Health Informatics In Asia (Gunadarma U)Joko

Health Informatics in the Asia PacificHealth Informatics in the Asia PacificHealth Informatics in the Asia PacificHealth Informatics in the Asia Pacific

Professor K. C. LunPast President, International Medical Informatics Association,Past President, International Medical Informatics Association,

CEO Gateway ConsultingCEO Gateway Consulting

Professor K. C. LunPast President, International Medical Informatics Association,Past President, International Medical Informatics Association,

CEO Gateway ConsultingCEO Gateway ConsultingCEO, Gateway Consulting,CEO, Gateway Consulting,Professor (Adjunct), DukeProfessor (Adjunct), Duke--NUS Graduate Medical SchoolNUS Graduate Medical School

Professor (Adjunct), School of Biological SciencesProfessor (Adjunct), School of Biological SciencesNanyangNanyang Technological University SingaporeTechnological University Singapore

CEO, Gateway Consulting,CEO, Gateway Consulting,Professor (Adjunct), DukeProfessor (Adjunct), Duke--NUS Graduate Medical SchoolNUS Graduate Medical School

Professor (Adjunct), School of Biological SciencesProfessor (Adjunct), School of Biological SciencesNanyangNanyang Technological University SingaporeTechnological University SingaporeNanyangNanyang Technological University, SingaporeTechnological University, Singapore

kclun@ntu edu sg

NanyangNanyang Technological University, SingaporeTechnological University, Singapore

kclun@ntu edu sg

© KC Lun, SingaporeMedical Informatics Seminar, Gunadarma University, 3 Nov 2007

[email protected]@ntu.edu.sg

The Asia-Pacific: A vibrant and di idiverse regionin terms of• geography• socio-economysocio economy• culture

liti• politics


The Asia-Pacific Di it lDiversity also presents many h ll i thchallenges in the

development of health informaticshealth informatics:• communication• information sharing• information sharing• pace of development• standards implementationstandards implementation• manpower training


Health Informatics Development fin the Asia-Pacific

• Wide ranging• Highly correlated

with socio-economic development

• Depends onDepends on government and industryindustry commitment to health infocomm


health infocomm infra-structures

Asia Pacific - a major playerin telemedicinein telemedicine

Factors contributing to need:√√ large sized countries√ low specialist:population

ratioratio√ technology and

telecommunication costs increasingly affordableincreasingly affordable

√ helps developing countries jumpstart medical informatics

√ High penetration rate for equitable distribution of


equitable distribution of healthcare services

Health Informatics Initiatives - Asia Pacific Showcases

Telemedicine in Bhutan• ITU/IDRC project• multipurpose community• multipurpose community

telecentre in Jakar• email consults, teleradiology,


epidemiologic surveillance


• Japan – a leader in telemedicine projects in the Asia Pacificprojects in the Asia Pacific

• National Cancer Center of Japan:p

• Network of 14 Cancer Centers throughout Japan

• 130 teleconferences per year with 16,000

i iparticipants

• High-resolution image transfers 2000 x 2000


(source: H Mizushima)transfers – 2000 x 2000 pixels

Special Issue:Special Issue:Telemedicine in the Asia Pacific

May 2001 edition:International Journal ofInternational Journal of Medical Informatics(Vol 61, Issues 22–23 )

Guest Editor:Dr K C Lun



China’s Golden Projects: Modernizing the Chinese economyg y

• Telecommunication and information infrastructureinformation infrastructure initiatives beginning 1993

• Project categorized into 4 hphases

• Phase 3: Golden Health Project• China Golden Health Medical

Network (CGHN) started in 1996 by Ministry of Public Health linking 30 hospitals and


Health linking 30 hospitals and > 3000 medical experts


China’s Golden Projects: Modernizing the Chinese economy

• Chinese Medicine International Telemedicine Center (1997) to

id TCM lt ti f

g y

provide TCM consultation for Chinese and non-Chinese patients worldwide

• Dalian Telemedicine Center (1996) connecting Beijing Sino-Japanese Friendship HospitalJapanese Friendship Hospital and two remote sites (Changhai and Zhuanghe Hospitals) as well

ith th E I tit t i


as with the European Institute in Strasbourg, France


Health Informatics projects of the Hospital Authority of Hong Kong

Clinical Management

Hospital Authority of Hong Kong

• Clinical Management System since 1995

– Integrated clinical gworkstation supporting order entry, electronic patient record clinicalpatient record, clinical data reporting and analysis, medication d i i t


decision support, outcome documentation Source: Dr C P Wong, H.K.


Health Informatics projects of the Hospital Authority of Hong Kong

eSARS system

Hospital Authority of Hong Kong

• Set up by HA in March 2003 to combat SARS

• Connected HA CMS with• Connected HA CMS with the HK police MIIDSS to trace relatives and contacts of SARS patients

• Largescale use of the internet to help manage a


internet to help manage a public health problem

Source: Dr C P Wong, H.K.


Malaysia Telemedicine Flagship ProjectF A li tiFour Applications:

• Tele-consultation•Tele CME for health•Tele-CME for health

professionals•Mass customized

PersonalizedPersonalized Information & Education

• Lifetime Health Plan

Good example of government


Source: Dato Dr Abu Bakar Sulaiman

gcommitment


Taiwan Healthcare IC Card Project• NHI project using Java cardNHI project using Java card

technology• 4 kinds of information

personal infopersonal infoNHI-related infomedical service infopublic health administration info

• As of Sept 2003, 95% of 22.5m population issued with smart cardspopulation issued with smart cards

• Accepted in 70% of hospitals and clinicsProblems with paper cards identity


Source: Smart Card Alliance• Problems with paper cards – identity

fraud and false claims


Singapore iN2015 – 10-year MasterplanGoals for Healthcare and BiomedicalGoals for Healthcare and Biomedical Sciences:

• Personal health records to give public t bilit t th i h lthgreater ability to manage their health

• Infocomm systems to support well-integrated quality healthcareg q y

• Clinical decision support systems to provide POC clinical practice informationinformation

• Conducive regulatory framework to facilitate data collection and sharing for bi di l d h lth i


biomedical and health services research

Tapping Singapore’s EHR capabilities


• CXO Forum• 1-day Conference with the theme: Integrating1 day Conference with the theme: Integrating

Healthcare / Empowering Patients• Featured Distinguished Industry Speaker, invited

international speakers and showcased Singapore projects

• 5 day Executive Medical Informatics Course


• 5-day Executive Medical Informatics Course

National Health Informatics Initiatives:Key Success Factorsy

• National vision and commitment– Taiwan’s Healthcare IC Card– Malaysia’s Telemedicine

FlagshipSingapore’s iN2015 Initiative– Singapore s iN2015 Initiative

• FundingNational (government govt &– National (government, govt & industry)

– International agencies (e.g.


Bhutan telemedicine project)

National Health Informatics Initiatives:K S F t

• Good Health & Infocomm Infrastructures

Key Success Factors

Infrastructures– Lack of good infocomm

infrastructure limits the HI activities achievable

• Dynamic leadership to drive projects

– Needed to lead development and– Needed to lead development and sustain it

• Strong customer buy-in– Large and sustainable user-base to– Large and sustainable user-base to

ensure project long-term viability• International Networking

– Know what resources and expertise


– Know what resources and expertise are available and how to tap them

Networking for Skill d R Sh iSkills and Resource Sharing

• Asia Pacific projects show that there is no shortage f h lth i f ti kill d i i thof health informatics skills and experience in the

region

• Useful for Asia-Pacific countries with expertise and resources to share them with other countries in the regionregion

• Sharing formula could be bil t l ltil t lbilateral, multilateral or through international agencies such as ADB


agencies such as ADB, UNDP and World Bank

APAMI as Regional Networking Facilitator

• Established in 1994 as an IMIA regional group to promote

i l ti dregional co-operation and development of health informaticsinformatics

• To-date, APAMI has 15 national members and 4 corresponding members

• APAMI conferences:• Singapore (1994)• Singapore (1994)• Sydney (1997)• Hong Kong (2000)

D K (2003)


• Daegu, Korea (2003)• Taipei (2006) Web: www.apami.org

APAMI Leadership RolesHosting the 9th World Congress on Medical Informatics in Seoul, Aug 18-22 1998 and the 12th World Congress in Brisbane, Aug 20-24 2007

Spawned national health informatics associations inSpawned national health informatics associations in Malaysia, Indonesia, Sri Lanka, India and the Philippines

Promoted cross country scientific interaction at nationalPromoted cross-country scientific interaction at national health informatics meetings of Singapore, Hong Kong, Australia, Japan, Korea, Thailand, Malaysia, Sri Lanka, the Philippines and Taiwan

Generated health informatics awareness in India,


Ge e ated ea t o at cs a a e ess d a,Pakistan, Sri Lanka, Vietnam and Fiji

Need for standards


Importance of Standards in Health Informaticsin Health Informatics

• Data standards have always been a major focal point inbeen a major focal point in health informatics

• Impact on:Impact on:– data quality and patient safety– interoperability - the ability of

one computer system to exchange data with another computer

basic interoperabilityfunctional interoperabilitysemantic interoperability


semantic interoperability

Data exchange in a hospitalData exchange in a hospital


Source: Dr Michio Kimura, Japan

Facilitating data exchange ith f twith one format


Source: Dr Michio Kimura, Japan

APAMI Committee for Asian Health Informatics Standardization (CAHIS)Informatics Standardization (CAHIS)

• Established at APAMI 2003 in DaeguEstablished at APAMI 2003 in Daegu• Recognizes need to harmonize differences in

health informatics standards between Asian and non-Asian countries

• Differences arising from:g– Language and character sets– Data vocabulariesa a ocabu a es– Practice pattern and systems


Contact person – Dr YS Kwak, Korea ([email protected])

APAMI Committee for Asian Health I f ti St d di ti (CAHIS)Informatics Standardization (CAHIS)

• CAHIS complements the work of ISO/TC 215 andwork of ISO/TC 215 and CEN/TC 251

• Focuses on standards issues that are specific to Asian region

• Proposed CAHIS working• Proposed CAHIS working groups:– Electronic Health Record (EHR)– Messaging and Communication– Healthcards– Vocabulary


Vocabulary– Character sets

Growing HI development in AsiaGrowing HI development in Asia• eHealth Consortium in

H KHong Kong• Healthcare IT Innovation

W k i SiWeek in Singapore• Health informatics courses

i K (D ) Hin Korea (Daegu), Hong Kong, Taiwan and Singapore (?)Singapore (?)

• e-JHI (Australia)


Looking beyond thebeyond the Asia Pacific

region


International Medical Informatics AssociationGlobal Network (founded 1968)

(www.imia.org)

EFMIGoal and Objectives:• the promotion of informatics in health care and biomedical research

APAMI

EFMIthe promotion of informatics in health care and biomedical research • the advancement of international cooperation • the stimulation of research, development and education • the dissemination and exchange of information

APAMIIMIA-LAC HelinaIMIA-LAC

49 Member Countries3 R i l G3 Regional Groups12 Corporate Institutional Members15 Academic Institutional Members

(www imia org)(www.imia.org)

20072007年国际医药信息大会将在澳大利亚举行年国际医药信息大会将在澳大利亚举行20072007年国际医药信息大会将在澳大利亚举行年国际医药信息大会将在澳大利亚举行

di f 2004© KC Lun, SingaporeMedical Informatics Seminar, Gunadarma University, 3 Nov 2007

www.medinfo2004.org

Other Major IMIA ActivitiesOther Major IMIA Activities

IMIA C d fIMIA

World IMIA Code of Ethics for

Health Professionals

Recommendationsfor Informatics in Health and

Medical Ed ti

World, Regional and WG/SIG Conferences EducationConferences

Official Recommendations

© KC Lun, SingaporeMedical Informatics Seminar, Gunadarma University, 3 Nov 2007Publications

IMIA Yearbooks of Medical Informatics


IMIA Working Groups & Special Interest Group on Nursingte est G oup o u s g

Special Interest Group 1: NursingWG1 Health and Medical Informatics EducationWG2 C H lth I f tiWG2 Consumer Health InformaticsWG3 Intelligent Data Analysis and Data MiningWG4 Data Protection in Health Information SystemsWG5 Primary Health Care InformaticsWG5 Primary Health Care InformaticsWG6 Medical Concept RepresentationWG7 Biomedical Pattern RecognitionWG8 Mental Health InformaticsWG8 Mental Health InformaticsWG9 Health Informatics for DevelopmentWG10 HIS and Health Profession WorkstationsWG11 Dental InformaticsWG13 Organization and Dental IssuesWG15 Tech Assessment & Quality Developn in Hlth InfoWG16 Standards in Health Care Informatics


WG17 Computerized Patient RecordsWG18 Telematics in Healthcare

Asian Penetration of HI Journals• Survey of Paper Authorship in last 5

issues of International Journal of Medical Informatics and Methods ofMedical Informatics and Methods of Information in Medicine

• Out of 134 papers, only 10 (7.5%) *Out of 134 papers, only 10 (7.5%) were from the Asia Pacific region (including Australia and New Zealand)

• Publications and conference presentations are the two major channels through which we can getchannels through which we can get our HI work recognized by the international community!


* by 1st author only

Thank You !Thank You !

E-mail:E-mail:[email protected]

Health Informatics In Asia (Gunadarma U)Joko

Documents

Transcript of Health Informatics In Asia (Gunadarma U)Joko