Adam Greig

Peter Beck

Abstract: It is important to properly manage the growing pool of elderly patients with (multiple) chronic diseases due to the increasing burden for the patient and for society alike. It is technically not difficult to properly manage patients with chronic diseases with available national and international guidelines along with medical skills. On the other hand, it is logistically very complex to organize workflow in such a way that all patients benefit from these medical skills. The experience of 8 years, 1000 practices and 300.000 patients reveals that this appears to be very difficult to cope with for the medical professional.

 It takes 4 ingredients to solve the barrier of perceived complexity and to have the patient benefit, both as the customer as well as in the position of the patient:

• Organise care according to the accepted guidelines of the relevant medical societies.
• Involve all care providers in an integrated, co-operative health chain, in which all should play their respective roles according to these guidelines.
• (Help practices to) implement this multidisciplinary organisation in daily practice.
• Use an appropriate multidisciplinary ICT solution, which ensures the lasting success of the above, due to the following key-features:
  • Access to all involved care providers in a shared and patient centered patient record.
  • Multidisease functionality to cope with comorbid patients.
  • Support regarding workflow, clinical decision making and population management.
  • Support regarding logistic, administrative and financial requirements and systems.
  • Meaningful feedback on the quality of the care process and the care outcomes to all professionals involved.
  • Empowering patients to take an active role in the management of their own health condition.

 Concrete cases studies in diabetes and COPD will be presented as evidence of this approach.

Adrian Flowerday

Abstract:

• In most  countries about 80% of the medical and nursing encounters in both primary and specialised care are about the management of chronic conditions. Coping with the epidemic of chronic conditions is considered the main challenge in health care in the next decade.
• The present organization of the medical care and reimbursement policies does not allow for the provision of the best treatment and care for chronic conditions. A recent international survey revealed stark differences in access to information systems in primary care practices. For example, at least two of five U.S. and Canadian doctors find it "very difficult" or "impossible" to identify patients overdue for a test or preventive care. Although in some European countries the situation is slightly better, there is yet much that can be done to improve care for chronic conditions.
• Regarding the highly important dimension of financing and managing chronic disease, in that same survey, a high proportion of doctors in all countries (25% to 30% or more), except Germany (70%), said they are not well-prepared to care for patients with multiple chronic conditions. There are wide variations in the use of care teams and systems known to improve outcomes for such patients.
• As a response, health care in many countries is beginning to be re-organised in a different way and using different models and tools in most countries. The main objective is to build more integrated health care systems to ensure that patients with chronic conditions such as diabetes, asthma, hepatitis, HIV/AIDS, hypertension , arthritis  and some mental disorders are kept on the radar screen so appropriate identification and follow up is possible.This implies organising medicine in a more proactive and personalised way.

Dr. Abdulrahman M. Bashaikh

Abstract: When the Quality Management Department at King Fahad Medical City was looking into automating the tool which was used for collecting incident reports, the department was faced with more than automation of the reporting form. Challenges which were faced included the need to develop a safety blame free culture, a new tool for reporting, and an organizational arrangement for multidisciplinary collaboration to deal with such reports.
The strategies for change included developing an electronic opportunity reporting system with all the required arrangements for the system to be implemented such as establishing the different quality improvement committees and quality representatives in each respective area with their roles clearly defined to integrate efforts. As a way to change the culture and increase reporting, staff education, open communication and feedback measures were established.
As a result of implementing the new system, an increase in reporting by all hospital staff has been observed. Staff are more comfortable in reporting knowing that they will not be blamed or punished and their participation in educational seminars has been dramatically improved.

Miguel Cabrer

Abstract: The presentation will review the key issues for a success Electronic Health Record national implementation: patient identification (EMPI), clinical data repository, clinical portal and security. The solution of an interoperable framework (hybrid model) is a good approach because of the flexibility and the facility to be implemented and also because already existing projects and information system are also integrated in the project. The approach of having a integrated framework and technology for an EHR makes also easier to define clinical workflow and multicenter pathways. An example of a "case of success" will be reviewed and the facility to integrate asyncronous teleconsultation platform (with medical images) in the framework will also be demonstrated.

Mazhar Pasha

Abstract: Integration of Electronic Medical Record with Blood bank and Advanced Laboratory Information System is desirable in today' environment in any Health care Installation in any part of world or in any country. More important each of them compliments the other. The need assessment as traced include both by functional and as well Support services. This presentation will evaluate the various challenges encountered in such integration across same platform or different platforms. The much desirable need of Web based environment and its benefits are explored to advantage of the participants. Key areas which are dealt include Web based systems and its integration advantages and disadvantages, Complimenting and supporting each of them. Exploring how EMR becomes absolute in integration with Blood bank and as well Advanced Laboratory System. The Productivity and effective use of precious and costly medical equipment is also discussed.

Dr. Ingo Behrend, MBA

Abstract: The presentation will give an overview of the NEXUS Health Care Information System and will outline the NEXUS Arabia project in Saudi Arabia (Case Study)

Implementing an integrated Healthcare Information System (HIS) is a technological challenge and an organizational challenge at the same time. Only fully integrated systems can provide the required process support for customers. At the same time, the system needs to be adaptable to the particular needs of each hospital in order to ensure user acceptance throughout the clinics. All main modules of the system refer to the same data structure and therefore preclude any data redundancy and interfacing within the system. At the same time, the modular and flexible system design provides the possibility of customizing the system in line with customer needs. NEXUS / HIS is running in over 600 hospitals in 17 countries and has proven its flexibility in various environments. NEXUS is investing more than 6 million US$ annually in the enhancement of the system.

Dr.Ramin Moghaddam

Abstract: The term of Electronic Health Record (EHR) is used to describe the concept of a longitudinal record of human health and healthcare – from cradle to grave. It integrates information from primary healthcare as well as subsets of information associated with the outcomes of secondary and tertiary care held in the Electronic Patient Record systems. Rapid growth of Smart Card industry fosters a new trend of using this valuable media for data exchange in the national EHR architecture. Moreover, in competition with networking industry leaders, smart card industry leaders interpret the using of this innovation as a strategic migration from conventional healthcare to modern healthcare in the 21st century. However, from different perspectives, the question, which is, remained that which one is adoptable and more feasible to enable healthcare process owners to exchange secure health information whenever and wherever needed: using networking solutions or smart card technology solutions.

By the way , The building of EHR itself is actually a demanding change management project and it will require a multi-disciplinary approach from clinical, managerial, technical, socio-technical and financial perspectives. Merging smart card technology in the EHR architecture is definitely in favor of industry leaders as it causes a blow in the health ICT market but from the healthcare process owners’ perspective, it may impose the risk of lots of failures, which may impair patient care. These potential risks could be resolved with the radical transformation program before any deploying  of new technologies, which affect the healthcare processes.

Dr. Yaseen Arabi

Daniel Z. Sands, MD, MPH

Abstract: Connected information technology has the potential to transform medical practice through increasing safety, improving quality of care, and increasing cost-effectiveness.  Yet physicians are often reluctant to adopt.  As a result, physicians are labeled as "technophobes," yet nothing could be farther from the truth.  Physicians are rational individuals.  They will gravitate to something when it serves their needs.  Witness the rapid adoption of stethoscopes, hemodialysis, CT scans, mobile phones, and cardiac catheterization.  In each case physicians derive value or receive direct compensation for utilizing technology. 

Health information technology often requires expending a great amount of resource, be it financial or workflow adaptation.  In some cases the end result is worthwhile and in other cases the technology either benefits others much more than the physician or is so poorly designed or dysfunctional as to provide a disincentive to future use. If physicians are to adopt health information technology, we must justify the expense.  We must work with physicians to understand their needs and introduce technology that helps both them others in the health ecosystem.

Adnan Alaqeel

Abstract: Ever since the introduction of the use of computers in the medical filed in the mid 1950’s there has been a growing yet gradual trend towards the adoption and the use of computers in the health field, especially when the technology became both readily available and more affordable. As each organization began to adopt medical informatics, the staffing to run and maintain these systems has been from within these organizations, how ever their training was not.

Ralf Gerhard Birkemeyer

Abstract: The demographic changes of the past decades put enormous pressure on many health services. Especially cardiovascular medicine is confronted with an ever growing number of individuals with more complex disease and numerous comorbidities. Due to restraints on health expenditures healthcare providers therefore have to deliver increasingly complex care more efficiently. This necessitates optimization of clinical workflow from admission to discharge, a perfect documentation of all relevant refunding information and a thorough analysis of cost structures in relation to quality of care. The appropriate tool for this is a complete IT assisted cardiological workflow. Given an intelligent software structure byproducts are the complete documentation of all medical activities, a description of the quality of care and a detailed cost information on the patient level. We used this information to construct probabilistic clinical and cost models. Practical issues will be presented.

Greg Saint James, BA, MBA.

Abstract: GE is leading an initiative called “Healthcare Re-Imagined: driving clinical efficacy and healthcare system efficiency.” We are making this initiative a reality by bringing together the business, scientific and technological expertise needed to transform healthcare, enabling us, and our healthcare partners, to discover new ways to predict, diagnose, treat and monitor, earlier than ever- so patients can live life to the fullest. GE believes that Healthcare IT is critical to delivering on this initiative, by connecting the entire continuum, healthcare information technology enables better decisions at critical points along the continuum of care. In his speech, Greg Saint James will provide more specifics about how GE is architecting its roadmap in this context and opportunities for healthcare providers, vendors, and consumers to participate and benefit from this industry transformation.

Hamad Al-Daig

Abstract: According to the 17th Annual Healthcare Information and Management Systems Society (HIMSS) Leadership Survey, the top four current and projected CIO priorities include the reduction of medical errors/promotion of patient safety, implementation of an EMR, connecting IT between hospital and remote locations and process/workflow redesign. The one enabling technology that provides leverage in each of these areas is the Data Warehouse--a central repository for selected clinical and non-clinical data from disparate, often loosely-integrated systems throughout the healthcare enterprise.

By integrating disparate data sources (clinical, administrative and logistics) into a single source data model, a Data Warehouse enables a full compliment of queries in order to draw information from data, eg, medication ordering, correlating physician ordering activities with admissions related to medical errors. By providing clinicians and administrators with access to data from a variety of otherwise non-compatible or poorly integrated sources, the Data Warehouse supports rapid data mining, report generation and decision support--all key components of a full-featured EMR. However, developing a Data Warehouse and using it to enhance patient safety or provide healthcare enterprise with a fully-integrated EMR are complex undertakings.

In developing a Data Warehouse, it is important to note that value comes not from the technology itself, but from the use of information transformed out of the data in the warehouse. Use, in turn, requires substantial organizational change as well as the full support, commitment and involvement of top management. With these caveats in mind, the Data Warehouse development should include: Provide an improved method of storing and retrieving data, thereby enabling users to make informed decisions. Provide management with the ability to access, analyze and explore information and achieve improved, informed and fact-based decision making. Enable users to realize operational efficiencies from the reduction in the time and effort required to request, extract and analyze data. Provide management with the information required to improve trend analysis. Provide management with access to better, more timely information so that it can more effectively meet the needs of patients, governments, employees and suppliers.

Provide senior management with information in a sophisticated, graphical way that supports intuitive exploration of data. Creating a Data Warehouse is a complex process that demands careful management, insightful leadership, adequate resources, and, above all, a good technical design, including the data model, logical and physical architecture, underlying data model, the ETL process, provision for backup and recovery, and reporting. Finally, not only is it imperative to quickly build trust in the system among the user community at the start of implementation, but outreach must continue through implementation and training. As has been demonstrated by this and countless other healthcare IT initiatives, a Data Warehouse or other application is simply a tool that must be trusted, accepted and used in order to improve the quality of healthcare.

Dr. Mukhtar AL-Hashimi

Abstract: In this session the author will introduce different concepts, themes and possible solutions for the challenges facing modern medical private practices. The role of information technology in medical practice with respect to operational, managerial, and strategic will be identified. Thus, a framework for effective, innovative medical practice, knowledge management, cost containment; e-Health and mega market strategies will be presented in this session. Medical practitioner need to understand the impact of comprehensive health insurance for foreign is essential for effective management. The objective of this paper is to outline the major issues relevant to effective medical practice with modern infrastructure.