Who would think that I would start a health IT blog in Rome? Why not? Rome is hosting one third of the whole art patrimony of the world and it is city that reminds us that the human creativity has no limits. For example, that Rome's Coliseum, a huge amphitheatre which could seat 50,000 people is one among the Seven Wonders of the World and celebrates its 2000 year of existence.
© Pictures of Rome courtesy of Rome.info
Last week, this city of art has hosted the 20th annual forum of Public Administration (Forum PA) which is one of the most important Congresses regarding number of attendees and importance. This year, a special session was dedicated to Web 2.0 and eHealth and has gathered representatives from local health authorities from Italian Ministry of Health, Veneto region, UK NHS, a Finish region, University of Rome, industry (France Telecom, Microsoft). Briefly, under the fluid and polyglot guidance of our moderator - Dr. Sylviane Toporkoff, we learned from Ms Paola Tarquini and later from Mr Paolo Donzelli how the Ministry of Health in Italy would tackle the fragmentation of implementation of diffident eHealth solutions; how they plan to develop a citizen Personal Health Record, how they would interconnect different types of Electronic Health Records and Hospitals Information systems in the years to come. Moreover, ePrescription and online booking systems are foreseen for the years to come. The Italian plan has its roots in the regional achievements and aims to integrate in the European landscape.
All the interventions underlined the problems that healthcare is facing around the world with an aging population and increase of costs due to chronic diseases. Italy is expecting to spend more than 10% of the GDP by 2025. According to the Italian representatives, "developing eHealth services means investing in National and European infrastructures, in development of broadband based services, contents and services for ICT". The web 2.0 is seen as a platform to introduce interactive web technologies in the delivery of social and health services "citizens oriented". Some experiences on self directed therapy and exchange of good practice have shown some benefits in countries with disadvantaged neighborhoods.
The excellent presentation done by Thierry Zylberberg, Executive vice president of Orange Healthcare emphasized the content of Web 2.0:
He described healthcare as becoming more and more a networking issue. Web 2.0 is part of the tool box and would facilitate the exchange of experience between health professionals as way of increasing quality of care.
Mr Kaj Söderman from Archipelago Networks LTD - - Region Åboland r.f. explained us a use case from a finish region proving that telemedicine and videocommunication can increase the quality of care of elderly people situated in remote locations while reducing cost of transportation.
Mr Angelo Rossi Mori from the Italian National Research Center (CNR) emphasized the role of a "full" Personal Health Record, including in the Patient Record not only medical data as a result of exchange with the health professional, but also the data coming from his/her own measurements from medical devices and social exchanges with networks of patients having the same disease. In a perspective of disease management, the exchanges would be extended to the care manager and the administration.
Mr Mario Po from the local health administration of Asolo (Veneto Region) has shown us an impressive achievement: Hospital information systems coupled with a portal for patients very easy to use and very intuitive. Not only the graphic interface is impressive but the use of a virtual assistant makes it even more intuitive and accessible to disabled people. Moreover, the knowledge is indexed using a semantic engine based on 3000 terms, which allows the health professionals to perform refined searches in medical documents and retrieve meaningful patterns and statistical data.
My presentation emphasized a new paradigm defined by Knowledge Driven Healthcare, avoiding putting the doctor or the citizen in a center of a circle. In reality this "circle" has multiple centers - patient, health professional, payer, community, research, public health.- and no circumference. Instead of concentrating on one actor of the process of healthcare, which includes wellness and prevention and not only treatment, we need to strengthen the exchange of knowledge among patients (individuals) and between them and health professionals. Each of the actors will benefit from new ICT solutions which emphasize collaboration and knowledge exchange. ICT will allow health professionals to use evidence based medicine and state of the art procedures and inform, educate the patient about his/her options. The patient will be able not only to receive information, but to send relevant information, such as monitoring results, his/her own observations and questions. The new type of Personal Health Record, such as HealthVault, allows seamless connection to several types of monitoring devices and transfer them to the EHR of the physician. Moreover, when PHR is part of a regional system, the interconnection with the EPRs, EHRs, HIS of local health providers allow the patient to access securely to his latest medical data. It is interesting to note that the benefits retrieved from implementation of EHRs are higher when the EHR is integrating a Decision Support System and a workflow management system. This will allow doctors to be informed about validated guidelines and be informed in real time about any change in the status of his patient. The path towards real IT solutions for Chronic Disease management is opened, but a great work is necessary to ensure the organizational conditions to make it effective.
Finally, I strongly believe that must be a convergence between the solutions in the area of eHealth, eInclusion, eGovernment. This federated approach based on the infrastructure and identification, security, transport, search layers would save costs and allow individuals to take advantage of a wealth of services while using only one ID. Some of these principles have been developed in the Connected Health Platform, an open architecture concept developed by Microsoft and accepted by many industry solution vendors.