Utilizing Health Information Technology to Support Universal Healthcare Delivery: Experience of a National Healthcare System
|
|
- Dale Reeves
- 6 years ago
- Views:
Transcription
1 Utilizing Health Information Technology to Support Universal Healthcare Delivery: Experience of a National Healthcare System Shabbir Syed-Abdul, MD, MS, PhD, 1 Min-Huei Hsu, MD, PhD, 1,2 Usman Iqbal, PharmD, MBA, 1 Jeremiah Scholl, PhD, 3 Chih-Wei Huang, MSc, 1 Phung Anh Nguyen, PhD, 1 Peisan Lee, PhD, 1 Maria Teresa García-Romero, MD, 4 Yu-Chuan (Jack) Li, MD, PhD, 1,5 and Wen-Shan Jian, PhD 6,7 1 Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan. 2 Bureau of International Cooperation, Ministry of Health and Welfare, Taipei, Taiwan. 3 Health Informatics Centre, Karolinska Institutet, Stockholm, Sweden. 4 Massachusetts Institute of Technology, Cambridge, Massachusetts. 5 Department of Dermatology, Wan Fang Hospital, Taipei, Taiwan. 6 School of Health Care Administration, Taipei Medical University, Taipei, Taiwan. 7 Faculty of Health Sciences, Macau University of Science and Technology, Macau. Abstract Recent discussions have focused on using health information technology (HIT) to support goals related to universal healthcare delivery. These discussions have generally not reflected on the experience of countries with a large amount of experience using HIT to support universal healthcare on a national level. HIT was compared globally by using data from the Ministry of the Interior, Republic of China (Taiwan). Taiwan has been providing universal healthcare since 1995 and began to strategically implement HIT on a national level at that time. Today the national-level HIT system is more extensive in Taiwan than in many other countries and is used to aid administration, clinical care, and public health. The experience of Taiwan thus can provide an illustration of how HIT can be used to support universal healthcare delivery. In this article we present an overview of some key historical developments and successes in the adoption of HIT in Taiwan over a 17-year period, as well as some more recent developments. We use this experience to offer some strategic perspectives on how it can aid in the adoption of large-scale HIT systems and on how HIT can be used to support universal healthcare delivery. Key words: health informatics, medical informatics, health information technology, advance technologies, universal health, health policy Introduction Recent efforts at healthcare reform in the United States have ignited discussions about the organization of national health systems. One issue related to this discussion is how health information technology (HIT) can help achieve goals related to universal healthcare delivery. 1 In addition to other structural and cultural changes, it is hoped, for example, that usage of HIT on a large scale (i.e., national scale) will support cost containment and overall efficiency and quality of the system and thus make universal healthcare more achievable. 1,2 To date, these discussions have mostly relied on visions about the potential for future HIT systems 1 but have not included experiences taken from using national-scale HIT systems to support universal healthcare. In the United States, such experience is difficult to draw upon as large-scale HIT systems have proven more difficult to implement in practice than it was hoped for a few years ago. The reasons for this include both technical and sociotechnical (organizational) factors related to successful implementation and utilization of HIT. 3 A technical perspective is that HIT systems generally need to be custom-built or adapted on-site for healthcare organizations, and this is a difficult task due to the complexity of these organizations. 3,4 The fragmented healthcare system in the United States presents additional challenges compared with other countries, as it can be difficult to address all the stakeholders concerns regarding the costs and benefits of HIT systems in order to allow them to unite around one overall implementation strategy. 4 There are several other countries, such as the United Kingdom, Denmark, Norway, and Australia, however, with experience using national-scale HIT systems to support universal care. 5,6 In Taiwan, for example, universal healthcare is organized under the Bureau of National Health Insurance (BNHI), and the healthcare system is supported by HIT in a more extensive way than in many other countries. National-level HIT systems aid in administration, clinical care, and public health. 6,7 742 TELEMEDICINE and e-health SEPTEMBER 2015 DOI: /tmj
2 UTILIZING HEALTH INFORMATION TECHNOLOGY The HIT system in Taiwan is interesting to consider in these discussions as Taiwan has been quite successful at building a high-quality and efficient healthcare system. 8 In 2008, Taiwan spent about 7% of gross domestic product (GDP) on healthcare and covered over 99% of its population with a satisfaction rate of above 83%. 9 The major health indicators like life expectancy at birth are almost the same as the United States, and the infant mortality rate is also comparatively better in Taiwan (Table 1). 8,10 In this article, we present an overview of some key historical developments and successes in the adoption of HIT in Taiwan over a 17-year period. Our goal is to contribute to the discussions around how large-scale HIT systems can support universal healthcare and to help efforts at implementing HIT for this purpose by addressing the following research questions: 1. How has national-level HIT aided the universal healthcare system in Taiwan, and what does that tell us about how national-level HIT might support healthcare systems in other countries? 2. What key lessons can be taken from the Taiwanese experience that can aid in the successful adoption of large-scale (i.e., national-scale) HIT systems in other countries? Table 1. A Summary of the Major Health Indicators, Utilization, and Expenditure for Taiwan and the United States TAIWAN UNITED STATES Health indicators Life expectancy at birth (in years) Infant mortality/1,000 live births Health facility utilization Average number of outpatient clinic visits per year 14 4 Average length of hospital stay (in days) 10 5 Health facility cost (in U.S. $) Cost of hospital stay per day 169 3,949 Spending on pharmaceuticals per capita National health insurance coverage and expenditure (in %) Population covered under national health insurance Satisfaction with healthcare system Health expenditure in percentage of GDP 7 17 GDP, gross domestic product. The Taiwanese Healthcare System Taiwan is an Eastern Asia Island with a population of 23 million. Despite its political isolation internationally, Taiwan is a leading exporter of hi-tech products, particularly computer technology, and has a GDP per capita of U.S. $38,200, 10 making it one of the richest countries in the Asia Pacific region. 9 Since 1995, the national health insurance in Taiwan has been run by BNHI, one of the bureaus of the Department of Health (DOH), and enrollment is mandatory for all citizens and legal residents. All public and private healthcare providers (about 19,000 in total) are affiliated with the program, including regional and district specialist hospitals, local clinics, and general practitioners offices. Citizens may obtain services from the hospitals and/or clinics they choose and can make appointments with a specialist without needing a referral from a general practitioner and without needing to spend extra time on a waiting list. There is a small financial incentive for patients to go through a general practitioner and receive a referral, but in practice many patients choose to visit a specialist directly. Although the single-payer system in Taiwan has generally been a success, there are some challenges with its delivery. 9 Cultural factors result in a high usage rate of healthcare by the citizens. Today each person in Taiwan visits a health facility on average times annually, 9 whereas Americans visit only four times a year. There are challenges related to the overutilization of emergency rooms. 11 Taiwan faces challenges similar to those faced by healthcare systems in other developed countries, such as an increase in costs due to technological advances that increase the cost of care while contributing to the longevity of the population. Despite these challenges, as noted in Figure 1, Taiwan s national health expenditure as a percentage of GDP has been maintained at a fairly constant rate for the last 17 years. Although in this article we focus on the role of HIT in helping to support the healthcare system, there are also other issues related to how the healthcare system is organized that contribute to its overall efficiency and quality. BNHI has introduced a global budget 2,9 and diagnosis-related group payment system to cap costs. This policy has resulted in the reduction of salaries along with increased working hours for healthcare staff. BNHI has full control over provider payments and over the cost of pharmaceuticals and procedures. Administrative costs are quite low, with the administrative costs of BNHI being only 2.23%, for example, compared with 25 30% of the healthcare expenditure in the United States being devoted to administration. 2,12 ª MARY ANN LIEBERT, INC. VOL. 21 NO. 9 SEPTEMBER 2015 TELEMEDICINE and e-health 743
3 SYED-ABDUL ET AL. Fig. 1. Health expenditure trends by gross domestic product (GDP) for the United States and Taiwan (TW). The Role of HIT in Taiwan The usage of HIT in Taiwan has been strategically pursued since the inception of the BNHI. The evolution of the nationalscale HIT system is shown in Figure 2. The first component was implemented in 1995, when it became mandatory that all health providers should submit electronic claims (e-claims) to BNHI. The e-claims must include information like the demographics of the patient, diagnosis, laboratory investigations ordered, and medications prescribed. 6 As the e-claims include such extensive information, the system became an extensive data repository. The e-claims database accumulates records for hundreds of millions of patient visits each year and allows the DOH to gain access to daily reports that summarize all the claims submitted to the BNHI. 13 The national-scale HIT system is also used in various ways to reduce abuse and misuse of health resources. 9 Medical institutions must file an application and receive approval before Fig. 2. Evolution of health information technology in Taiwan. BNHI, Bureau of National Health Insurance; CPOE, computerized physician order entry; e-claim, electronic claims. surgery. Efforts are taken to reduce medical treatments prone to misuse, such as heart, liver, and bone marrow transplantation, radiation therapy, stereotactic radiosurgery, and other high-technology treatments. In 2000, in total, 633 cases were fined, suspended, or terminated in contracts. 9 BNHI also traces and counsels individuals who make an excessive number of outpatient visits. This prevents waste by guiding these heavy users of the healthcare system on how to properly seek treatment. Malpractice and medication errors can be traced, and measures can be taken to reduce them. 14 The e-claims database has become a resource for researchers to develop knowledge-based and evidence-based guidelines for best practices and computerized decision support systems. 15 Annually, hundreds of research articles are published based on analysis of the data contained in the e-claims database. The e-claims system has had a positive impact on the adoption of computerized physician order entry systems and electronic medical record (EMR) systems, as it resulted in providers implementing a workflow that included extensive input of digital information. Over the years additional measures have been taken by the DOH to further the development of HIT on a national scale. A common information security infrastructure was implemented, an EMR interoperability subsidy program was created, and the DOH took additional measures to make healthcare administration more efficient with HIT. 8 These measures included the adoption of health smart cards in 2004, as a means for the identification of patients, physicians, and healthcare facilities, and medical affairs management systems that provide the DOH and local public health agencies with a framework for managing medical, pharmaceutical, nursing, and psychiatric rehabilitation institutions. 6 The adoption of EMR systems in Taiwanese hospitals is fairly high, compared with other developed countries. 6 The computerized physician order entry and EMR usage rates have become high, which has supported the adoption of computerized decision support systems. Such systems are proven to improve the safety and quality of the healthcare system. 16,17 One study from Taiwan, for example, reported that with the use of electronic prescriptions, medication errors have been reduced from 4% to 0.71%. 18 The health smart card system provides clinical advantages because the essential information contained in the cards helps to inform treating physicians about drug/food allergies, immunization status, medical procedures, and willingness to be an organ donor. 14, TELEMEDICINE and e-health SEPTEMBER 2015 ª MARY ANN LIEBERT, INC.
4 UTILIZING HEALTH INFORMATION TECHNOLOGY HIT is used in order to overcome geographical barriers to delivering equitable care in 30 townships in mountainous regions and 8 townships on outlying islands. A medical care network has been established that consists of 145 points of service in remote areas, as well as teaching hospitals, medical centers, and regional hospitals have joined the network to provide teleconsultation. It also is used as a platform to provide training for medical personnel. 9 This is a notable achievement when considering the extreme difficulty that telemedicine experts consider is faced for the development of national-level telemedicine systems. 20 The BNHI has sought to use the Internet in order to improve general functioning and planning of the healthcare system by opening a two-way dialog with different stakeholders that might normally have trouble communicating with health authorities. The government allows the public to gain information through the Internet on BNHI in the shortest possible times and allows them to communicate and share opinions and engage in discussions with BNHI via . 9 More recently, we also have used Facebook in order to better understand issues related to challenges with emergency rooms, as expressed by the health staff. 11 Looking toward the future, the DOH is continuing to improve the HIT infrastructure in Taiwan to expand the benefits to the healthcare system. One of the more interesting projects that has been initiated over the past few years, for example, is that the information inputted into the e-claims system is being used to develop an information exchange system that will reduce the number of tests repeated when a patient visits a new hospital. 8 The e-claims system is already being used by several hospitals, with national-scale implementation expected in the next few years. Discussion The systems described above illustrate how HIT is used to support universal healthcare delivery in Taiwan, which is driven by e-claims adoption. They provide advantages on a national scale in healthcare administration, clinical medicine, and public health. They also enable synergy among these areas, as data created in one bureau of the DOH can be used to support other bureaus. 6,21 The experience in Taiwan thus provides a concrete example of how HIT can be used to generally support universal healthcare, as recently proposed by Fineberg. 1 As healthcare systems vary greatly among countries, it is worth discussing how the experience in Taiwan can provide strategic perspectives on how to approach the adoption of large-scale HIT systems to support universal healthcare more generally. It has been noted that large-scale integrated institutions have advantages in adopting HIT, for example, due to their ability to more clearly manage potential conflicts among different stakeholder groups. The Taiwanese experience is similar to that in countries such as United Kingdom, Denmark, Norway, and Australia, as they have a single-payer system and use HIT extensively. 5,6 Together, these experiences suggest that the single-payer model might have advantages over other models in adoption of HIT on a national scale. A few aspects of the experience in Taiwanese provide some indications, however, on how to succeed with the adoption of HIT on a large scale using other models. One important feature is that success in Taiwan has come with a system that involves both public and private health providers. Another important issue is how the adoption of HIT on a national scale in Taiwan was supported heavily by the implementation of an e-claims system to support administration of the national health insurance. The implementation of the e-claims system made it easier to promote the adoption of EMR systems, computerized decision support systems, and computerized physician order entry systems in the future and is being used to improve meaningful use of data generated at clinics and hospitals. These issues clarify how it may not be necessary to organize healthcare delivery so it is conducted by a single integrated organization in order to successfully adopt integrated and large-scale HIT systems. Instead, it is the economic integration of different elements of healthcare that seems to be more significant in removing barriers in the adoption of HIT on a large scale. This is supported by other evidence. Israel, for example, is quite far along in the adoption of HIT and is noted for having an efficient and high-quality universal healthcare system. Its healthcare system consists of four separate health maintenance organizations (HMOs), and the government pays the membership fee for citizens to the HMO of their choice. 22 It has been reported how one of these HMOs was able to successfully overcome barriers related to the adoption of EMR systems on a wide scale more easily than would be the case with a more fragmented healthcare delivery model. 4 In the United States, there are also a few islands where HIT use is highly successful, and these islands tend to be organizations such as HMOs (e.g., Kaiser Permanente, Massachusetts General Hospital, Boston s Beth Israel, and Brigham and Women s Hospital) that are economically integrated. The Taiwanese experience thus suggests that organizing healthcare delivery to achieve economic integration can provide long-term advantages by making the adoption of large-scale HIT more possible. This could be accomplished through other mechanisms rather than the creation of a ª MARY ANN LIEBERT, INC. VOL. 21 NO. 9 SEPTEMBER 2015 TELEMEDICINE and e-health 745
5 SYED-ABDUL ET AL. national single-payer system. One strategy, for example, could be to enable the development of universal healthcare based on HMOs supported by HIT, as has occurred in Israel, and another could be to develop single-payer systems at the state level, similar to recent efforts in Vermont. 23,24 Another lesson that can be taken from the Taiwanese experience is that it demonstrates how a strategic focus on support for electronic administration, and specifically e-claims, can be used to further national-scale HIT systems more generally. The connection between the adoption of e-claims and other HIT systems is sometimes not mentioned, and thus the possibility for e-claims to indirectly lead to greater benefits than only administrative efficiency may be overlooked. 2 An overview of how different countries have approached the implementation of national-level electronic health record systems has identified several challenges such as acceptance and change management, basic legal conditions and data protection, project management, funding, and health policy-related goals and implementation strategy. 5 These issues are important for any national-level HIT system, so experience in implementing an e-claims system nationally can provide stakeholders with experience on these issues while dealing with a system that is less technically complex and generally more homogeneous (i.e., similar usage at each site) than electronic health record systems. The benefits of focusing on e-claims systems is interesting when considering that research efforts are less focused on e-claims. The terms electronic claims (110 hits) and e-claims (10 hits) in PubMed return a total of only 120 hits, whereas the terms electronic medical records (2,130 hits) and electronic health records (3,702 hits) return a total of 5,832 hits. It is important to note that the Affordable Healthcare Act does mandate the adoption of e-claims. 25 This has the potential to provide additional benefits in the future beyond just direct administrative efficiency. It is noted that additional efforts are still needed beyond that in the legislation in order to optimize the gains from e-claims, and suggestions have been made for.the government to lay out a set of milestones and a path for meeting them, as it has sought to do with electronic medical records. 26 Conclusions The experience of a national-scale HIT system in Taiwan provides an example of how HIT can be used to support an efficient and high-quality universal healthcare system. Economic integration (through a single-payer system) is an important feature of the healthcare system that has enabled the widespread adoption of HIT in Taiwan. The adoption of a national-scale e-claims system by the BNHI has proved to be a critical step in the overall development of the national-scale HIT system infrastructure. Researchers and policy makers should thus increase their focus on supporting the adoption of e-claims and making meaningful use of claimed data for public health initiatives. National healthcare systems and other large-scale healthcare organizations may thus benefit if they view HIT as a standard component of healthcare delivery and take sustained efforts over the long term to continually develop and improve their HIT systems. This can lead to incremental benefits as HIT systems continuously evolve and improve over time. Disclosure Statement No competing financial interests exist. REFERENCES 1. Fineberg HV. Shattuck Lecture. A successful and sustainable health system How to get there from here. N Engl J Med 2012;366: Ginsburg JA, Doherty RB, Ralston JF, et al. Achieving a high-performance health care system with universal access: What the United States can learn from other countries. Ann Intern Med 2008;148: Scholl J, Syed-Abdul S, Ahmed LA. A case study of an EMR system at a large hospital in India: Challenges and strategies for successful adoption. J Biomed Inform 2011;44: Kaye R, Kokia E, Shalev V, Idar D, Chinitz D. Barriers and success factors in health information technology: A practitioner s perspective. J Manag Market Healthc 2010;3: Deutsch E, Duftschmid G, Dorda W. Critical areas of national electronic health record programs Is our focus correct? Int J Med Inform 2010;79: Kushniruk A, Borycki E, Kuo M-H. Advances in electronic health records in Denmark: From national strategy to effective healthcare system implementation. Acta Inform Med 2010;18: Arnrich B, Mayora O, Bardram J, Troster G. Pervasive healthcare: Paving the way for a pervasive, user-centered and preventive healthcare model. Methods Inf Med 2010;49: Ministry of Health and Welfare, Taiwan (ROC). Taiwan public health report Available at Report2011_ pdf (last accessed September 10, 2014). 9. Chan WSH. Taiwan s healthcare report EPMA J 2010;1: Published online December 2, doi: /s The World Factbook. Available at (last accessed May 10, 2012). 11. Syed-Abdul S, Lin C-W, Scholl J, et al. Facebook use leads to health-care reform in Taiwan. Lancet 2011;377: Woolhandler S, Campbell T, Himmelstein DU. Costs of health care administration in the United States and Canada. NEnglJMed 2003;349: Reinhardt UE. Humbled in Taiwan. BMJ 2008;336: Hsu MH, Li YC, Liu CT. ADRs and smart health cards. CMAJ 2006;175: Chen CC, Chen K, Hsu CY, Li YC. Developing guideline-based decision support systems using Protégé and Jess. Comput Methods Programs Biomed 2011;102: Bates DW, Gawande AA. Improving safety with information technology. N Engl J Med 2003;348: TELEMEDICINE and e-health SEPTEMBER 2015 ª MARY ANN LIEBERT, INC.
6 UTILIZING HEALTH INFORMATION TECHNOLOGY 17. Bates DW, Cohen M, Leape LL, et al. Reducing the frequency of errors in medicine using information technology. J Am Med Inform Assoc 2001;8: Liu H-W, Lee HH-C, Kao C-L, et al. Prevention of chemotherapy prescription errors with hematology oncology computerized physician order entry system Experience from a medical center. J Cancer Res Pract 2011;27: Hsu MH, Yen JC, Chiu WT, et al. Using health smart cards to check drug allergy history: The perspective from Taiwan s experiences. J Med Syst 2011;35: Wootton R, Krupinski E. The JTT at 100. J Telemed Telecare 2008;14: Reinhardt UE. Taiwan s progress on health care. The New York Times July 27, Shlomo Mizrahi NC. Privatization through centralization in the Israeli health care system: The case of the national health insurance law and its amendments. Admin Soc 2012;44: Wallack AR. Single payer ahead Cost control and the evolving Vermont model. N Engl J Med 2011;365: Hsiao WC, Knight AG, Kappel S, Done N. What other states can learn from Vermont s bold experiment: Embracing a single-payer health care financing system. Health Aff (Millwood) 2011;30: Affordable Care Act. Available at affordable-care-act.html (last accessed November 10, 2014). 26. Cutler DM, Ly DP. The (paper) work of medicine: Understanding international medical costs. J Econ Perspect 2011;25:3 25. Address correspondence to: Wen-Shan Jian, PhD School of Health Care Administration Taipei Medical University 250 Wuxing Street Xinyi District, Taipei Taiwan jj@tmu.edu.tw jjtmutw@gmail.com Received: September 15, 2014 Revised: November 11, 2014 Accepted: November 12, 2014 ª MARY ANN LIEBERT, INC. VOL. 21 NO. 9 SEPTEMBER 2015 TELEMEDICINE and e-health 747
Taiwan s s Healthcare Industry. Taiwan Institute of Economic Research Dr. Julie C. L. SUN 16 January 2007
Taiwan s s Healthcare Industry Taiwan Institute of Economic Research Dr. Julie C. L. SUN 16 January 2007 Content Taiwan s s Healthcare Industry Overview of National Health Insurance Global Budget Payment
More informationProviding Telehealth Services to a Public Primary Care Network: The Experience of RedeNUTES in Pernambuco, Brazil
Providing Telehealth Services to a Public Primary Care Network: The Experience of RedeNUTES in Pernambuco, Brazil Paula Rejane Beserra Diniz, PhD, 1,2 Fernando José Ribeiro Sales, PhD, 1,3 and Magdala
More information2011 Electronic Prescribing Incentive Program
2011 Electronic Prescribing Incentive Program Hardship Codes In 2012, the physician fee schedule amount for covered professional services furnished by an eligible professional who is not a successful electronic
More information4. Hsu, N.L., Chen, B.T-H., Lee, L.L., Chung, M.H.,
Research Papers 1. Chi, L.M., Hsu, N.L., Chiu, H.J., & Shaw, C.K. (2004). A study of the effectiveness on relieving primary dysmenorrhea by acupressure. Journal of Tzu Chi Nursing, 3(4), 29-37. 2. Lai,
More informationDriving Business Value for Healthcare Through Unified Communications
Driving Business Value for Healthcare Through Unified Communications Even the healthcare sector is turning to technology to take a 'connected' approach, as organizations align technology and operational
More informationA Primer on Activity-Based Funding
A Primer on Activity-Based Funding Introduction and Background Canada is ranked sixth among the richest countries in the world in terms of the proportion of gross domestic product (GDP) spent on health
More information2012 National Patient Safety Goals and National Priorities Partnership Goals addressed in this case study
(ROI) University of California Davis Health System 2315 Stockton Blvd., Sacramento, CA 95817 Noel Sousa Finance Director noel.sousa@ucdmc.ucdavis.edu Michael Smith Financial Analyst michael.smith@ucdmc.ucdavis.edu
More informationJason C. Goldwater, MA, MPA Senior Director
The History of Health Information Technology in 45 Minutes Jason C. Goldwater, MA, MPA Senior Director April 5, 2017 Agenda Where We are With Health Information Technology and Where We are Going The Alphabet
More informationEqual Distribution of Health Care Resources: European Model
Equal Distribution of Health Care Resources: European Model Beyond Theory to Social Justice in Health Care Children s Hospital of New Orleans Saturday, March 15, 2008 New Orleans, Louisiana Alfred Tenore
More informationPediatric Population Health
JANUARY 25, 2018 Swedish Pediatric CME 2018 Pediatric Population Health Michael Dudas, MD Chief of Pediatrics, Virginia Mason Medical Center Co-Chair, Health Care Transformation Committee, WCAAP 1 Objectives
More informationDr. Shwu-Feng Tsay RN, PhD, MS, M.P.H. Director-General, Department of Nursing and Health Care, Ministry of Health and Welfare (R.O.C.
Dr. Shwu-Feng Tsay RN, PhD, MS, M.P.H. Director-General, Department of Nursing and Health Care, Ministry of Health and Welfare (R.O.C.) EDUCATION PhD, Institute of Public Affairs, National Sun Yet-Sen
More informationA Crash Course on the Taiwanese Health Care System
A Crash Course on the Taiwanese Health Care System Jason Tan de Bibiana The Taiwanese health care system has famously been described as a car manufactured domestically from parts imported from abroad [3].
More informationLeveraging Health Care IT Investment
Leveraging Health Care IT Investment A Harvard Business Review Webinar featuring David M. Cutler and Robert S. Huckman Sponsored by OVERVIEW In recent years, health care organizations have made massive
More informationChronic Disease Management: Breakthrough Opportunities for Improving the Health And Productivity of Iowans
Chronic Disease Management: Breakthrough Opportunities for Improving the Health And Productivity of Iowans A Report of the Iowa Chronic Care Consortium February 2003 Background The Iowa Chronic Care Consortium
More informationU.S. Healthcare Problem
U.S. Healthcare Problem U.S. Federal Spending GDP (%) Source: Congressional Budget Office This graph shows that government has to spend a lot of more money in healthcare in the future and it is growing
More informationSMART Careplan System for Continuum of Care
Case Report Healthc Inform Res. 2015 January;21(1):56-60. pissn 2093-3681 eissn 2093-369X SMART Careplan System for Continuum of Care Young Ah Kim, RN, PhD 1, Seon Young Jang, RN, MPH 2, Meejung Ahn, RN,
More informationDefinition of Meaningful Use of Certified EHR Technology for Hospitals Approved by the HIMSS Board of Directors April 24, 2009
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 Definition of Meaningful Use of Certified EHR Technology for Hospitals Approved by
More informationCOMPUTERIZED PHYSICIAN ORDER ENTRY (CPOE)
COMPUTERIZED PHYSICIAN ORDER ENTRY (CPOE) Ahmed Albarrak 301 Medical Informatics albarrak@ksu.edu.sa 1 Outline Definition and context Why CPOE? Advantages of CPOE Disadvantages of CPOE Outcome measures
More informationThe Collaborative to Advance Social Health Integration (CASHI)
The Collaborative to Advance Social Health Integration (CASHI) "Let me tell you the story of one patient we worked with in Boston. He was screened for unmet health-related social needs as part of a newly
More informationOverview. Improving Safety with Health Information Technology. Prioritizing Safety. Question 22/10/2013
Improving Safety with Health Information Technology ISQua 2013, Edinburgh David Bates, MD, MSc Chief Quality Officer, Chief, Division of General Internal Medicine, Brigham and Women s Hospital Medical
More informationElectronic Prescribing of Chemotherapy-It s Not a Video Game!
Faculty Disclosures Electronic Prescribing of Chemotherapy-It s Not a Video Game! Mary Mably has no disclosures Mary S. Mably, RPh, BCOP Pharmacy Oncology Coordinator, University of Wisconsin Hospital
More informationSuccessful Clinical Process Redesign in a Connected Healthcare Community. Linus Diedling Allison Foley, MD Elliot Sternberg, MD Michelle Woodley, RN
Successful Clinical Process Redesign in a Connected Healthcare Community Linus Diedling Allison Foley, MD Elliot Sternberg, MD Michelle Woodley, RN AGENDA Care Redesign from 3 Perspectives Chief Medical
More informationHow can oncology practices deliver better care? It starts with staying connected.
How can oncology practices deliver better care? It starts with staying connected. A system rooted in oncology Compared to other EHRs that I ve used, iknowmed is the best EHR for medical oncology. Physician
More informationAdvanced Use of Health Information Technology to Support New Models of Care
AMERICAN HOSPITAL ASSOCIATION ANNUAL SURVEY IT SUPPLEMENT BRIEF #4 JULY 2018 Advanced Use of Health Information Technology to Support New Models of Care A growing number of hospitals and health systems
More informationIntegrating Health Information Technology Safety into Nursing Informatics Competencies
222 Forecasting Informatics Competencies for Nurses in the Future of Connected Health J. Murphy et al. (Eds.) 2017 IMIA and IOS Press. This article is published online with Open Access by IOS Press and
More informationAssessing and Increasing Readiness for Patient-Centered Medical Home Implementation 1
EVALUATION Assessing and Increasing Readiness for Patient-Centered Medical Home Implementation 1 Research Summary No. 9 March 2012 Introduction The current model of primary care in the United States is
More informationSaint-Luc Transformation: Impacted by Belgian Network Regulation?
Saint-Luc Transformation: Impacted by Belgian Network Regulation? Renaud Mazy CEO University Hospital Saint-Luc Patientfriendly & Smarter Healthcare Agenda Healthcare evolution Saint-Luc University Hospital
More informationFixing the Public Hospital System in China
Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Executive Summary Fixing the Public Hospital System in China Overview of public hospital
More informationThe Evolution of eprescribing The Start of the Journey Professor Jamie Coleman
The Evolution of eprescribing The Start of the Journey Professor Jamie Coleman He wrote in a doctor s hand the hand which, from the beginning of time, has been so disastrous to the apothecary and so profitable
More informationSecond Opinion. Introduction. Second Opinion. Yoshio YAZAKI
Second Opinion Second Opinion JMAJ 48(3): 155 159, 2005 Yoshio YAZAKI President, National Hospital Organization Abstract: Getting a second opinion is a means for patients or their family members to obtain
More informationUse of classifications in Korea
Use of classifications in Korea The 6th Meeting of the Asia Pacific Network of the WHO Family of International Classifications Bangkok July 18, 2013 Korean Collaborating Center Sukil Kim Contents Current
More informationAdministrative Update: How to Implement Discharge Pharmacy Services (DPS) Objectives
Administrative Update: How to Implement Discharge Pharmacy Services (DPS) Morgan Pendleton, PharmD, BCOP Hematology/Oncology Clinical Pharmacist Wake Forest Baptist Health Objectives Evaluate the need
More informationAetna Health of California, Inc.
Easily locate PrimeCare participating providers at www.aetna.com/docfind/primecare PLAN FEATURES Deductible (per calendar year) Member Coinsurance Lifetime Maximum Primary Care Physician Selection Referral
More informationTransitioning to a Value-Based Accountable Health System Preparing for the New Business Model. The New Accountable Care Business Model
Transitioning to a Value-Based Accountable Health System Preparing for the New Business Model Michael C. Tobin, D.O., M.B.A. Interim Chief medical Officer Health Networks February 12, 2011 2011 North Iowa
More information21 st Century Health Care: The Promise and Potential of a Learning Health System
21 st Century Health Care: The Promise and Potential of a Learning Health System Carolyn M. Clancy, MD Director Agency for Healthcare Research and Quality National Science Foundation Learning Health System
More informationMetabolic & Bariatric Surgery. Nate Sann, MSN, FNP-BC
Telemedicine in Metabolic & Bariatric Surgery Nate Sann, MSN, FNP-BC Disclosures: Apollo Endosurgery Faculty Member Exam Med Consultant Long term follow-up in Metabolic & Bariatric Surgery Obesity is a
More informationText-based Document. Advancing Nursing Informatics to Improve Healthcare Quality and Outcomes. Authors Sensmeier, Joyce E.
The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based
More informationEvaluation & Management ( E/M ) Payment and Documentation Requirements
National Partnership for Hospice Innovation 1299 Pennsylvania Ave., Suite 1175 Washington DC, 20004 September 10, 2017 Seema Verma Administrator Centers for Medicare & Medicaid Services, Department of
More informationMeasuring Digital Maturity. John Rayner Regional Director 8 th June 2016 Amsterdam
Measuring Digital Maturity John Rayner Regional Director 8 th June 2016 Amsterdam Plan.. HIMSS Analytics Overview Introduction to the Acute Hospital EMRAM Measuring maturity in other settings Focus on
More informationKingdom of Saudi Arabia Ministry of Defense General Staff Command Medical Services Directorate King Fahad Armed Forces Hospital, Jeddah
Kingdom of Saudi Arabia Ministry of Defense General Staff Command Medical Services Directorate King Fahad Armed Forces Hospital, Jeddah Aim: To share with the participants the development of the health
More informationINCENTIVES AND SUPPORT SYSTEMS TO FOSTER PRIVATE SECTOR INNOVATION. Jerry Sheehan. Introduction
INCENTIVES AND SUPPORT SYSTEMS TO FOSTER PRIVATE SECTOR INNOVATION Jerry Sheehan Introduction Governments in many countries are devoting increased attention to bolstering business innovation capabilities.
More informationPatient-Centered Medical Home (PCMH) & Patient-Centered Specialty Practice (PCSP)
Patient-Centered Medical Home (PCMH) & Patient-Centered Specialty Practice (PCSP) Foundation for a Better Health Care System Presenter Jeanette Ikan, M.D., MHAI Objectives: Definition and benefits of PCMH,
More informationTrends in hospital reforms and reflections for China
Trends in hospital reforms and reflections for China Beijing, 18 February 2012 Henk Bekedam, Director Health Sector Development with input from Sarah Barber, and OECD: Michael Borowitz & Raphaëlle Bisiaux
More informationLearning from Swedish Health Care
Learning from Swedish Health Care Staffan Bjessmo, MD, PhD Cardiothoracic Surgeon Chief Medical Officer, Synergus AB CEO, CollaboDoc AB 1 Agenda Overview of Swedish Health Care System How decentralized
More informationEnd-to-end infusion safety. Safely manage infusions from order to administration
End-to-end infusion safety Safely manage infusions from order to administration New demands and concerns 56% 7% of medication errors are IV-related. 1 of high-risk IVs are compounded in error. 2 $3.5B
More informationTerms of Reference Kazakhstan Health Review of TB Control Program
1 Terms of Reference Kazakhstan Health Review of TB Control Program Objectives 1. In the context of the ongoing policy dialogue and collaboration between the World Bank and the Government of Kazakhstan
More informationProfessor Dato Dr Jai Mohan, FRCP (Lon), FAMM
Professor Dato Dr Jai Mohan, FRCP (Lon), FAMM Professor of Health Informatics & Paediatrics, International Medical University President, Malaysian Health Informatics Association Jai_Mohan@imu.edu.my Accurate,
More informationSweden and Australia have longstanding bilateral relations. Sweden and Swedish businesses were among the first to establish a presence and
Sweden and Australia have longstanding bilateral relations. Sweden and Swedish businesses were among the first to establish a presence and international relations with Australia and still today, the Swedish-Australian
More information1. What are the requirements for Stage 1 of the HITECH Act for CPOE to qualify for incentive payments?
CPPM Chapter 8 Review Questions 1. What are the requirements for Stage 1 of the HITECH Act for CPOE to qualify for incentive payments? a. At least 30% of the medications in the practice must be ordered
More informationAlternative Managed Care Reimbursement Models
Alternative Managed Care Reimbursement Models David R. Swann, MA, LCSA, CCS, LPC, NCC Senior Healthcare Integration Consultant MTM Services Healthcare Reform Trends in 2015 Moving from carve out Medicaid
More informationCMS-0044-P; Proposed Rule: Medicare and Medicaid Programs; Electronic Health Record Incentive Program Stage 2
May 7, 2012 Submitted Electronically Ms. Marilyn Tavenner Acting Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services Room 445-G, Hubert H. Humphrey Building
More informationA template-based computerized instruction entry system helps the comunication between doctors and nurses
Digital Healthcare Empowering Europeans R. Cornet et al. (Eds.) 2015 European Federation for Medical Informatics (EFMI). This article is published online with Open Access by IOS Press and distributed under
More informationDigital Economy.How Are Developing Countries Performing? The Case of Egypt
Digital Economy.How Are Developing Countries Performing? The Case of Egypt by Nagwa ElShenawi (PhD) MCIT, Egypt Produced for DIODE Network, 217 Introduction According to the OECD some of the most important
More information1.800MD offers physicians a competitive advantage
Physician Overview 1.800MD offers physicians a competitive advantage No administrative headaches Guaranteed payment Directed patient volumes Increased revenue Flexible schedule What is Telemedicine? Telemedicine
More informationHome Health Monitoring
Home Health Monitoring deployment to date What s driving demand for Home Health Monitoring technologies? Health Spending and Information and Communication Technologies Creating new vistas for Canadian
More informationTranslating the abstracts of Cochrane Database Systematic Reviews (CDSR) into Chinese in Taiwan
Translating the abstracts of Cochrane Database Systematic Reviews (CDSR) into Chinese in Taiwan Chiehfeng (Cliff) Chen MD MPH PhD Associate Director, Center for Evidence-Based Medicine, Taipei Medical
More informationInternational ICT data collection, dissemination and challenges
DATA - ICT Research Conference Royal College of Physicians Dublin, Ireland 12 March 2009 ICT data collection, dissemination and challenges Esperanza Magpantay Statistician Market Information and Statistics
More informationDigital Disruption meets Indian Healthcare-the role of IT in the transformation of the Indian healthcare system
Digital Disruption meets Indian Healthcare-the role of IT in the transformation of the Indian healthcare system Introduction While the Indian healthcare system has made important progress over the last
More informationCALIFORNIA Small Group HMO Aetna Health of California, Inc. Plan Effective Date: 04/01/2007. Aetna Value Network* HMO $30/$40
PLAN FEATURES Deductible (per calendar year) Member Coinsurance Lifetime Maximum Primary Care Physician Selection Referral Requirement PHYSICIAN SERVICES CALIFORNIA Small Group HMO Primary Care Physician
More informationehealth Report for Ed Clark November 10, 2016 My Background and Context:
ehealth Report for Ed Clark November 10, 2016 My Background and Context: I worked for a number of years for OHIP at the Ministry of Health in Kingston. Several major project initiative involved converting
More informationBELGIUM DATA A1 Population see def. A2 Area (square Km) see def.
BELGIUM A1 Population 10.796.493 10.712.000 10.741.129 A2 Area (square Km) 30.530 30.530 30.530 A3 Average population density per square Km 353,64 350,87 351,82 A4 Birth rate per 1000 population 11,79......
More informationCA Group Business 2-50 Employees
PLAN FEATURES Network Primary Care Physician Selection Deductible (per calendar year) Member Coinsurance Copay Maximum (per calendar year) Lifetime Maximum Referral Requirement PHYSICIAN SERVICES Primary
More information7/13/2016. Patient Care through Telepharmacy July Objectives. Agenda. Adam Chesler, PharmD
Patient Care through Telepharmacy July 2016 Adam Chesler, PharmD Objectives 1.Describe why telepharmacy started and how it has evolved with technology 1.Explain how telepharmacy is being used to provide
More informationMeaningful use care coordination criteria: Perceived barriers and benefits among primary care providers
Meaningful use care coordination criteria: Perceived barriers and benefits among primary care providers RECEIVED 10 June 2015 REVISED 18 August 2015 ACCEPTED 27 August 2015 PUBLISHED ONLINE FIRST 13 November
More informationUNIVERSAL HEALTH COVERAGE in TURKEY:
UNIVERSAL HEALTH COVERAGE in TURKEY: CHALLENGES and OPPORTUNITIES September 29, 2011 1 OUTLINE Universal Coverage Global Status Status in Turkey Prior to 2003 Health Transformation Program / 2003-2011
More informationMeeting of the Health Committee at Ministerial Level
For Official Use English - Or. English For Official Use DELSA/HEA/MIN(2010)6 Organisation de Coopération et de Développement Économiques Organisation for Economic Co-operation and Development English -
More informationTransformational paradigms poised to redefine healthcare delivery. November 2016
Transformational paradigms poised to redefine healthcare delivery November 2016 Frost & Sullivan s Transformational Health Practice Addresses the Forces Driving Change in Healthcare Factors Transforming
More informationSNOMED CT AND 3M HDD: THE SUCCESSFUL IMPLEMENTATION STRATEGY
SNOMED CT AND 3M HDD: THE SUCCESSFUL IMPLEMENTATION STRATEGY Federal Health Care Agencies Take the Lead The United States government has taken a leading role in the use of health information technologies
More informationWHITE PAPER. Taking Meaningful Use to the Next Level: What You Need to Know about the MACRA Advancing Care Information Component
Taking Meaningful Use to the Next Level: What You Need to Know Table of Contents Introduction 1 1. ACI Versus Meaningful Use 2 EHR Certification 2 Reporting Periods 2 Reporting Methods 3 Group Reporting
More informationNational Multiple Sclerosis Society
National Multiple Sclerosis Society National 1 Kim, National diagnosed MS in Society 2000 > HEALTH CARE REFORM PRINCIPLES America s health care crisis prevents many people with multiple sclerosis from
More informationMEDICATION ERROR REPORTING SYSTEMS LESSONS LEARNT EXECUTIVE SUMMARY OF THE FINDINGS
MEDICATION ERROR REPORTING SYSTEMS LESSONS LEARNT EXECUTIVE SUMMARY OF THE FINDINGS Authors: Anna-Riia Terzibanjan a ; Raisa Laaksonen b ; Marjorie Weiss b, Marja Airaksinen a ; Tana Wuliji c a University
More informationAdverse Drug Events in Wyoming
Adverse Drug Events in Wyoming Where We Are and Where We Need to Go Stevi Sy, PharmD, RPh Adverse Drug Event Task Lead Mountain-Pacific Quality Health August 2017 Objectives Upon completion of this program
More informationExamining the Differences Between Commercial and Medicare ACO Models
Examining the Differences Between Commercial and Medicare ACO Models Michelle Copenhaver December 10, 2015 Agenda 1 Understanding Accountable Care Organizations 2 Moving to Accountable Care: Enhancing
More informationCenter for Labor Research and Education University of California, Berkeley Center for Health Policy Research University of California, Los Angeles
Center for Labor Research and Education University of California, Berkeley Center for Health Policy Research University of California, Los Angeles School of Public Health University of California, Berkeley
More informationAn Integrated Approach for Improving Occupational Health and Safety Management: The Voluntary Protection Program in Taiwan
J Occup Health 2005; 47: 270 276 Journal of Occupational Health Field Study An Integrated Approach for Improving Occupational Health and Safety Management: The Voluntary Protection Program in Taiwan Teh-Sheng
More informationAvailable online at ScienceDirect. Procedia Computer Science 86 (2016 )
Available online at www.sciencedirect.com ScienceDirect Procedia Computer Science 86 (2016 ) 252 256 2016 International Electrical Engineering Congress, ieecon2016, 2-4 March 2016, Chiang Mai, Thailand
More informationA Computerized Order Entry System Was Adopted with High User Satisfaction at an Orthopedic Teaching Hospital
HSSJ (2014) 10:52 58 DOI 10.1007/s11420-013-9377-1 ORIGINAL ARTICLE A Computerized Order Entry System Was Adopted with High User Satisfaction at an Orthopedic Teaching Hospital Mary Murray-Weir, PT, MBA
More informationTHE BEST OF TIMES: PHARMACY IN AN ERA OF
OBJECTIVES THE BEST OF TIMES: PHARMACY IN AN ERA OF ACCOUNTABLE CARE Toni Fera, BS, PharmD October 17, 2014 1. Describe the role of pharmacists in accountable care organizations (ACO). 2. List four key
More information1 Background. Foundation. WHO, May 2009 China, CHeSS
Country Heallth Systems Surveiillllance CHINA 1 1 Background The scale-up for better health is unprecedented in both potential resources and the number of initiatives involved. This includes both international
More informationAbstract. Are eligible providers participating? AdvancedMD EHR features streamline meaningful use processes: Complete & accurate information
Abstract As part of the American Recovery and Reinvestment Act of 2009, the Federal Government laid the groundwork for the nationwide implementation of electronic health records (EHR) systems as a measure
More informationHospital information systems: experience at the fully digitized Seoul National University Bundang Hospital
Review Article Hospital information systems: experience at the fully digitized Seoul National University Bundang Hospital Sooyoung Yoo 1 *, Hee Hwang 1 *, Sanghoon Jheon 2 1 Center for Medical Informatics,
More informationAN OVERVIEW OF THE ISRAELI MEDICAL DEVICES INDUSTRY
The global healthcare systems are facing many challenges. Aging populations and burgeoning middle classes along with expectations of higher-quality care and a squeeze on funding have created a drive for
More informationALBANY MEDICAL CENTER, PPS LEADS REGIONAL INITIATIVE to Boost Care Quality and Slow Medicaid Costs
ALBANY MEDICAL CENTER, PPS LEADS REGIONAL INITIATIVE to Boost Care Quality and Slow Medicaid Costs OVERVIEW New York is one of the first states to participate in the Delivery System Reform Incentive Payment
More informationTiming It Right - Patients Online Access to Their Record Notes in Sweden
336 Building Continents of Knowledge in Oceans of Data: The Future of Co-Created ehealth A. Ugon et al. (Eds.) 2018 European Federation for Medical Informatics (EFMI) and IOS Press. This article is published
More informationPayment innovations in healthcare and how they affect hospitals and physicians
Payment innovations in healthcare and how they affect hospitals and physicians Christian Wernz, Ph.D. Assistant Professor Dept. Industrial and Systems Engineering Virginia Tech Abridged version of the
More informationAIS Electronic Library (AISeL) Association for Information Systems. Jitsuzo Katsumata Keio University,
Association for Information Systems AIS Electronic Library (AISeL) PACIS 2010 Proceedings Pacific Asia Conference on Information Systems (PACIS) 2010 Possibility of the Introduction of Telemedicine in
More informationTurkey. Note: A Mental Health Action plan is prepared but has not been published yet.
GENERAL INFORMATION Turkey Turkey is a country with an approximate area of 775 thousand square kilometers (O, 2008). The population is 75,705,147 and the sex ratio (men per hundred women) is 100 (O, 2009).
More informationIMPACT OF TECHNOLOGY ON MEDICATION SAFETY
Continuous Quality Improvement IMPACT OF Steven R. Abel, PharmD, FASHP TECHNOLOGY ON Nital Patel, PharmD. MBA MEDICATION SAFETY Sheri Helms, PharmD Candidate Brian Heckman, PharmD Candidate Ismaila D Badjie
More informationLong term commitment to a new vision. Medical Director February 9, 2011
ACCOUNTABLE CARE ORGANIZATION (ACO): Long term commitment to a new vision Michael Belman MD Michael Belman MD Medical Director February 9, 2011 Physician Reimbursement There are three ways to pay a physician,
More informationUAMS/SVI Partnership Agreement. Proposal
UAMS/SVI Partnership Agreement Proposal Introduction The University of Arkansas for Medical Sciences (UAMS) is the health sciences and academic medical component of the University of Arkansas. St Vincent
More informationTELEHEALTH INDEX: 2015 PHYSICIAN SURVEY
TELEHEALTH INDEX: 2015 PHYSICIAN SURVEY Overview Telehealth is accelerating in 2015. As many as 37% of hospital systems have at least one type of telemedicine solution to meet a variety of objectives,
More informationUnderstanding CQM MU Requirements for Hospitals. Phil Deering Sarah Tupper, MS, RN-BC, LHIT-HP 3/27/2012
Understanding CQM MU Requirements for Hospitals Phil Deering Sarah Tupper, MS, RN-BC, LHIT-HP 3/27/2012 REACH - Achieving - Achieving meaningful meaningful use of your use EHR of your EHR Let s Hear Your
More information$10 copay. $10 copay. $10 copay $5 copay $10 copay $5 copay. $10 copay. No charge. No charge. No charge
PLAN FEATURES * ** Deductible (per calendar ) Member Coinsurance Copay Maximum (per calendar ) Lifetime Maximum Unlimited Primary Care Physician Selection Required Upon enrollment to a Vitalidad Plus plan,
More information2019 Research Grants Application Guide
1. Introduction This Research Grant serves to outline the overarching funding rules of all Stroke Foundation Research Grants. This document should be read before completing an application form. 2. Background
More informationThe Performance of Japan s Health System Analysis with the Harvard-Flagship Health Reform Approach *1
Conferences and Lectures JMARI Public Lecture on the Future Image of Japan s Healthcare Lecture 1 The Performance of Japan s Health System Analysis with the Harvard-Flagship Health Reform Approach *1 JMAJ
More informationTrends in Health Information Exchange (HIE) and Links to Medicaid Led Quality Improvement
Trends in Health Information Exchange (HIE) and Links to Medicaid Led Quality Improvement July 25, 2007 Regional Quality Improvement Initiative Shannah Koss Avalere Health LLC Avalere Health LLC The intersection
More informationBulgaria GENERAL INFORMATION GOVERNANCE FINANCING MENTAL HEALTH CARE DELIVERY. Primary Care
GENERAL INFORMATION Bulgaria Bulgaria is a country with an approximate area of 111 thousand square kilometers (O, 2008). The population is 7,497,282 and the sex ratio (men per hundred women) is 94 (O,
More informationPatient-Centered Specialty Practice: Building the Medical Neighborhood
Patient-Centered Specialty Practice: Building the Medical Neighborhood Margaret E. O Kane President, National Committee for Quality Assurance June 6, 2014 1 Overview Central challenge: Creating systems
More informationCost effectiveness of telemedicine for the delivery of outpatient pulmonary care to a rural population Agha Z, Schapira R M, Maker A H
Cost effectiveness of telemedicine for the delivery of outpatient pulmonary care to a rural population Agha Z, Schapira R M, Maker A H Record Status This is a critical abstract of an economic evaluation
More informationMental Health Atlas Department of Mental Health and Substance Abuse, World Health Organization. Mongolia
GENERAL INFORMATION Mongolia Mongolia is a country with an approximate area of 1567 thousand square kilometers (O, 2008). The population is 2,701,117 and the sex ratio (men per hundred women) is 98 (O,
More information