Charles V Scatchard

Abstract: Ageing and growing populations drive significant challenges in the healthcare systems resulting in:

• Governments are trying to establish a working healthcare infrastructure (health cards, health records)
• Healthcare providers are being asked to manage patient demand
• Healthcare insurance entities are trying to reduce costs of operation by optimizing processes

The vision of Oracle, the world leading enterprise software company, in healthcare is to improve human health through effective use of information technology. We are trying to achieve this by:

• Maximizing patients benefits from medicines, devices and healthcare delivery
• Empowering our partners to find, develop and deliver valuable products & services for the healthcare industry
• Help our customer's people to maximize their full potential
• Helping to improve operational efficiencies

The healthcare IT is one of the most exciting markets in the Middle East and in Saudi Arabia. Commitments by market leaders, such as Oracle, are required to ensure successful implementation of IT to meet the above mentioned healthcare challenges.

Dr. Najeeb Alshorbaji

Abstract: e-Health is defined as “the use, in the health sector, of digital data-transmitted, stored and retrieved electronically-for clinical, educational and administrative purposes, both at the local site and at a distance”. The mushrooming expansion of e-Health services and activities has made it of prime importance to consider the legal and ethical aspects of the delivery of these activities and services.

One of the recognized obstacles facing e-Health implementation is the lack of national e-Health policies, strategies, plans and legislative framework in many countries of the Region. e-Health will only flourish if the right governance and legal framework are in place.

The HIPAA Security Regulations require that any health plan, health care clearing-house or health care provider that electronically maintains or transmits individually identifiable health information must adopt policies, practices and procedures to protect the confidentiality of that information.
The different legal aspects that might be considered are:

1. Physician (healthcare provider)-patient (citizen) relationships on the Internet; 
2. Link between e-government, e-commerce, e-banking,  etc and e-Health; 
3. Liability issues in the practice of telemedicine: medical malpractice on the Internet; 
4. Quality aspects of health information on the Internet; 
5. Protection of data in electronic health records; and
6. Cross-border processing of health data (personal and public data).

Ethical aspects in e-Health is another area in which major concerns have aroused.  The e-Health code of ethics and the many forms of it in many courtiers have emerged in response to a need in an area where legal frameworks are not strong enough.
Data security is another major aspect that any legal framework in e-Health needs to consider. This includes:

1. Authenticity: to know and vet the identity of the specific sender of a message or initiator of a transaction, and the identity of its intended receiver;
2. Integrity: to be totally sure that the contents of the message or transaction have not been changed;
3. Confidentiality: to ascertain that nobody, other than the sender and the intended recipient, has the ability to view, copy or otherwise know the contents of the message or transaction;
4. Privacy: to ensure that personal health information is not used or disclosed inappropriately leaving the individual vulnerable to unwanted exposure, stigma and discrimination;  
5. Non-repudiation: to maintain an unequivocal record of a message or a transaction such that neither its initiator nor its recipient is able to later deny the message exchange or the transaction.

The draft International Convention on Telemedicine and Tele-Health was proposed by the International Bar Association Section on Legal Practice in July 1999 as a tool to support implementation of e-Health in countries.

Dr. Kazem Behbehani, PhD, FRCPath

Abstract: The recent rapid global changes in socio-economy, technology, and social values, have given rise to new complex health issues and increasing public demand for better health services.  Consequently many countries, including GCC, are emphasizing planning for more effective health services including the use of Information Technology, (e-Health), aimed at efficiency, safety and citizen satisfaction.

The challenges are numerous, with the main components being the need for human capacity building, introducing management skills, optimal use of new technology, access to and sharing information, transparency, governance, developing a learning network, applying findings of new research to practice, accepting change, and dealing with the patient as a customer.  More attention is also needed to periodical training of managers, in: policy implementation and management of health systems; applying continuous and measurable improvement of management processes; focusing on customer satisfaction and needs; and the use of a common language and tools.  Much benefit can be derived from sharing knowledge and experiences within and amongst countries.  More attention needs to be given to developing  common standards between GCC countries in line with International accepted norms and practices.

In the present climate of global connectivity and information sharing, it is high time to embark upon developing a knowledge based society.  That is empowering people with knowledge for better decision making and, in this case, applying preventive and public health measure to their life style using new educational tools (eLearning).  Countries need to develop Citizen Centered Healthcare Systems, in contrast to present day hospital based services.  This will provide closer access to needed services for their citizens, including in their home environment, and will result in increased efficiency, better safety, and time and cost savings.

Dr Misha Kay

Abstract: The presentation will overview the objectives of the Global Observatory for e-Health, the results of the first global survey on e-Health, the second survey to be conducted in 2008, and plans for strengthening the Observatory's network data collecting and reporting.

Bulent Kunac

Abstract: In the last decade enormous number and variety of new technologies, devices, systems emerged one after another. Any new concept and entity brings its own requirements, prerequisites and ecosystem. It is almost impossible to follow and benefit from all these. Besides, all vendors claim they have the best solutions ever produced and provide the ultimate solution any enterprise would dream of. Purchasing so many "best-of-breed" products, many healthcare enterprises have already became "Frankensteins" in terms of HIT and desperately trying to survive with these over-granular environment, consuming their valuable efforts and resources for "integration?" rather than their core businesses. An illusive "success?" sometimes comes initially, but fades away quickly as some or many key building components of a "sustainable" success is missing.  

Then what shall the stakeholders of healthcare environment do? What is key for them to do and what is not?
The importance of two concepts "implementability" and "sustainability" in the health information technologies field is also explained in the presentation, as well as what is necessary to achieve them. Briefing the key components of a successful "implementation" and "sustainable" success, the presentation specially focuses on business processes and workflow as a key success differentiator of any HIT project. Good examples from King Fahad Medical City (KFMC) and King Khalid Eye Specialist Hospital (KKESH) are also given in the presentation, where corTTex workflow based Integrated Hospital Information Management System has formed the basis of electronic hospital for them as well  as a reference model for future sustainable HIT implementations.

H. Stephen Lieber, CAE

Topic: Global Trends and Issues in Healthcare Information Technology and Policy

Marc Probst

Abstract: Interest in electronic medical record (EMR) systems has never been higher, and sales of both the hospital and office practice versions of these systems are booming. EMR system vendors and other proponents cite numerous benefits of using these systems; however, there are few studies showing that commercial systems will deliver the benefits demonstrated. A recent, comprehensive review of 256 published studies, found no rigorous analysis that quantified the economic benefits of a full-functioned, vendor-supplied EMR system.

This presentation looks at Intermountain Healthcare's experience with Electronic Medical Record systems and the strategy for using data as a differentiator and strategic advantage in healthcare delivery. Additionally the presentation estimates the potential benefits of a fully installed level 3 EMR (examples would be Cerner, EPIC, Centricity, etc.) within a typical 300 bed hospital and then presents the additional benefits available in the next generation (level 4) EMR in the same 300 bed hospital. Estimates for the level 3 EMR were developed from a detailed review of professional papers and documents. The estimates for the level for results were developed from an exhaustive review of Intermountain Healthcare's HELP based systems which have many of the characteristics of a level 4 EMR.

This analysis performed by an objective 3rd party suggests that benefits of a level 3 EMR for this hypothetical 300 bed hospital would be in the range of $2 - $10 million dollars (the range is highly impacted by the hospital's payor mix, and whether the hospital is often at capacity.The estimated benefits for the same hospital with a level 4 EMR would be in the range of an additional $1-$12 million (again, depending on the payor mix and capacity).This is a detailed study and provides interesting conclusions as to why provider organizations will migrate to the next generation of EMR as they become available over the next few years.

Prof. Reinhold Haux

Abstract: Information and Communication Technology (ICT) has become a major factor for quality and efficiency of health care worldwide. ICT in health care also emerged to a leading industry branch. Reports from the European Union (EU) state that the “e-Health industry in the EU was estimated to be worth close to 2 billion Euro in 2006” and that its “ICT industry has the potential to be the third largest industry in the health sector with a global turnover of 50-60 billion Euro” [1]. To enable ICT in health care and also to safeguard these significant investments well-educated health care professionals (as users) and well-educated health informaticians (as specialists) are crucial. This is equally given for ICT in hospitals, home care, and for e-Health initiatives in regions, nations or beyond.

IMIA, the International Medical Informatics Association, has published widely used recommendations on health and medical informatics education [2], which are currently being updated. High quality education and international collaboration of leading academic centers is also an important component of IMIA’s strategic plan [3]. Reports on educational programs, such as the one here at KSAU-HS University in Saudi Arabia [4] are annually presented in IMIA’s Yearbook of Medical Informatics [5].

In this talk I will report on different approaches for developing and establishing educational programs in health informatics. I will give examples of such programs, including our medical informatics curriculum at the Peter L. Reichertz Institute, and of how international collaboration can successfully be established [6]-[8]. Finally I will point out what should be considered today for high quality health informatics education in order to be prepared to meet the future demands of good and sustainable health systems.