Healthcare in the Network Economy

1. gsc11_joint_33 Healthcare in the Network Economy

2. Canada has become an e-Society • 100% of schools and libraries connected by 1999 • 600,000 refurbished computers given to schools • Student-to-computer ratio (median) is 5 to 1 (Statistics Canada, 2004) • Established 3,900 community Internet access sites • CA*net 4: the world’s first national optical research and education network • 81% of households (IPSOS-Reid 2005) & 82% Firms use the Internet (SECT 2004) • One of the highest rates of broadband penetration (OECD 2004) • #1 in Government Online (GOL)(Accenture 2001, 2002, 2003, 2004, 2005) Citizens, businesses and governments are going online

3. Canadians moving online and demanding high-speed Broadband Penetration Source: Yankee Group, North America Consumer Fixed-Line & Media Forecast (March 2005)

4. Seek health information… Source: Canadian Internet Project, May 2005

5. Why focus on the health care sector? • 10.4% of Canada’s GDP (2004) • Estimated $142 B spending in 2005 • Close to 40% of P/T expenditures • Employs over 1.1 million people (2004) • Responsible for estimated 24% of business R&D (2004) Sources: CIHI, Statistics Canada …crucial economic sector

6. Real Health Expenditures per Capita 1500 Ageing, no other pressures 1250 $1997 1000 750 1997 500 1980 1988 1996 2004 2012 2020 2028 2036 2044 2052 2060 Health spending pressures rising • Average cost to provide health care for 1 year: • 30 year-old man: $230 • 65 year-old man: $2,400 • In constant $ 1997 • Source: CBoC, (2004) We must increase productivity in health care Source: Hogan & Hogan, “How Will the Ageing of the Population Affect Health Care Needs and Costs in the Foreseeable Future?”, for Commission on the Future of Health Care in Canada, 2002.

7. Canada Health Infoway is national lead $1.2 B to ensure 50% of Canadians have EHR by 2009. Has committed investment in 146 projects across Canada totaling $536 M by the end of next month (e.g. EHR standards, diagnostic imaging, telehealth) www.infoway-inforoute.ca Provinces and territories are making progress Hospital Connectivity:Most provinces/territories have already connected their hospitals through high-speed private networks Physicians:Funding for connectivity or ICTs (ON, Quebec, Alberta) Pharmacies: Pharmacy networks and/or online accessible prescription databases. Other issues: privacy, billing, liability, claims etc. Work underway to improve ICTs in health

8. But we are not there yet:Health sector among least ICT-intensive sectors ICT Investment as a Percentage of Total Investment by Industry, 2004* • And invests 35% less in ICTs than U.S. health sector • Canada: 10.5 % • U.S. 15.9 % health care sector *Total investment includes all fixed investments (structures, M&E, etc.), but excludes inventories. Source: A. Sharpe, Canadian Centre for Living Standards, “What explains the Canada-US ICT gap?” http://www.csls.ca/data/ict.asp, Table S21 (2005).

9. Health care facilities are under investing in ICTs • Canadian hospitals spend only between 1.8 % and 2.5 % of their annual operating budgets on ICTs (CBoC 2004) • Compared to 4% in Sweden, which has EHRs online in every hospital and primary health care centre. (CBoC 2004) • And 9-13% in ICT-intensive sectors (ITAC, 2003) • Hospitals face the same transformation challenges as other enterprises: • changing business practices • need for sector-wide and supply-chain wide solutions • Lack of experts with combination of skills to implement

10. And physicians not integrating ICTs in workflow • Physicians in general areearly adopters of ICTs, but have difficulty integrating into workflow and direct patient care • 88% of Canadian physicians use the Internet, but one out of every 2 users accesses it from home, rather than in the office. • Compared to 80% of physicians in the EU connected to electronic data interchange system (European Commission 2006) • Demographics are changing use: 53% of Canadian physicians under 35 are using PDAs (compared to less than 33% of physicians over 55). (CMA) • GP offices face the same challenges as other SMEs in using ICTs (lack of time and expertise, transforming business processes, need solution as part of supply chain). Sources: Canada Health Infoway, End User Acceptance Strategy – Current State Assessment, May 2005. Brewin, Bob, “Canada outpaces U.S. in health IT, FWC.com, February 15, 2006.

11. Room for Improvements Canadian physicians not maximizing benefits of ICTs • only 34% have digitized medical records in their offices (as compared to 51% in the U.S.) • only 10% communicate with patients via email (as compared to 22% in New Zealand) • only 8% use e-prescribing (as compared to 87% in the U.K.). • Only 14% of Canadian physicians use electronic medical records (2001) (as compared to 59% in the U.K.) Sources: Canada Health Infoway, End User Acceptance Strategy – Current State Assessment, May 2005 and Harris Interactive, 2001.

12. A crowded field of SDOs • IEEE 1073 • Medical device communication • ISO TC 215 • Healthcare ICT system interoperability • IEC TC 62 • Electrical medical equipment, including EMC • CEN TC 251 • Health informatics • ITU-T SG 16 • Generic architecture for multimedia telemedicine apps

13. And some less well-known • Health Level 7 • Integrating the Healthcare Experience • Clinical Data Interchange Standards Consortium • Digital Imaging and Communications in Medicine • American Society for Testing and Materials • Healthcare Info and Management Systems Society • American Dental Association • Clinical Laboratory Standards Institute • And many more

14. Some recent initiatives • IEEE SA Healthcare Standards Study Group • Gap analysis, followed by new project proposals • Healthcare IT Standards Panel (ANSI) • Harmonize standards for communicating data among healthcare software applications • ETSI

15. Conclusion • Time to add Healthcare as a High Interest Subject. • GSC should collaborate with IEEE SA Healthcare Study Group and/or ANSI Healthcare IT Standards Panel.