ICT-enabled health

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gsc11_joint_33
Healthcare in the Network Economy
SOURCE ISACC
TITLE Healthcare in the Network Economy
AGENDA ITEM Joint GTSC-GRSC 4.4
CONTACT Jim MacFie

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Canada has become an e-Society

• 100 of schools and libraries connected by 1999
• 600,000 refurbished computers given to schools
• Student-to-computer ratio (median) is 5 to 1
  (Statistics
  Canada, 2004)
• Established 3,900 community Internet access sites
• CAnet 4 the worlds first national optical
  research and
  education network
• 81 of households (IPSOS-Reid 2005) 82 Firms
  use the Internet (SECT 2004)
• One of the highest rates of broadband penetration
  (OECD 2004)
• 1 in Government Online (GOL) (Accenture 2001,
  2002, 2003, 2004, 2005)

Citizens, businesses and governments are going
online
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Canadians moving online and demanding high-speed
Broadband Penetration
Source Yankee Group, North America Consumer
Fixed-Line Media Forecast (March 2005)
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Seek health information
Source Canadian Internet Project, May 2005
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Why focus on the health care sector?

• 10.4 of Canadas GDP (2004)
• Estimated 142 B spending in 2005
• Close to 40 of P/T expenditures
• Employs over 1.1 million people (2004)
• Responsible for estimated 24 of business RD
  (2004)

Sources CIHI, Statistics Canada
crucial economic sector
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Health spending pressures rising

• Average cost to provide health care for 1 year
• 30 year-old man 230
• 65 year-old man 2,400
• In constant 1997
• Source CBoC, (2004)

We must increase productivity in health care
Source Hogan Hogan, How Will the Ageing of
the Population Affect Health Care Needs and Costs
in the Foreseeable Future?, for Commission on
the Future of Health Care in Canada, 2002.
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Work underway to improve ICTs in health

• Canada Health Infoway is national lead
• 1.2 B to ensure 50 of Canadians have EHR by
  2009.
• Has committed investment in 146 projects across
  Canada totaling 536 M by the end of next month
  (e.g. EHR standards, diagnostic imaging,
  telehealth)
• www.infoway-inforoute.ca

• Provinces and territories are making progress
• Hospital Connectivity Most provinces/territories
  have already connected their hospitals through
  high-speed private networks
• Physicians Funding for connectivity or ICTs
  (ON, Quebec, Alberta)
• Pharmacies Pharmacy networks and/or online
  accessible prescription databases.
• Other issues privacy, billing, liability, claims
  etc.

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But we are not there yetHealth sector among
least ICT-intensive sectors
ICT Investment as a Percentage of Total
Investment by Industry, 2004

• And invests 35 less in ICTs than U.S. health
  sector
• Canada 10.5
• U.S. 15.9

health care sector
Total investment includes all fixed investments
(structures, ME, etc.), but excludes
inventories. Source A. Sharpe, Canadian Centre
for Living Standards, What explains the
Canada-US ICT gap? http//www.csls.ca/data/ict.as
p, Table S21 (2005).
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Health care facilities are under investing in ICTs

• Canadian hospitals spend only between 1.8 and
  2.5 of their annual operating budgets on ICTs
  (CBoC 2004)
• Compared to 4 in Sweden, which has EHRs online
  in every hospital and primary health care centre.
  (CBoC 2004)
• And 9-13 in ICT-intensive sectors (ITAC, 2003)
• Hospitals face the same transformation challenges
  as other enterprises
• changing business practices
• need for sector-wide and supply-chain wide
  solutions
• Lack of experts with combination of skills to
  implement

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And physicians not integrating ICTs in workflow

• Physicians in general are early adopters of ICTs,
  but have difficulty integrating into workflow and
  direct patient care
• 88 of Canadian physicians use the Internet, but
  one out of every 2 users accesses it from home,
  rather than in the office.
• Compared to 80 of physicians in the EU connected
  to electronic data interchange system (European
  Commission 2006)
• Demographics are changing use 53 of Canadian
  physicians under 35 are using PDAs (compared to
  less than 33 of physicians over 55). (CMA)
• GP offices face the same challenges as other SMEs
  in using ICTs (lack of time and expertise,
  transforming business processes, need solution as
  part of supply chain).

Sources Canada Health Infoway, End User
Acceptance Strategy Current State Assessment,
May 2005. Brewin, Bob, Canada outpaces U.S. in
health IT, FWC.com, February 15, 2006.
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Room for Improvements

• Canadian physicians not maximizing benefits of
  ICTs
• only 34 have digitized medical records in their
  offices (as compared to 51 in the
  U.S.)
• only 10 communicate with patients via email
  (as compared to 22 in New
  Zealand)
• only 8 use e-prescribing
  (as
  compared to 87 in the U.K.).
• Only 14 of Canadian physicians use
  electronic medical records
  (2001)
  (as compared to 59 in the U.K.)
  
  

Sources Canada Health Infoway, End User
Acceptance Strategy Current State Assessment,
May 2005 and Harris Interactive, 2001.
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A crowded field of SDOs

• IEEE 1073
• Medical device communication
• ISO TC 215
• Healthcare ICT system interoperability
• IEC TC 62
• Electrical medical equipment, including EMC
• CEN TC 251
• Health informatics
• ITU-T SG 16
• Generic architecture for multimedia telemedicine
  apps

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And some less well-known

• Health Level 7
• Integrating the Healthcare Experience
• Clinical Data Interchange Standards Consortium
• Digital Imaging and Communications in Medicine
• American Society for Testing and Materials
• Healthcare Info and Management Systems Society
• American Dental Association
• Clinical Laboratory Standards Institute
• And many more

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Some recent initiatives

• IEEE SA Healthcare Standards Study Group
• Gap analysis, followed by new project proposals
• Healthcare IT Standards Panel (ANSI)
• Harmonize standards for communicating data among
  healthcare software applications
• ETSI

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Conclusion

• Time to add Healthcare as a High Interest
  Subject.
• GSC should collaborate with IEEE SA Healthcare
  Study Group and/or ANSI Healthcare IT Standards
  Panel.