COCIR activities in Healthcare-IT Kees Smedema Chairman COCIR

COCIR activities in Healthcare-IT Kees Smedema Chairman COCIR IT Committee Philips Medical Systems

Contents • • Why Healthcare-IT in COCIR? IT Committee: What IT Committee: How Examples – – Standards IHE EHR EU Commission and Parliament • HINE and COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 2

Why Healthcare-IT in COCIR • Radiology itself is the forerunner in IT and integration in the hospital – IHE started in Radiology – Radiologists are rather “technical” • The radiology/cardiology companies are diversifying through own developments and through acquisitions in the Healthcare-IT domain • Patient monitoring has also become highly IT intensive with many integration challenges Currently COCIR is the only industry association that also represents the Healthcare-IT industry COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 3

IT Committee: What? (1) • Prepare and enlarge the market in Europe for Healthcare-IT – Remove obstacles such as incompatible approaches between countries – Enable new technologies to be introduced on a wider scale – Address the challenges of the rising healthcare costs by supporting better quality and more efficient healthcare delivery – Support healthcare authorities in the use of EU structural funds for healthcare – Avoid regulation that is not effective and efficient, e. g. certification, SW quality regulation COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 4

IT Committee: What? (2) • Ensure cost-effective product and solution development and implementation across Europe – Prevent unnecessary differences between European countries – Prevent unnecessary differences between the USA and Europe, so that as much as possible we can have global products and solutions COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 5

IT Committee: How? (1) • Develop a vision on e. Health in Europe and promote this vision – With EU policy makers and the EU Commission – With national Healthcare Authorities – In relevant conferences and other forums • Be THE authoritative European industry association to be consulted for developments in Healthcare-IT – European Commission advice and consulting – Healthcare Policy conferences: Bad Gastein, e. Health • Cooperate with relevant USA and APAC organisations to prevent different approaches – NEMA, EHRVA, HIMSS, – Regulation, privacy/security, EHR, interoperability COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 6

IT Committee: How? (2) • Ensure effective and efficient development and deployment of standards – HL 7, DICOM, IHE – Avoid specific European standards – Involve users • Provide relevant education and information – Demonstrations, seminars – Papers (e. g. on safety/security) • Cooperate between members for a common approach – Participation and membership involvement – Preparation of positions COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 7

Example: Standards • “Official” Europe (EU, CEN) emphasize European standards through traditional standards bodies (CEN, ISO) – Emphasis on “the best”, on legal aspects, not on the “most accepted” or “most practical” – EU provides only support for CEN standards, even if other standards are more appropriate • COCIR companies support and participate in consortium standards such as DICOM, HL 7 – Efficient process with the stakeholders – Often with support from user-organisations (RSNA, HIMSS) • If a good standard is coming from the USA, there is no need to design a different standard. COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 8

Example: IHE • IHE: the most succesful program for healthcare interoperability based on uservendor cooperation and workflow analysis – Supported by many user organisations • COCIR started IHE-Europe and made IHE truly an international program – Secured European funds – Provides secretariat and co-chair – Organised Connect-a-thons (some 100 companies participating) – Discuss within IT committee how to support this further, e. g. obstacles in certain countries COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 9

Example: EHR in Europe • Some slides taken from COCIR presentation to the European Internet Foundation (EIF) • EIF is forum of Members of European Parliament for new technology developments. • EIF decided to organise a meeting on e. Health • Presentations were given by Cisco, Siemens, Philips, COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 10

The Healthcare Industry in Europe • European healthcare industry has worldwide a strong position • Europe can also become world leader in Healthcare IT industry • This requires one market for healthcare-IT systems, not 25. COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 11

Required for a healthy Healthcare-IT industry • A common policy across the member states for Interoperability between different Healthcare-IT systems, especially for the Electronic Health Record (EHR) – enables access to EHR from any place in Europe, thus leading to better clinical decisions – decreases healthcare costs by having uniform interfaces in all countries (less customisation required) – reduces product complexity, while improving quality. This enables the necessary economy of scale for the European Healthcare-IT industry to be competitive in a world market – accelerates deployment of Healthcare-IT in Europe COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 12

Standards for Interoperability? • So far the Healthcare industry has organised standardisation in consortia together with users: DICOM, HL 7, … – De facto open standards adopted worldwide – No intervention from healthcare authorities or standards organisations – Practice-oriented interoperability profiles developed by IHE • National Governments now start own e. Health programs: – E. g. UK NPf. IT program, Denmark’s EHR, France’s EHR, Netherlands GP summary are all separate programs without any coordination COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 13

What does EU? • Unfortunately, the EU has no mandate in healthcare – EU e. Health Action Plan offers only guidelines – Despite EU e. Health conferences and programs, nothing substantial takes place between EU Member States to align their roadmaps – Cooperation between INFSO, SANCO, ENTR is very weak COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 14

Interoperability Standards in Healthcare Until 2003: Industry-User Consortia for worldwide standards. No national programs Now: Member States are setting their own programs and standards EU is absent: no mandate Many different solutions COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 15

Europe needs an EU interoperability program • Use model of IHE (Integrating the Healthcare Enterprise) – 6 years of positive worldwide experience – Priority-setting by all stakeholders together: vendors, users, but also policymakers, patients, insurers, … – Use of existing standards as much as possible – Yearly improvement, efficient process, great impact – Education, promotion, local deployment • Appoint one person, one DG to champion this (compare US, UK) • Emphasis on – Pushing national authorities to provide the right (and harmonized) boundary conditions for the infrastructure – Pushing standards organisations to provide the missing pieces COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 16

Involvement of EU policymakers is key • Member States have to be persuaded to accept a stronger role for the EU in Healthcare-IT – especially regarding interoperability • The EU Commission has to – Re-organise internally in order to take a leading role – Establish a (high level) forum to set priorities and roadmap towards EHR and interoperability by directly involving stakeholders (on its way) – Re-consider its standardisation policy for healthcare-IT; supporting consortia is often more efficient than funding standards organisations • MEPs should actively encourage this policy wherever possible with all policy tools at their disposal Only together we can make a difference. Healthcare IT vendors are looking forward working with you ! COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 17

Results of the EIF Meeting • Clear vision about what industry expects from EU was really appreciated by MEP’s as well as by other EU officials (there were many) • Closer contact with Commissioner Reding (we were invited to send our vision to her) • Invitations to hearings of MEP’s • Strengthened COCIR position to be THE industry voice in the EHR debate. COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 18

Recent Commission activities in EHR and interoperability • Formed an e. Health Working Group (e. HWG) with representatives from healthcare authorities • Formed a Stakeholders Group (e. HSG) with representatives from users, industry, and others • Asked e. HSG to come with proposals for a European Roadmap on, initially, Patient Summaries, Patient ids, . . – Modelled after IHE, and on COCIR’s advice – COCIR is the vendor co-chair COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 19

HINE • HINE has an excellent market-research program for the developing Healthcare-IT market in Europe, and this should be continued • HINE has not a clear governance structure – What is done in the name of HINE? • HINE is not an industry association, but is sometimes acting like one, causing confusion – Companies in HINE not represented in COCIR, so “if we invite COCIR and HINE we have a good industry representation” • Examples: – HIMSS, Stakeholders Group, meetings with Commission Services, Healthcare Authorities, …. COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 20

COCIR and HINE: re-enforce each other! • The Healthcare-IT industry position in Europe can be improved by strengthening COCIR – Less confusion – More influence • HINE should strictly be a marketing research organisation, with a better governance structure • A “treaty” between HINE and COCIR strengthens both organisations – What are the conclusions from the market research? – What is therefore our message towards EU, MS? COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 21

Questions • Do you agree that the influence of the Healthcare-IT industry in Europe can be improved by having only one industry association, which is COCIR? • Do you agree that HINE should focus on market research? • Can you imagine an agreement between HINE and COCIR about using HINE’s information for improving COCIR messages? COCIR Meeting with (Healthcare) IT industry, Kees Smedema, 2006 -02 -20, 22