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Government Sponsored E-health Initiatives

Posted on August 23, 2011 I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at

Ever heard of NeHTA?  I hadn’t before last week, and I don’t enjoy feeling that I don’t know something around the realm of electronic health records.  Not knowing has always been a psychological, must-climb-that-mountain thing with me.  However, after figuring it out, I decided to bone up on my international electronic medical records knowledge in order to be a little more well-rounded in the world of EMRs.  After all, it’s a small world and I’m interested to know how countries outside the US deal with electronic health technology.

I remembered previously reading about the UK’s national EMR project to bring electronic records to the majority of UK citizens.  This $18 billion initiative of the National Health Service (NHS) has now been largely called a failure (in such articles as Don’t Repeat the UK’s Electronic Health Records Failure).  This is most likely because of the way it was structured, with a limited number of software companies (four in total) allowed into the mix by the government and a lack of accountability to user physicians.  If the EMR vendors were operating in a free market system like the U.S., “customer” doctors could otherwise walk away when the product didn’t meet their needs or desires.  There are a number of assertions in Don’t Repeat the UK’s Electronic Health Records Failure that I think may be a misinterpretation of how similar the UK and US programs actually are (or rather aren’t).

NeHTA, on the other hand, is the National E-Health Transitional Authority, the Austrialian national health program to bring EMRs to the population at large.  The Health Identifiers Initiative program has been criticized for overspending and not meeting established deadlines.  However, their Health Identifiers Initiative is interesting in that it attempts to go  beyond US NPI (National Provider Identifier) program to the point of also requiring all patients to have their own unique numbers.  Currently in the US, only social security numbers (SSN) are unique to each individual in the population.  Western Australia to Push Health Identifiers explains the simple concept.

Although at this point, it’s all still as clear as mud to me, I think it may do me some good to know more about these international EMR programs.  Therefore, I think I’ll explore and write on these from time to time to enhance my understanding of the who, what, when, and where of our fellow brothers and sisters in the world.

Dr. West is an endocrinologist in private practice in Washington, DC.  He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.  He can be reached at

Singapore Launches National EHR, London Hospitals Go To The Cloud

Posted on 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.

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?