Digital Health in Asia Pacific: Current Situation and Future (SICMPH 2016) (June 13, 2016)
0 likes561 views
The document discusses the status of digital health in Thailand and the Asia Pacific, emphasizing the slow progress in eHealth adoption and the need for a focus on 'smart health' rather than merely digitization. It highlights challenges in healthcare systems, including fragmented services, and the importance of integrating technology to improve efficiency, safety, and patient-centered care. Recommendations for advancing eHealth include governance, standards, and learning from regional initiatives.
Digital Health in Asia Pacific: Current Situation and Future (SICMPH 2016) (June 13, 2016)
- 1. Digital Health in Thailand & Asia Pacific: Current Situation & Future Nawanan Theera-Ampornpunt June 13, 2016
- 2. 2 The Road to Digitizing Healthcare Being “Smart” in Digitizing Health eHealth Situation in Thailand Outline
- 4. 4 While thinking about the slow pace of eHealth Let’s take a look at these pictures...
- 5. 5Image Source: https://en.wikipedia.org/wiki/Industrial_robot (KUKA Roboter GmbH) “Smart” Manufacturing
- 7. 7ER - Image Source: nj.com Healthcare (On TV)
- 8. 8 (At an undisclosed hospital) Healthcare (Reality)
- 9. 9 • Life-or-Death • Difficult to automate human decisions – Nature of business – Many & varied stakeholders – Evolving standards of care • Fragmented, poorly-coordinated systems • Large, ever-growing & changing body of knowledge • High volume, low resources, little time Why Healthcare Isn’t (Yet) “Smart”?
- 10. 10 • Large variations & contextual dependence Input Process Output Patient Presentation Decision- Making Biological Responses Standardizing Healthcare
- 11. 11 The World of Smart Machines Image Sources: http://www.ibtimes.com/google-deepminds-alphago- program-defeats-human-go-champion-first-time-ever-2283700 http://deepmind.com/
- 12. 12 Digitizing Healthcare Image Source: http://www.bloomberg.com/bw/stories/2005-03-27/cover-image-the-digital-hospital
- 13. 13 “To computerize the hospital” “To go paperless” “To become a Digital Hospital” “To have EHRs” Why Adopting Health IT?
- 14. 14 • “Don’t implement technology just for technology’s sake.” • “Don’t make use of excellent technology. Make excellent use of technology.” (Tangwongsan, Supachai. Personal communication, 2005.) • “Health care IT is not a panacea for all that ails medicine.” (Hersh, 2004) Some “Smart” Quotes
- 15. 15 Being Smart #1: Stop Your “Drooling Reflex”!!
- 16. 16 Being Smart #2: Focus on Information & Process Improvement, Not Technology
- 17. 17 The key is not “Digital Health” but rather...
- 18. “Smart Health”
- 19. 19 The Road to Digitizing Healthcare Being “Smart” in Digitizing Health eHealth Situation in Thailand Outline
- 20. 20 Microsoft Health Future Vision https://www.microsoft.com/en-us/download/details.aspx?id=12801
- 21. 21 Connecting People to a Healthy Future With Personalized Care – Kaiser Permanente https://www.youtube.com/watch?v=gxz9ZVvduGc
- 23. 23 To treat & to care for their patients to their best abilities, given limited time & resources Image Source: http://en.wikipedia.org/wiki/File:Newborn_Examination_1967.jpg (Nevit Dilmen) What Clinicians Want?
- 24. 24 • Safe • Timely • Effective • Patient-Centered • Efficient • Equitable Institute of Medicine, Committee on Quality of Health Care in America. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press; 2001. 337 p. High Quality Care
- 25. 25 Information is Everywhere in Healthcare
- 26. 26 26 WHO (2009) Components of Health Systems
- 27. 27 27 WHO (2009) WHO Health System Framework
- 28. 28 • Safe –Drug allergies –Medication Reconciliation • Timely –Complete information at point of care • Effective –Better clinical decision-making Image Source: http://www.flickr.com/photos/childrensalliance/3191862260/ Being “Smart” in Healthcare
- 29. 29 • Efficient –Faster care –Time & cost savings –Reducing unnecessary tests • Equitable –Access to providers & knowledge • Patient-Centered –Empowerment & better self-care Being “Smart” in Healthcare
- 30. 30 (IOM, 2001)(IOM, 2000) (IOM, 2011) Landmark Institute of Medicine Reports
- 31. 31 Summary of These Reports • Humans are not perfect and are bound to make errors • Highlight problems in U.S. health care system that systematically contributes to medical errors and poor quality • Recommends reform • Health IT plays a role in improving patient safety
- 32. 32 Image Source: (Left) http://docwhisperer.wordpress.com/2007/05/31/sleepy-heads/ (Right) http://graphics8.nytimes.com/images/2008/12/05/health/chen_600.jpg To Err is Human 1: Attention
- 33. 33Image Source: Suthan Srisangkaew, Department of Pathology, Facutly of Medicine Ramathibodi Hospital To Err is Human 2: Memory
- 34. 34 • Medication Errors –Drug Allergies –Drug Interactions • Ineffective or inappropriate treatment • Redundant orders • Failure to follow clinical practice guidelines Common Errors
- 35. 35 Documented Values of Health IT • Guideline adherence • Better documentation • Practitioner decision making or process of care • Medication safety • Patient surveillance & monitoring • Patient education/reminder
- 36. 36 Being Smart #3: Link IT Values to Quality (Including Safety)
- 38. 38 Hospital A Hospital B Clinic C Government Lab Patient at Home Ultimate Goal: Connected Health
- 39. 39 A Smart Machine: DeepMind Image Sources: http://www.ibtimes.com/google-deepminds-alphago- program-defeats-human-go-champion-first-time-ever-2283700 http://deepmind.com/
- 40. 40Image Source: englishmoviez.com Rise of the Machines?
- 41. 41Image Source: amazon.com Smart Phones, Dumb People?
- 42. 42 Smart Hospital, Dumb Users? It shouldn’t be that way...
- 43. 43 Clinical Decision Support Systems • CDSS as a replacement or supplement of clinicians? – The demise of the “Greek Oracle” model (Miller & Masarie, 1990) The “Greek Oracle” Model The “Fundamental Theorem” Model Friedman (2009) Wrong Assumption Correct Assumption
- 44. 44 Being Smart #4: Don’t Replace Human Users. Use ICT to Help Them Perform Smarter & Better.
- 45. 45 The Road to Digitizing Healthcare Being “Smart” in Digitizing Health eHealth Situation in Thailand Outline
- 46. 46 Kijsanayotin B, et al. eHealth in Thailand: The current status. Stud Health Technol Inform 2010;160:376–80. 46 Thailand’s eHealth: 2010
- 47. 47WHO & ITU eHealth Components (WHO-ITU Model)
- 48. 48 Strategy&Investment Standards & Interoperability Infrastructure Services, Applications Software Leadership & governance Legislation,policy&compliance Workforce Thailand eHealth: Unbalanced Development Kijsanayotin B
- 49. 49 Thailand eHealth: Shaky Foundations eHealth Applications Enabling Policies and Strategies Foundation Policies and Strategies Kijsanayotin B
- 50. 50 eHealth Governance Body Standards & Interoperability Healthcare-Specific Privacy Laws Adequate eHealth Workforce Proposed Actions Kijsanayotin B, et al. eHealth in Thailand: The current status. Stud Health Technol Inform 2010;160:376–80.
- 52. 52 Asia Pacific eHealth Efforts Asia eHealth Information Network (AeHIN) Meetings Health Information Management Systems Society (HIMSS) Asia Pacific Conferences
- 53. 53 • Piggyback on national agenda (e.g. Digital Economy) • Use WHO-ITU model as a guide • Start with national eHealth governance • Identify how IT adds value in healthcare • Standards over apps • Recognize value of “humans” • Walk together with neighbors How Should We Move Forward?
- 54. 54 • “Digital Health” doesn’t mean the goal is digitizing everything. Rather, it means Smart Health: using ICT smartly to improve quality of care. • Thailand is moving toward “Digital Health”, slowly.... • Regional efforts are instrumental in national progress Summary