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.

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?

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.

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.