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Study: EMRs Have Saved Canadian Health System $1.3B Since 2006

At our current stage of EMR implementation, the evidence is sketchy at best that EMRs are draining costs from the U.S. health system.  But our friends to the north seem to be capturing tangible savings, according to new research by Pricewaterhouse Coopers LLP (PwC).

The PwC study, which was backed by the Canada Health Infoway, a not-for-profit whose focus is accelerating the development of EMRs by family physicians, looked at the implementation of EMRs by family doctors across Canada.  The study focused on the period between 2006 and 2012.

Adoption of EMRs by primary care doctors in Canada has more than doubled between 2006 and 2012, from 23 percent to 56 percent, Healthcare Informatics reports. These EMR investments were paid for largely through investments by the provinces and territories in EMR programs, medical practices and  Infoway.

According to Healthcare Informatics, PwC found that during that period, the Canadian system saved $800 million Canadian dollars in administrative efficiencies, such as staff spending less time pulling charts and less time by doctors reading and maintaining paper files.

PwC also found savings of $584 million Canadian dollars in health system efficiencies, such a drop in duplicated diagnostic testing and adverse drug events.

In addition to concrete financial savings, EMR adoption improved chronic disease management and preventive care, such as mammogram screening rates.  EMR use also improved communication between care providers, as EMRs allowed new providers to quickly and easily research histories on patients without resorting to archaic fax communications.

As part of PwC’s research, they cited examples which paint the picture of how EMRs are changing healthcare in Canada.

Since implementing EMRs, PwC notes, 67 percent of Saskatchewan’s family doctors, office managers and specialists say that their medical practices are more or significantly more productive than before.  Also, 94 percent of of doctors enrolled in Alberta’s EMR program said that patients get their test results faster; in addition, 97 percent said that they’re not needlessly repeating tests and investigations.

May 3, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @annezieger on Twitter.

Global eHealth Olympics

Blair Butterfield is a senior health IT executive and eHealth expert with over twenty years of global experience in new market and business development, general management, government initiatives, strategic marketing, product strategy and consulting. He is currently president of VitalHealth Software’s North American Division and is the former VP of eHealth International Development for GE Healthcare.

For nearly two weeks, all eyes have been on London as we’ve watched athletes vie for gold in the world’s foremost sports competition. It makes you wonder what would happen if that same competitive nature was applied across other aspects of our national identities—namely healthcare. What if we compared our healthcare system to those of Europe, Asia and the Middle East in terms of areas like integration, communication and population health? How would the U.S. fare?

With the global healthcare system in the midst of a major transition, now is the perfect time to look at how the U.S. compares to other nations, especially with respect to one of the biggest trends we’re seeing worldwide—eHealth. eHealth can be described as the use of information technology to facilitate higher quality, more accessible healthcare at lower costs. As countries across the globe amp up their eHealth programs, they are seeing that the success of these major transformations requires engagement and support by all stakeholders, as well as strategic, controlled governance of eHealth implementation.

While the healthcare industry is experiencing a shift on a global level, the strategies and methods for eHealth initiatives vary at the national level. If we were to look at how different countries compare in the healthcare arena, eHealth Olympic events would include:

  • Standards adoption
  • Terminology and coding adoption
  • Patient consent policies
  • Interoperability infrastructure
  • Prevalence of EHRs
  • National funding for eHealth
  • National governance for eHealth
  • Tolerance  for regional variations
  • Import/export of eHealth best practices

In terms of these events, let’s take a closer look at some of the top medal contenders across the world to see why they have had eHealth success in particular areas:

Standards, Terminology and Coding Adoption

For these events, France and Austria are definite medal contenders. France has employed an incremental eHealth strategy that includes a standards-based architecture at the core, which has allowed vendors to test and adopt standards that address IT and clinical needs in a coherent, proven framework. Austria’s eHealth strategy includes a data sharing architecture that enables data portability and standardization of clinical content. By employing an IHE-XDS sharing architecture, Austria’s system has allowed for seamless data content sharing without disrupting the sharing infrastructure. Also Austria had a very clever “training regimen” that resulted in full adoption of coded data elements by physicians who had initially pushed back against it until they realized the value of coded data.

Interoperability Infrastructure

As England was one of the first countries to invest heavily in eHealth, its early adopter status has allowed the country to improve upon its infrastructure, namely in terms of interoperability. England’s eHealth strategy uses an interoperability “spine” to connect regions of the country. This sharing of health records of documents on the spine has ultimately proved effective by reducing costs and complexity while simplifying data sharing models. It took more than one try to medal, as the first attempt was a failure and resulted in a “back to the drawing board” decision to re-design the infrastructure using newer standards and profiles based on IHE.

National Governance and Funding with Regional Variations

To take the overall gold in eHealth, a key component is a balance of national strategy enforcement and tolerance for regional variations, which is prevalent in the strategies of both Canada and the U.S.  Canada’s federally funded “Canada Health Infoway” has established a national EHR blueprint, while EHR implementation itself is governed at the sub-province level and driven by local priorities, such as funding and regional business drivers. Similarly, the larger health reform legislation in the U.S. wraps around the IT program with a national eHealth funding budget of $30 billion for a wide range of related programs. At the same time, the U.S. recognizes regional variations in IT drivers and business needs as the value propositions to support long-term maintenance of HIEs. In  addition, the national funding of regional extension centers assists providers in complex processes of selecting and implementing healthcare IT systems that are right-sized for their organizations with an adequate training and support infrastructure to ensure successful adoption, modeled on the same lines as the regional agricultural assistance program from decades ago that taught farmers about best practices.

Import/Export of eHealth Best Practices

As previously stated, England’s head start in eHealth investment and adoption has given the country a wealth of learning and best practices that can be shared with other nations looking to employ strategies of their own. Countries like Singapore have been very receptive to this information sharing as its strategy includes global sourcing for expertise and investing in technology to enable interoperability. However, the top-honor for eHealth collaboration may go to Canada as the nation has shown ample willingness to be collaborative with other countries and adopt best practices from around the world. It should also be noted that willingness to learn from other countries’ eHealth strategies is an area where the U.S. has typically fallen short.

In addition to evaluating these eHealth best practices around the globe, it’s important to note fundamental strategies that should be employed in all nations, including: the need to address privacy and security concerns at the onset of the program; ensuring clinician involvement during the entire process; providing ongoing education and training; and employing an incremental adoption strategy.

Though we are seeing eHealth success at varying levels around the world, what is being built today is just the foundation for the future of IT-enabled healthcare delivery systems—no nation has yet realized the vision of patient-centric prevention and disease-management, evidence-based medicine, and ubiquitous provider use of IT. So although countries across the globe are closely competing for eHealth’s top honor, no one country can claim that elusive, exclusive gold. With a vision of connected healthcare, where health information exchange powers population health management, patient activation, clinical decision support, community analytics, collaboration, and information liquidity, competition to win the gold medal in eHealth initiatives should be a huge motivating factor towards improved performance.

August 9, 2012 I Written By

John Lynn is the Founder of the blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: and, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Healthcare IT in China

I’ve had an ongoing fascination with China. I think it first started in high school when some Chinese policies were the topic for the debate team I was on. I traveled all over the US (literally coast to coast) debating the impact of various chinese policies like the controversial one child policy. Add in the amazing size of China (the billion+ people still astounds me) and let’s just say I’m absolutely intrigued by China.

Needless to say, this fascination with China has grown into an interest in healthcare IT in China. In fact, I’ve been considering attending a healthcare IT conference in Asia to learn even more. Plus, I think the US healthcare system can learn a lot by looking outside our borders at other countries.

I recently found an article by Ben Zhou, a Dell Senior Executive over China, where he shared some really interesting information about the changing healthcare landscape in China and healthcare IT in China.

The whole article is worth a read, but for those short on time here’s the section on healthcare IT in China:

The Chinese government began investing in a Hospital Information System (HIS) several years ago. In 2008, data from the Ministry of Health shows that 80 percent of hospitals implemented HIS. In the next five years, they will invest more in a national Electronic Medical Record (EMR) system.

Chinese EMR systems have developed slowly over the past few years because of the absence of a single standard for all EMR system providers. As a result, hospitals are unable to share information or provide qualified health services to patients.

To support EMR systems, hospitals will invest more in data centers, IT outsourcing, and mobility. Cloud services would be an attractive solution for hospitals looking for flexible computing and managing EMR systems effectively. Mobility solutions would enable doctors to receive and update information anywhere and at any time.

Sounds like the face some similar challenges to us (ie. single standard for all EMR system providers). Although, an 80% HIS implementation by Chinese hospitals is pretty impressive. I wish we could say the same for the US hospitals.

I’ll be keeping an eye on China. If we thought it was hard to provide healthcare to a few hundred million people. Imagine doing the same for well over a billion people. Not to mention, many of which are in rural areas.

September 8, 2011 I Written By

John Lynn is the Founder of the blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: and, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Singapore Launches National EHR, London Hospitals Go To The Cloud

Today I bring you a couple of interesting clinical data stories from outside the U.S. One involves a cloud pilot and the other a national EHR; while U.S. providers are toying with the former, I doubt the latter will ever happen. Anyway, without further ado:

* Singapore Launches National EHR

Working with Accenture, the country of Singapore recently launched one of the world’s first national EHR systems. The system itself seems straightforward — it will capture medical data and patient demographics across clinic, acute care and community hospital settings — but its scale makes the project unique.

Obviously, the U.S. is nowhere near to creating such a network, and given our industry’s chaotic structure, I don’t see it happening anytime soon. Even centralized, nationally-controlled health systems are struggling to pull something like this off.

It certainly helps that Singapore has a population of just five million; the country plans to spend $144 million just to reach this relatively small group. It’s hard to imagine what it would cost to roll out such a network across the U.K., much less a giant country like the U.S.

Not surprisingly, Accenture worked with many vendors to make the rollout work, including Oracle, Orion Health, IBM and HP.  The partners completed the first stage of the rollout in 10 months (pretty impressive, if you ask me!)

*  National Health Service Pilots Cloud-Based Health Data Services

Next month, London’s Chelsea and Westminster Hospitals plan to begin storing all patient data in in the cloud. The effort, known as E-Health Cloud, is a National Health Service pilot test. The system will offer fine-grained access controls, allowing patients to decide exactly which clinicians, friends and family members can access their records.  According to a report in Engadget, security is tight; users will have to verify their ID multiple times to access their medical data.

As you may know, a small number of U.S. hospitals are experimenting with storing data in private and public clouds. But I’d wager that this effort, backed by a national entity that can roll things out when it pleases, is likely to move far more quickly than U.S. healthcare cloud deployments.

So, progress in Singapore and the U.K.  Somehow, knowing what can be done, the state of regional HIEs and cloud projects in the U.S. seems a little bit depressing, doesn’t it?

June 27, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

EMR in Paris

I’m always fascinated to learn about various international EMR and healthcare IT. While in many cases it’s hard to compare the various health systems with the US, I think there’s often something we can learn. Plus, when I saw the title of this article, “Dear EMR: Greetings from Paris, Wish You Were Here,” how could I resist not reading it? In fact, you should do the same. Go read, and I’ll wait for you to get back….

Maybe I was also drawn to this story because I’ve had a similar experience with healthcare in Italy. Luckily, it was my friend that was the patient and not me. He actually suffered from ulcers and we got to enjoy the quality Italian medical care up close and personal. Luckily, unlike the lady in the story, we spoke Italian and had an Italian with us who was the daughter of one of the doctors that worked there.

Even so, I can imagine how much better it had been if they’d had access to my friend’s medical record. The care they could have provided would have been much better. Information is power. Although, I was surprised how little information they took before treating my friend. I’m sure the thought of communicating what happened at the visit back to a primary care doctor was the last thing on their mind. Thankfully in the two years I lived in Italy I never had to visit a doctor myself. Even though some of them I met outside of the hospital we’re incredibly smart and talented individuals. I think I was ruined when I was visiting another friend and the cigarette butts were on the floor of the halls.

For those that didn’t read the above article, the last paragraph was pretty interesting for me:

Perhaps my own story makes me sound like a demanding, spoiled American who expects Cadillac medical care. And maybe I am. But even though I write about healthcare technology for a living, having a personal experience of what healthcare is like without it helped me to better understand its importance.

May 3, 2011 I Written By

John Lynn is the Founder of the blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: and, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Singapore EMR

I’m always fascinated by the various EMR initiatives that are happening around the world. I think there’s a lot to learn from other countries that are smaller and have different healthcare systems which don’t cause the same problems we have in the US. One project I heard about recently has the Singapore government inviting EMR vendors to make a proposal for a Singapore EMR system. Here’s some details of what Singapore’s doing from Future Gov.

The Singapore government is inviting vendors to submit proposals to ‘design, develop, supply, deliver, install, test, commission and support’ a clinical management system (CMS) cum electronic medical record (EMR) system for general practitioners.

The GP Clinic Electronic Medical Record and Operation System (“Project CLEO”), will comprise of a CMS and a GP-oriented EMR, with the focus of ‘facilitating better quality and safer patient care in addition to optimizing clinic operations for better and more efficient patient service’, according to the Information Systems Division of Ministry of Health Holdings (MOHH), subsidiary of the Ministry of Health which takes care of the country’s public hospitals.

MOHH is also responsible for the development of the country’s National Electronic Health Record (EHR), an ambitious project to realise ‘one patient, one record’ in the island-state.

Sounds like an ambitious and very interesting EMR project. If you know of other EMR projects happening around the world, please let me know.

January 6, 2010 I Written By

John Lynn is the Founder of the blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: and, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.