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One Pathway to Thailand’s eHealth:
A Personal Quick Thought
Nawanan Theera-Ampornpunt
February 15, 2016
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Key Problems
•No clear & common goal/vision of eHealth
•No linkage between eHealth vision & health system’s vision
•No roadmap/strategy toward eHealth vision
•Building blocks not in place toward eHealth vision
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A Proposed Vision: Health Information Exchange (HIE) & Personal Health Records (PHRs)
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Personal Health Records (PHRs)
Markle Foundation (2003), cited in Kaelber et al. (2008)
Markle Foundation (2003), cited in Tang et al. (2006)
Hersh (2009)
Health Information Exchange (HIE)
Hersh (2009)
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A Proposed Vision: Health Information Exchange (HIE) & Personal Health Records (PHRs)
Hospital A Hospital B
Clinic C
Government
Lab Patient at Home
1. eHealth Governance
2. IT-Driven Hospitals3. Data & Exchange Standards
5. Patient-Accessible Platforms
4. Data Use by Policymakers
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Building Blocks & Vision
Better Health Care
HIE (Data Exchange among Providers, Policymakers & Administrators)
Governance, Policy, Law
Infrastructure Standards
PHRs (Patient Access to Data)
Applications Workforce
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One Possible Pathway
Strengthening eHealth Building Blocks
• eHealth Governance & Strategy
• Infrastructure
• Standards
• Integrated Applications
• Workforce
Quick Wins
• Governance Body
• Hospital IT Quality
• eReferral
• Data Warehouse through Health Data Centers
• Pilot for Patient-Accessible PHRs
HIE & PHRs (Expanding Scope & Scale)
• Exchanging Patient Records among Providers
• Patient’s Access
High Quality Health Care
• Safe, timely, effective & efficient care through information exchange
• Patient engagement & centeredness through PHRs
• Better policymaking & research
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Proposed Projects & Tasks
• eHealth governance reform (18 mo.)• Create interim eHealth structure (2 mo.)• Determine long-term governance structure (3 mo.)• Draft necessary laws (6-12 mo.)• Go through lawmaking process (18 mo.)• Ensure sustainable & collaborative eHealth decision-
making mechanism
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Proposed Projects & Tasks
•Hospital IT Quality Improvement (18 mo.)• Policy to encourage/endorse hospital IT quality
improvement (3 mo.)• Training (6-12 mo.)• Hospitals implement IT quality initiatives (6-12 mo.)• Survey & assess initial batches (12-18 mo.)
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Proposed Projects & Tasks
• Integrated (Standard-based) eReferral Platform (18 mo.)• Develop eReferral standards (Data Models, Exchange
Formats, Connectivity Platforms, Privacy) (6 mo.)• Integrate various eReferral apps (12 mo.)• Policy for standard adoption (12-18 mo.)• Expand scope of exchange (outside eReferral) e.g.
emergency, etc.
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Proposed Projects & Tasks
•Health data centers (data warehouse) (12 mo.)• Review proper infrastructure & data model per unmet
needs (3 mo.)• Design & implement new data models & infrastructure for
new use cases (12 mo.)
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Proposed Projects & Tasks
•Patient-accessible PHRs (18 mo.)• Review data models, existing standards, needs for change
(3 mo.)• Design platform & standards (6 mo.)• Pilot among selected ready hospitals (12 mo.)• Expand scope & scale (18 mo.)• Create/revise standards (18 mo.)
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A Proposed Vision: Health Information Exchange (HIE) & Personal Health Records (PHRs)
Hospital A Hospital B
Clinic C
Government
Lab Patient at Home
1. eHealth Governance
2. IT-Driven Hospitals3. Data & Exchange Standards
5. Patient-Accessible Platforms
4. Data Use by Policymakers
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Key Problems Solved
•No clear & common goal/vision of eHealth
•No linkage between eHealth vision & health system’s vision
•No roadmap/strategy toward eHealth vision
•Building blocks not in place toward eHealth vision