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BENCHMARKING HIT ADOPTIONS AND CROSS COUNTRY LEARNING

Agenda

1)Introduction- What does adoption of HIT mean


2)HIT as a global endeavour
3)Cross country comparison
4) Insights from country specific approaches
5) Conclusion

What does HIT adoption mean


a)Computerized systems and secured exchanges
between consumers, providers, insurers.
b) Adoption of EHR and EMR
c) mHealth
d)eRx

HIT Adoption in the US


1)Since 2010, the proportion of hospitals having a basic electronic health
record (EHR) has tripled.
2)More than 38 percent of physicians report having adopted basic EHRs in
2012.
3) Hospitals were more likely to implement EHR functions to record
patient demographics, vital signs, and smoking status than they were
functions for electronically submitted lab reports, health surveillance
data, summary records for patient transitions between care settings,
and functionalities for patient use.
4) U.S. providers could do more using HIT to engage patients with
educational materials tailored to an individuals diagnosis and health
literacy level.

HIT as a global endevour


An OECD survey identified four common core
objectives for HIT implementation across countries
a)To increase the quality and efficiency of care
b)To reduce the operating costs of clinical services
c)To reduce the administrative costs of running the
health care system
d)To enable entirely new models of health care
delivery

Cross country comparison


WHO
a) Focused on implementation of ehealth,
telemedicine, mobile health, patient information
management.
b) Total of 114 member states chose to participate in
the 2009 survey.

WHO GOe Telemedicine Survey

WHO mhealth survey


Member states reporting at least one mhealth
initiative, by WHO region.

Elearning in health sciences

European Commission
a) Survey in late 2010 to access the use of e-health in
hospitals.
b) Found that 65% European hospitals have a common
EHR system, only 45 percent of acute hospitals can
exchange clinical information electronically with
other settings, and telemonitoring remains rare
(8%).

Commonwealth Fund
a) In 2012, released findings of a survey of primary care
physicians in 10 countries.
b) Found notable increase in the use of EHRs but differences
across countries existed.
c) Reported the use of specific HIT capabilitiessuch as order
entry management; generating patient information;
generating panel information; or routine clinical decision
supportand found lower rates of adoption.

OECD
a) Survey uses functionality based approach to measure
availability and use of electronic systems to perform specific
clinical tasks, rather than relying on vague terms that may
mean different things in different settings.
b) OECD approach uses a model survey framework, which is
composed of separate, self-contained modules that afford
flexibility and adaptability to a rapidly changing environment.

Country Specific Approaches


Sweden
100 % of prescriptions are ordered and renewed elect100 % of
prescriptions are ordered and renewed electronically
All laboratories in the nation are fully computerized
Shared technical infrastructure
Challenges faced

More than 50% of the counties choose different


platform
EHR adoption and interconnectivity within counties
Regional EHRs do not connect to the 60 national
condition-specific quality registries

Center for eHealth introduced national wide use of


IT in the decentralized health and social care
systems.
Focus was made on improving national information
structures and creating national terminology
standards.
U.S. health care has also taken the national
approach with MU standards and a common set of
EHRs.
Adoptions U.S can make from Sweden approach

Germany
64% adoption of EHRs among acute-care hospitals
and 90% adoption in primary care.
Like Sweden, Germany has struggled to achieve
broad connectivity
Patients at the center of the process for electronic
clinical data sharing
U.S. solution relies almost exclusively on health care
providers sending and receiving information.

efforts are heavily subsidized by the government


uncertain return-on-investment for providers who
choose to participate.
Advantages of following the adopting the German
approach
MU criteria that patients should have information
over their health records.
Enables direct access to health information of
patients.
patient- centered care

Canada
(EHR) is defined as a complete health record that holds all
relevant health information about a person over their lifetime
from all sources.
Acts in place of a series of connections between providers to
exchange specific pieces of clinical data
Canadian approach offers a middle ground between the
provider centric approach of U.S. and the patient-centric
approach of Germany.
Patient-centric, lifelong record, and require that providers
report the key pieces of data.

Conclusions
From all that we have seen we know that
1.There has been a huge paradigm shift in the adoption and the
use of HIT in the US
2.However this is not just a US wide shift but a global one.
3.WHO, the European and the OECD have made real efforts to
facilitate this movement.
4.The US has a lot to learn from countries whose EHR adoption is
at a much advanced level.

References
http://www.who.int/goe/survey/2009/figures/en/index1.html
http://www.ehr-impact.eu/downloads/documents/ehr_impact_study_fin
al.pdf
http://www.ehr-impact.eu/downloads/documents/ehr_impact_study_fin
al.pdf

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