Highlights of First Report of the Leadership in Global Health Technology Initiative Global Connectio

1
Highlights of First Report of the Leadership in
Global Health Technology InitiativeGlobal
Connections Requirements, Enablers and
Roadblocks to Implementing HIT and Electronic
Connectivity for Better Health and Healthcare
Worldwide

• Ticia GerberDirector of International Programs
• eHealth Initiative Foundation
• October 20, 2004

2
Geneva LIGHT Summit Overview

• Participants in the Geneva LIGHT Summit
• 47 high-level healthcare officers and executives
  from the public and private sectors around the
  globe
• 16 nations and five continents represented
• First summit of its kind focusing on HIT,
  electronic connectivity, and a health information
  infrastructure globally

3
Participants in Geneva Meeting

• Australia
• Bangladesh
• Brazil
• Canada
• Colombia
• Cuba
• European Union
• Kenya
• Korea

• Latin America
• Malaysia
• Mexico
• Peru
• Saudi Arabia
• South Africa
• United Kingdom
• United States

4
Geneva LIGHT Summit Focus

• Participants shared challenges, strategies, and
  lessons learned related to HIT, electronic
  connectivity, and a health information
  infrastructure
• Delivery of clinical care and improving quality,
  safety and efficiency
• Performance of clinical research and measurement
  of outcomes
• Delivery of training, medical education, and
  capacity building
• Conduct of public health surveillance, management
  and response

5
Geneva LIGHT Summit Focus

• Geneva Summit participants provided
• Healthcare system and financing overview
• Description of current HIT adoption, electronic
  connectivity, and health information
  infrastructure progress
• Key national and/or regional projects where HIT
  has had impact
• Areas of success and key success drivers
• Key barriers

6
Geneva LIGHT Summit Focus

• Geneva Summit participants provided high-level
  overview of national strategy (if applicable) in
  each of the following areas
• National leadership and governance strategies
• Upfront funding and ongoing financing vehicles to
  assure sustainability
• Technical issues such as architecture,
  applications, standards, security, and accurately
  and responsibly linking patient data
• Methods to facilitate clinician adoption,
  clinical process change, and application of
  clinical knowledge at the point of care
• Engaging patients and citizens

7
Overview of Geneva LIGHT Summit

• Participants represented a wide variance in terms
  of national population, topographic conditions,
  GDP, systems of governance, health system
  readiness, capacity and financing and disease
  burden
• Nations offered an insightful, cross-sectional
  overview of HIT development and use in countries
  around the globe.
• Nations are providing the building blocks for
  implementing HIT, electronic connectivity, and a
  health information infrastructure
• Country-specific activity reported on five
  continents Africa, Australia, Asia, Europe and
  North America

8
Overview of Geneva LIGHT Summit

• Many existing collaborations to integrate HIT
  with the patient care experience are regional in
  nature and are fueled, in part, by private
  funding
• Overall, nations are in nascent stages of HIT
  use, funding and development.

9
Geneva LIGHT Summit Learnings

• Summit learnings detailed in AHRQ-funded report
  of Summit entitled Global Connections
  Requirements, Enablers and Roadblocks to
  Implementing HIT and Electronic Connectivity for
  Better Health Worldwide
• Report profiles 10 Nations in depth Australia,
  Bangladesh, Canada, China, Kenya, Malaysia, Saudi
  Arabia, South Africa, United States, United
  Kingdom
• Report undergoing key stakeholder review before
  final distribution

10
Geneva LIGHT Summit Learnings

• Despite the diversity of participant experiences,
  many shared common views regarding factors
  critical to success
• Stakeholder involvement, cooperation and cohesion
• Buy-in from key stakeholders, particularly
  clinicians, consumers and the private sector
• Active collaboration between public and private
  sector stakeholders in the design and maintenance
  of system change
• Support by legislative bodies at the national and
  regional level
• Ensuring new electronic forms and processes used
  in system change are compatible with existing
  required documentation formats

11
Geneva LIGHT Summit Learnings

• Despite the diversity of participant experiences,
  many shared common views regarding factors
  critical to
• Focusing on the local role and participation in
  system change
• Tool-kits to capture and disseminate learnings,
  best practices and software
• Accompanying consumer education and awareness
  campaigns
• Knowledge transfer both from those nations who
  have gone before and between regions and
  provinces engaged in the system
  transformation.prototype legal agreements,
  governance models, and insight on requirements
  and specifications are key
• Importance of data standards and interoperability

12
Geneva LIGHT Summit Learnings

• Despite the diversity of participant experiences,
  many shared common views regarding factors
  critical to
• Availability of computer literate graduates,
  especially in every rural areas, where medical
  centers are located
• Innovative use of low-cost technologies such as
  Palm Pilots, cell phones and simple computer
  systems
• Appropriately addressing privacy and security
  concerns at every step in the process.

13
Geneva LIGHT Summit Learnings

• Despite their differences, participants also
  cited common advantages to HIT
• Enhanced record completeness and allowing a
  consolidated view of patient activity
• Appropriate 24/7 access to relevant patient
  information
• Efficiencies of clinical practice and elimination
  of redundant process execution
• Active management of the healthcare supply chain
• Increased patient satisfaction
• Support of patient health education and
  empowermentcritical to chronic care management
• Enhanced degree of transparency about care
  delivery

14
Geneva LIGHT Summit Learnings

• Despite their differences, participants also
  cited common advantages to HIT
• Savings of time and/or money
• Evidence for health outcomes questions
• Measures to assist in competing for allocation of
  scarce healthcare resources and monies
• Increasing information available at the frontline
  
• Liberating health care services and professionals
  from organizational silos

15
Geneva LIGHT Summit Learnings

• Common Challenge of Participants
• Maintaining HIT as a top item on the national
  agenda in shifting political and budgetary
  environments
• Antiquated laws and regulations
• Reducing deployment costs
• Jumpstarting system reform projects in nations
  where HIT systems are largely disparate and
  unintegrated and in which HIT strategic planning,
  standardized infrastructure and health
  information networks are severely lacking
• Monopolized telecommunications operations or an
  absence of integration among different network
  owners

16
Geneva LIGHT Summit Learnings

• Common Challenge of Participants
• Addressing cultural barriers and stigmas
• Adapting HIT to different care and practice
  environments
• Changing skill mix, structures and care processes
  to support patient-centred HIT services
• Creating a truly integrative EHR
• Change management challenges
• HIT procurement cycles longer than desired system
  reform pace
• Matching high patient volume with smaller HIT
  supplier capacity

17
Geneva LIGHT Summit Learnings

• Common Challenge of Participants
• For some developing countries a gap between
  educated experts and consultants and the HIT
  personnel resources required to implement system
  change
• Hesitancy of banking sector in some nations to
  finance HIT and e-Healthcare sector
• Increased participation desired for international
  aid agencies in health information infrastructure
  development

18
Geneva LIGHT Summit Summary

• Geneva LIGHT Summit participants provided
  valuable contributions regarding their countrys
  strategies for HIT
• Most reported that they are in the early stages
  of HIT healthcare reform projects, most within
  the past two to four years and therefore had
  limited quantitative results on which to base
  recommendations for a global strategic action
  plan to employ HIT
• This will change as programs instituted in recent
  years begin to yield tangible economic, care
  process and quality, safety and efficiency
  improvements that can be documented, shared and
  analyzed

19
Geneva LIGHT SummitAreas for Global
Collaboration

• The following were identified by summit
  participants as areas for global support and
  collaboration
• Developing a multi-national approach based on
  geographic location and cultural similarity
• Developing an aggressive, formal agenda for
  funding HIT initiatives in different countries
• Facilitating alignment between public and private
  sector activities
• Encouraging a more active role from organizations
  like WHO, USAID, the World Bank and UN bodies in
  developing countries
• Encouraging national EMR systems that are
  developed to incorporate globally accepted data
  standards and interoperability protocols

20
Looking Forward for LIGHT

• The variety and intensity of efforts by nations
  around the globe to improve healthcare through
  HIT is growing at an exciting pace and the health
  status and system improvements these initiatives
  achieve will only grow in the years ahead
• LIGHT will support this growth through
  continuance of its efforts to facilitate learning
  and information sharing among and across nations
  on the basic requirements, barriers and
  strategies for implementing HIT and electronic
  connectivity to support clinical care, research,
  health education and public health
• This includes in particular generating new and
  executable ideas around the use of HIT in global
  HIV/AIDS prevention and treatment efforts