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

COCIR activities in Healthcare-IT

Kees SmedemaChairman COCIR IT Committee

Philips Medical Systems

COCIR Meeting with (Healthcare) IT industry,Kees Smedema, 2006-02-20, 2

Contents

• Why Healthcare-IT in COCIR?• IT Committee: What• IT Committee: How• Examples

– Standards– IHE – EHR– EU Commission and Parliament

• HINE and COCIR


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


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


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


IT Committee: How? (1)

• Develop a vision on eHealth 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, eHealth

• Cooperate with relevant USA and APAC organisations to prevent different approaches– NEMA, EHRVA, HIMSS, – Regulation, privacy/security, EHR, interoperability


IT Committee: How? (2)

• Ensure effective and efficient development and deployment of standards– HL7, 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


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, HL7– 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.


Example: IHE

• IHE: the most succesful program for healthcare interoperability based on user-vendor 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


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 eHealth

• Presentations were given by Cisco, Siemens, Philips, COCIR


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.


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


Standards for Interoperability?

• So far the Healthcare industry has organised standardisation in consortia together with users: DICOM, HL7, …– 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 eHealth programs:– E.g. UK NPfIT program, Denmark’s EHR, France’s EHR,

Netherlands GP summary are all separate programs without any coordination


What does EU?

• Unfortunately, the EU has no mandate in healthcare– EU eHealth Action Plan offers only guidelines– Despite EU eHealth conferences and programs, nothing

substantial takes place between EU Member States to align their roadmaps

– Cooperation between INFSO, SANCO, ENTR is very weak


Interoperability Standards in Healthcare

Until 2003: Industry-User Consortia for worldwide standards. No national programsNow: Member States are setting their own programs and standards

Many different solutions

EU is absent: no mandate


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


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 !


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.


Recent Commission activities in EHR and interoperability

• Formed an eHealth Working Group (eHWG) with representatives from healthcare authorities

• Formed a Stakeholders Group (eHSG) with representatives from users, industry, and others

• Asked eHSG 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


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 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?


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?

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

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