Health Informatics In Asia (Gunadarma U)Joko

Health Informatics in the Asia Pacific

Professor K. C. Lun
Past President, International Medical Informatics Association,
CEO,
CEO Gateway Consulting,
Consulting
Professor (Adjunct), Duke-NUS Graduate Medical School
Duke-
Professor (Adjunct), School of Biological Sciences
Nanyang Technological University Singapore
University,

kclun@ntu.edu.sg
kclun@ntu edu sg

Medical Informatics Seminar, Gunadarma University, 3 Nov 2007 © KC Lun, Singapore

The Asia-Pacific: A vibrant and
diverse region
di i
in terms of
• geography
• socio-economy
socio economy
• culture
• politics
liti


The Asia-Pacific
Diversity also
Di it l
presents many
challenges i th
h ll in the
development of
health informatics:
informatics
• communication
• information sharing
• pace of development
• standards implementation
• manpower training


Health Informatics Development
in the Asia-Pacific
f
• Wide ranging
• Highly correlated
with socio-economic
development
• Depends on
government and
industry
commitment to
health infocomm
infra-structures

Asia Pacific - a major player
in telemedicine
Factors contributing to need:
√ large sized countries
√ low specialist:population
ratio
√ technology and
telecommunication costs
increasingly affordable
√ helps developing
countries jumpstart
medical informatics
√ High penetration rate for
equitable distribution of
healthcare services

Health Informatics Initiatives
- Asia Pacific Showcases

Telemedicine in Bhutan
• ITU/IDRC project
• multipurpose community
telecentre in Jakar
• email consults, teleradiology,
epidemiologic surveillance


• Japan – a leader in telemedicine
projects in the Asia Pacific
• National Cancer Center of
Japan:
p
• Network of 14 Cancer
Centers throughout Japan
• 130 teleconferences per
year with 16,000
participants
i i
• High-resolution image
transfers – 2000 x 2000
pixels (source: H Mizushima)

Special Issue:
Telemedicine in the Asia Pacific

May 2001 edition:
International Journal of
Medical Informatics
(Vol 61, Issues 22–23 )

Guest Editor:
Dr K C Lun


China’s Golden Projects:
Modernizing the Chinese economy
g y
• Telecommunication and
information infrastructure
initiatives beginning 1993
• Project categorized into 4
phases
h
• Phase 3: Golden Health Project
• China Golden Health Medical
Network (CGHN) started in
1996 by Ministry of Public
Health linking 30 hospitals and
> 3000 medical experts

China’s Golden Projects:
Modernizing the Chinese economy
g y
• Chinese Medicine International
Telemedicine Center (1997) to
provide TCM consultation for
id lt ti f
Chinese and non-Chinese
patients worldwide
• Dalian Telemedicine Center
(1996) connecting Beijing Sino-
Japanese Friendship Hospital
and two remote sites (Changhai
and Zhuanghe Hospitals) as well
as with the European Institute in
ith th E I tit t i
Strasbourg, France

Health Informatics projects of the
Hospital Authority of Hong Kong

• Clinical Management
System since 1995
– Integrated clinical
g
workstation supporting
order entry, electronic
patient record, clinical
record
data reporting and
analysis, medication
decision
d i i support, t
outcome documentation Source: Dr C P Wong, H.K.

Health Informatics projects of the
Hospital Authority of Hong Kong
eSARS system
• Set up by HA in March
2003 to combat SARS
• Connected HA CMS with
the HK police MIIDSS to
trace relatives and contacts
of SARS patients
• Largescale use of the
internet to help manage a
public health problem
Source: Dr C P Wong, H.K.

Malaysia Telemedicine Flagship Project
Four Applications:
F A li ti

• Tele-consultation
• Tele CME for health
Tele-CME
professionals
• Mass customized
Personalized
Information &
Education
• Lifetime Health Plan
Good example of
g
government
commitment
Source: Dato Dr Abu Bakar Sulaiman

Taiwan Healthcare IC Card Project
• NHI project using Java card
technology
• 4 kinds of information
personal info
NHI-related info
medical service info
public health administration info
• As of Sept 2003, 95% of 22.5m
population issued with smart cards
• Accepted in 70% of hospitals and
clinics
• Problems with paper cards – identity
Source: Smart Card Alliance
fraud and false claims

Singapore iN2015 – 10-year Masterplan
Goals for Healthcare and Biomedical
Sciences:
• Personal health records to give public
greater ability t manage th i h lth
t bilit to their health
• Infocomm systems to support well-
integrated q
g quality healthcare
y
• Clinical decision support systems to
provide POC clinical practice
information
• Conducive regulatory framework to
facilitate data collection and sharing for
biomedical and h lth services
bi di l d health i
research

Tapping Singapore’s EHR capabilities


• CXO Forum
• 1-day Conference with the theme: Integrating
1 day
Healthcare / Empowering Patients
• Featured Distinguished Industry Speaker, invited
international speakers and showcased Singapore
projects
• 5 day Executive Medical Informatics Course
5-day


National Health Informatics Initiatives:
Key Success Factors
y

• National vision and
commitment
– Taiwan’s Healthcare IC Card
– Malaysia’s Telemedicine
Flagship
– Singapore’s iN2015 Initiative
Singapore s
• Funding
– National (government, govt &
(government
industry)
– International agencies (e.g.
Bhutan telemedicine project)


National Health Informatics Initiatives:
Key Success F t
K S Factors
• Good Health & Infocomm
Infrastructures
– Lack of good infocomm
infrastructure limits the HI activities
achievable
• Dynamic leadership to
drive projects
– Needed to lead development and
sustain it
• Strong customer buy-in
– Large and sustainable user-base to
ensure project long-term viability
• International Networking
– Know what resources and expertise
are available and how to tap them


Networking for
Skills d R
Skill and Resource Sharing
Sh i
• Asia Pacific projects show that there is no shortage
of health informatics skills and experience i th
f h lth i f ti kill d i in the
region

• Useful for Asia-Pacific countries with expertise and
resources to share them with other countries in the
region
• Sharing formula could be
bilateral,
bil t l multilateral or
ltil t l
through international
agencies such as ADB
ADB,
UNDP and World Bank

APAMI as Regional Networking Facilitator
• Established in 1994 as an IMIA
regional group to promote
regional co-operation and
i l ti d
development of health
informatics
• To-date, APAMI has 15
national members and 4
corresponding members
• APAMI conferences:
• Singapore (1994)
• Sydney (1997)
• Hong Kong (2000)
• Daegu, K
D Korea (2003)
• Taipei (2006) Web: www.apami.org

APAMI Leadership Roles
Hosting the 9th World Congress on Medical Informatics in
Seoul, Aug 18-22 1998 and the 12th World Congress in
Brisbane, Aug 20-24 2007

Spawned national health informatics associations in
Malaysia, Indonesia, Sri Lanka, India and the Philippines

Promoted cross country scientific interaction at national
cross-country
health informatics meetings of Singapore, Hong Kong,
Australia, Japan, Korea, Thailand, Malaysia, Sri Lanka,
the Philippines and Taiwan

Ge e ated ea t
Generated health informatics a a e ess in India,
o at cs awareness d a,
Pakistan, Sri Lanka, Vietnam and Fiji

Need for standards


Importance of Standards
in Health Informatics
• Data standards have always
been a major focal point in
health informatics
• Impact on:
– data quality and patient safety
– interoperability - the ability of
one computer system to
exchange data with another
computer
basic interoperability
functional interoperability
semantic interoperability


Data exchange in a hospital

Source: Dr Michio Kimura, Japan


Facilitating data exchange
with one format
ith f t

Source: Dr Michio Kimura, Japan

APAMI Committee for Asian Health
Informatics Standardization (CAHIS)

• Established at APAMI 2003 in Daegu
• Recognizes need to harmonize differences in
health informatics standards between Asian
and non-Asian countries
• Differences arising from:
g
– Language and character sets
– Data vocabularies
a a ocabu a es
– Practice pattern and systems

Contact person – Dr YS Kwak, Korea (yskwak@kyungpook.ac.kr)

APAMI Committee for Asian Health
Informatics Standardization (CAHIS)
I f ti St d di ti
• CAHIS complements the
work of ISO/TC 215 and
CEN/TC 251
• Focuses on standards issues
that are specific to Asian
region
• Proposed CAHIS working
groups:
– Electronic Health Record (EHR)
– Messaging and Communication
– Healthcards
– Vocabulary
– Character sets


Growing HI development in Asia
• eHealth Consortium in
Hong K
H Kong
• Healthcare IT Innovation
Week i Singapore
W k in Si
• Health informatics courses
in Korea (D
i K (Daegu), H
) Hong
Kong, Taiwan and
Singapore (?)
• e-JHI (Australia)


Looking
beyond the
Asia Pacific
region


International Medical Informatics Association
Global Network (founded 1968)
(www.imia.org)

Goal and Objectives:
• the promotion of informatics in health care and biomedical research
EFMI
• the advancement of international cooperation
• the stimulation of research, development and education
• the dissemination and exchange of information
APAMI
IMIA-LAC Helina
49 Member Countries
3R i
Regional G
l Groups
12 Corporate Institutional Members
15 Academic Institutional Members

2007年国际医药信息大会将在澳大利亚举行
2007年国际医药信息大会将在澳大利亚举行

www.medinfo2004.org
di f 2004

Other Major IMIA Activities
IMIA
World,
World IMIA Code of
C d f Recommendations
Regional and Ethics for for Informatics
WG/SIG Health in Health and
Professionals Medical
Conferences Education
Ed ti

Official Recommendations

Publications

IMIA Yearbooks of Medical Informatics


IMIA Working Groups & Special
Interest G oup on Nursing
te est Group o us g
Special Interest Group 1: Nursing
WG1 Health and Medical Informatics Education
WG2 Consumer Health Informatics
C H lth I f ti
WG3 Intelligent Data Analysis and Data Mining
WG4 Data Protection in Health Information Systems
WG5 Primary Health Care Informatics
WG6 Medical Concept Representation
WG7 Biomedical Pattern Recognition
WG8 Mental Health Informatics
WG9 Health Informatics for Development
WG10 HIS and Health Profession Workstations
WG11 Dental Informatics
WG13 Organization and Dental Issues
WG15 Tech Assessment & Quality Developn in Hlth Info
WG16 Standards in Health Care Informatics
WG17 Computerized Patient Records
WG18 Telematics in Healthcare

Asian Penetration of HI Journals
• Survey of Paper Authorship in last 5
issues of International Journal of
Medical Informatics and Methods of
Information in Medicine
• Out of 134 papers, only 10 (7.5%) *
were from the Asia Pacific region
(including Australia and New Zealand)
• Publications and conference
presentations are the two major
channels through which we can get
our HI work recognized by the
international community!
* by 1st author only

Thank You !

E-mail:
kclun@ntu.edu.sg

Health Informatics In Asia (Gunadarma U)Joko

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