Oracle Ehr

eHealth Records – best practice examples

Dr. med. Ulrich Pluta

Business Development HealthcareeHealth 2007, April 18

2

Agenda

eHealth is everywhere

eHRs – What for?

Best practice examples

Obstacles

3

* 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

4

Agenda


eHRs – What for?


Obstacles

5

eHR: What for?

Increase Patient Satisfaction1 Reduce Medical Errors2

Contain Costs3

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

6

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

7

Agenda


eHRs – What for?


Obstacles

8

eHR- Functional Architecture

9

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.

2


•• 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%

1

10

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


•• 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

4


•• 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.

11

Agenda


eHRs – What for?


Obstacles

12

eHR: ObstaclesMoney for PhysiciansMoney for Physicians

Source: DATAMONITOR Report, July 2006

13

Thank you for your attention!

Documents

Oracle Ehr