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Global eHealth Olympics

Posted on August 9, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

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.

VitalHealth iPad Like EHR Interface

Posted on April 14, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.


During my time at HIMSS, one EHR vendor, VitalHealth EHR, made the pitch to me that they’ve really created an EHR from the ground up that was more innovative and usable than all the other EHR software out there. They described the doctors that stopped by their booth and saw a demo loved their interface and wondered why all the EHR software companies hadn’t done something similar. While an interesting pitch, I asked them whether such a pitch would be able to be heard above all the EMR noise.

After such a pitch I was certainly interested to see the product demo myself. I should say that going into the demo they’d told me that it was still in beta (maybe even alpha). Their website says it will become generally available in Q3 of 2011.

They did a demo of their product on a touch screen computer (I think they should have done it on the iPad. Especially with all the iPad Mania in Healthcare). However, the thing that struck me most was that even on this touch screen computer it looked and felt like an iPad. I’m not sure if they got their inspiration from the iPad and iPhone or if the iPad and iPhone stole it from them (I think I know which), but I was pretty amazed at how similar the interface and navigation felt to that of the iPad.

Unfortunately, outside of the interface, the feature set of the product was pretty disappointing. I asked them to do what I thought would be some pretty simple things (I think it was something with diagnosing) and that feature wasn’t quite built. Not all that surprising since they’re still in beta. Plus, I imagine they were trying to get something together before HIMSS. What will be more interesting is to see them after a year of development under their belt. Will they be able to get the required feature set for it to be a viable alternative? I’ll be certainly keeping an eye on it.

A post like this wouldn’t be worth anything without some screenshots of this “iPad” like interface. I’m not sure these screenshots quite do it justice since the navigation matters too, but you’ll notice some specific design things they’ve done to enable the touch screen capabilities of an iPad and similar devices. Either way, I love seeing EHR screenshots, so here’s a bunch of the VitalHealth EHR screenshots (click on them once to see a bigger shot. Click a second time to see it full size):

iPad Adoption Slow in Healthcare

Posted on March 24, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

At least that’s the case that was made in this blog post on the Software Advice website. The post is a few months old which is centuries in the tech world, but I have to disagree with them on their take that EMR vendors are slow to move their products to the iPad platform. In fact, I mentioned in their comments that I think every single EMR vendor has an iPad strategy.

They do get it right that doctors are adopting the iPad at a really dramatic pace. Here’s my reasons why it’s been so popular:
1. Battery life that lasts a full shift
2. 3G and Wireless Connectivity
3. Intuitive interface
4. $500 price point

We’re still waiting on some enterprise features that it seems like the Blackberry Playbook is trying to implement for healthcare. However, I’m pretty sure they’ll get there in time or someone will create an app that will create those features anyway.

Back to the iPad, the article only states 2 companies that have an iPad EMR offering. There are many more than that. I’ve seen some from Practice Fusion, GE, and VitalHealth to just name a few.

What I haven’t yet seen is how well doctors like the use of their EMR iPad interface. Is it really that usable for a doctor doing his rounds? Does it work well for clinical documentation? Is it a nice compliment to a desktop environment?

Sadly, I still can’t give my first hand account of using an EMR on an iPad. I got my refund from HIMSS since despite all the free iPad giveaways I came home without one. Oh well, the iPad 2 is out now and it would have been a shame to only won a first generation iPad. I’m told by Christmas there may even be an iPad 3, but I digress.

What might even be more interesting than EMR use on an iPad is the other creative ways that people are using iPads in healthcare. For example, I’ve heard of people using an iPad as a check in device for their clinics. There’s something cool about handing over an iPad instead of a clipboard for your patients to fill out their paperwork. I’m sure some patients would hate it, but I for one would be much happier feeling out the stack of paperwork electronically.