COCIR activities in Healthcare-IT

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COCIR activities in Healthcare-IT

• Kees Smedema
• Chairman COCIR IT Committee
• Philips Medical Systems

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Contents

• Why Healthcare-IT in COCIR?
• IT Committee What
• IT Committee How
• Examples
• Standards
• IHE
• EHR
• EU Commission and Parliament
• HINE and COCIR

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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
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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

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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

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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

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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

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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.

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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

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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

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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.

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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

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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, Denmarks EHR, Frances
  EHR, Netherlands GP summary are all separate
  programs without any coordination

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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

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Interoperability Standards in Healthcare
Until 2003 Industry-User Consortia for worldwide
standards. No national programs
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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

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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 !
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Results of the EIF Meeting

• Clear vision about what industry expects from EU
  was really appreciated by MEPs 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 MEPs
• Strengthened COCIR position to be THE industry
  voice in the EHR debate.

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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 COCIRs advice
• COCIR is the vendor co-chair

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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, .

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COCIR and HINEre-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?

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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 HINEs information for
  improving COCIR messages?