Beyond Medical Informatics

I gave a talk at the recent Hospital Build Asia 2011 conference in Singapore. I also stayed for the other topics. Two topics I found interesting were clinical data repositories and integration/interoperability standards.

Here are some of the lessons I learned. These are NOT verbatim content. They are from my memory and personal interpretations of the presentations.

Clinical Data Repositories (CDR)

• It had different names during the conference, e.g. Vendor Neutral Architecture, Common Data Repository, Carestream product, but they all shared the same concept.
• They implement an information exchange (IX) software to accept all incoming data.
• The information exchange (IX) software can be a middleware, integration platform, custom software or integration engine. Most common software used here in Singapore is Cloverleaf.
• The IX is setup for both international standards and customized interoperability protocols.
• CDR implementations can either handle clinical data and reports only (text) while others can implement redundant DICOM repositories.

Integration and Interoperability Standards

• In Singapore, even for the National EHR implementation, there are no HL7 v3 implementations.
• Most commonly implemented standards include HL7 v2.x and DICOM.
• But there are a lot of customized XML schemas implemented for documents not available in HL7 v2.x.
• They did not focus on "ideal standards". They avoided theoretical concepts in discussions of standards because it would be almost impossible to force compliance. Plus, they don’t have time to wait for everyone to comply to their "ideal standards" recommendation.
• Instead, they did a survey among hospitals, vendors and other stakeholders for interoperability standards available and/or ready for implementation.
• They also avoided theoretical discussions of implementations. Instead, they’d recommend putting viable ideas through proof-of-concept (POC) activities to provide more tangible better results.
• Decisions are made based on currently available data and results of POC activities.

That’s it. There were other lessons learned about other topics but I focused on these two because they were most useful to my current project plans.

I found a great online resource: IT Execs Release Guidebook on E-Health Records Implementation – CIO.com.

The College of Healthcare Information Management Executives released a guidebook for CIOs and other IT managers with tips and first-hand experiences in implementing electronic health records in order to meet government “meaningful use” standards.

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The publication, The CIO’s Guide to Implementing EHRs in the HITECH Era, includes best practices and steps health-care organizations should take to successfully implement EMRs, from the initial planning through the final documentation of results.

The guidebook is free for the public and can be downloaded here.

Singapore moves forward with their National EHR Project.

Singapore Awards US$144M EHR Contract

A consortium made up by Accenture, Oracle, and Orion Health has won Singapore’s National Electronic Health Record project, a credible source has told FutureGov.

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The National EHR project aims to connect all the EMRs in Singapore and achieve the “one patient, one record” vision.

Healthcare IT professionals all over the Asia-Pacific region should watch the progress of this project closely. I know I will. I can only hope we can start something similar in the Philippines.

I found very useful links c/o Neil Versel’s Healthcare IT Blog

An EHR primer
This is a short video on the concepts of EHR.

National Alliance for Health Information Technology
This one is new to me, but it’s already shutting down. Too bad. I also found out it published a good list of HIT definitions about a year ago. I like the idea of this National Alliance. Should we start one here in the Philippines? Is there one?

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Is there an interesting Healthcare IT-related link you’d like to share? Please post them below. Thanks!

Here’s a list of news, links and articles about Medical Informatics, Healthcare and IT that I found interesting this past 2 weeks (June 7 – 20, 2009). Starting today, all HIT List posts will be every 2 weeks. Enjoy!

IMIA News
IMIA has a new news site! This blog “is the new online news and information service from the International Medical Informatics Association (IMIA – www.imia.org).” I suggest subscribing to its RSS feed. That’s what I did.

Sweden launches national electronic health record
“Sweden rolled out the first stage of the Swedish National Patient Summary initiative last month, according to the project’s partnering IT vendors, InterSystems and Tieto. The nationwide EHR is billed as one of the first of its kind in the world.” Inspiring. I hope it works out. It can eventually serve as a template or model for other countries to use.

Healthcare IT News
I found another good resource for Healthcare IT professionals. This site is published in partnership with HIMSS.

Information Technology: Not a Cure for the High Cost of Health Care
A critical take and look at the flurry of HIT and EMR adoption activities in the US. It makes several good points about whether Healthcare IT can really impact the cost and quality of healthcare.

Making human body a videogame controller
The possibilities are endless! This has a lot of impact on healthcare and medicine. I’m just not sure how ‘gamer couch potatoes’ will feel about moving around the living room to play their favorite games.

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Is there an interesting Healthcare IT-related link you’d like to share? Please post them below. Thanks!

I was on vacation last week so this week’s HIT List is 2 weeks worth. Here are some interesting Medical Informatics, Healthcare and IT links I found in the past 2 weeks (May 24 – June 6, 2009):

Report: Health IT could help reform U.S. primary care system
Reports like these help fuel the growing awareness of Healthcare IT not only in the US but also in other countries. In the above article, electronic medical records were mentioned as a way to help in coordination of care. Here’s the direct link to the report: Remaking Primary Care: From Crisis to Opportunity (PDF). I’ll read the complete report and give feedback soon.

Google adds automatic translation to Gmail
"Google added automatic translation technology to Gmail, allowing users of its email service to translate messages in another language with a single mouse click." Cool! Automatic translation technology like these will surely be advantageous in a country like ours with multiple dialects. Imagine if our electronic medical records can translate medical histories and patient instructions to different local dialects, we’d probably improve our patient care processes.

5th Annual Games for Health Conference
The conference aims "to develop a community and best practices platform for the numerous games being built for health care applications. To date the project has brought together researchers, medical professionals, and game developers to share information about the impact games and game technologies can have on health care and policy." Pretty exciting! I wonder if these would spread to our local gaming development industry. Hmmm… I might need to brush up on my PS2 skills.

Hospitals Turn to Web 2.0 Technologies as Marketing Tools
It’s about time! When I spoke at a Health IT conference, one speaker from Hong Kong describe their experience implementing an internal Wiki and adopting the collaborative content nature of Web 2.0. It would be good to start something like that locally. This iHealthBeat article links to a New York Times article about a brain surgery webcast.

Newly Released CCHIT Guide Outlines Criteria for EHR Certification
The CCHIT Guides give excellent starting points as to what functions and features an Electronic Health Record should have. Here’s the very recent Concise Guide to CCHIT Criteria (PDF).

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Do you have an interesting Healthcare IT link, news or resource you’d like to share? Please post below. Thanks!

Here’s a list of news, links and articles about Medical Informatics, Healthcare and IT that I found interesting this past week (May 10 – 16, 2009).

The Healthcare IT field is growing—and in the process of organizing itself.

A stimulus to define informatics and health information technology
A BMC Medical Informatics and Decision Making article, it proposes a standard (or consesus) for definitions and terms of usage for Medical Informatics terminologies, including the difference between Clinical Informatics and Health Information Management. Formatted as a debate piece, it should spark discussions and interest among different Healthcare IT groups.

The Drive for More HIM Professionals
First there was AMIA 10×10 (10,000 trained by 2010). It later moved forward as 20/20—an international effort to educate 20,000 healthcare informaticists in other countries by 2020. Now, this article states that AHIMA “has developed Vision 2016 to help supply appropriately trained HIM professionals to meet the existing and growing demand.” Obviously, there is a growing need for more Healthcare IT professionals worldwide. We probably need to initiate something similar here in the Philippines.

Health IT players form EHR Stimulus Alliance for physician education
Vendors are making a collective effort to educate physicians in the use of electronic health records. This is part of a growing movement to increase adoption of Healthcare IT, collaboration between different parties and awareness of benefits of computerization.

What do these activities mean for Philippine Medical Informatics? What’s our next move?

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Is there an interesting Healthcare IT-related link you’d like to share? Please post them below. Thanks!