerted plans for EHR. However, security issues around patient data will be a key concern.

China, months after announcing a commitment of $124 billion over three years to provide affordable health, finally issued an implementation guideline on fixing the ailing health care system, including setting up diversified medical insurance systems in the next three years to better cover at-risk urban and rural residents with the goal of covering 90% of the population and also creating new hospitals and clinics.

What is your organization doing to support the government's healthcare reform initiatives in Asia Pacific and what are some of your concerns? I will be in Australia on May 15-19th for a provider CIO forum, New Zealand May 20-23rd for a Health Provider Executive Roundtable with the New Zealand Ministry of Health to discuss EHR and digital hospital, and Singapore May 25-26th. I look forward to hearing from you. Please look for our Health Industry Insights, Asia/Pacific Country Profile report series; Australia and New Zealand reports will be available by the end of May.

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