台湾医疗信息化发展路线图(徐建业)

IDC – Internet Data Center SC – Service Center HIN – Health Information Network 8 NHI VPN – Virtual Private Network
HCA Card医事人员卡及医保卡
RSA Card issues from HCA to health professionals
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HIMSS EMRAM in Taiwan
•Shuang Ho Hospital was certified as HIMSS EMRAM level 6 on 04/01/2013. •The first certified hospital in Taiwan and the 11th level 6 hospital in Asia (Singapore 4, China 3, India 2, Malaysia 1). •More hospitals is participating.
Stage 5 Stage 4
Stage 3 Stage 2 Stage 1 Stage 0
CPOE, Clinical Decision Support (clinical protocols)
Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside Radiology CDR, Controlled Medical Vocabulary, CDS, may have Document Imaging; HIE capable Ancillaries – Laboratory, Radiology, Pharmacy – All Installed All Three Ancillaries Not Installed
Service model
(Feasibility & Value)
Rehabilitation &Follow-up services
Value of service mode, Need more evidence, Insurance
from Dr. Hsu, Min-Huei , DOH, Taiwan
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Taiwan’s National Health IT Strategic Plan
• To establish a national electronic medical/health records and Medical Imaging exchange center. • Each citizen has his/her own electronic medical records. • Building Interoperable EHR is our top priority. EHR must be Patient-centric, patient-initiated, and patient-owned.
non-RSA Health insurance IC Card for all citizens
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Meaningful Use of Health/Medical Information -- 4P Medicine
• • • • • Personalization 個人化的醫療 Participation 病人參與式的醫療 Prediction 預測疾病模型 Prevention 預防疾病發生 More Ps
Big Data and Information
健康資料分析回饋
Business model
(Duplicability & profitability)
Operation model
(Sustainability)
Medical service s
Healthcare services
Innovation, Social Networking Wellness, travel, sport, dietary
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Scale of Healthcare in Taiwan
• Population: 23 million
• Insurance: 99% coverage • No waiting list • Outpatient visits: 14.8 /person/year • 34,000 physicians • 560 hospitals (Ranked into 3 levels) • 17,000 primary care clinics (including dental and
Others
網域
Public Health Knowledge Portal
小酒店 Health Examination Center
小酒店 Health Examination Center
People Hospital
Health Information Exchange Platform
醫院
Hospital
Chinese medicine clinics)
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The NHI VPN
DOH CDC
HIN
BOH
Admin
SC HCA
600 Hospitals
NHI headquarter
IDC
NHI local offices
NHI VPN
Other 100 HIS
5,000 Pharmacy 17,000 Clinics
Government e-Taiwan（2002~） e-Service & e-industrialization
Construct Healthcare Informatics Infrastructure
2008 2011
2002
2005
Promotion of EMR/EHR
National Health Information Project
亞健康 慢行病 管理 醫療 亞急性 保健 醫療 預防 健康 衛教
4. 健康資料 分析回饋
◎ 【2-2】署立醫院醫療照 護雲端服務計畫 [執行單位] 衛生署醫管 會、署立醫院、資策會
急性 醫療
【4-1】健康資料加 值中心網路化服務 長期 [執行單位] 衛生署統 居家 照護 計室、資策會 照護
機構 照護
社區 照護
3. 復健及後續性服務
資料來源：資策會-創研所整理, 2010
◎ 【3-1】遠距健康照護服務計畫 [執行單位] 衛生署照護處、工研院
1-1 個人健康照護資訊整合雲端服務 2-1 診所病歷雲端代管及備份服務 2-2 署立醫院醫療照護雲端服務 3-1 遠距健康照護服務計畫 4-1 健康資料加值中心網路化服務
Taiwan’s Healthcare System
• the health care system in Taiwan as one of the best in the world! -- Paul Krugman, Princeton Professor and 2008 Nobel Laureate in Economics • The mission of Taiwan's compulsory national health insurance system is to provide universal coverage and guarantee equal access to health care services. • Everyone pays relative low and affordable amount. We can choose any suitable hospitals/clinics we wish, any appropriate doctors we prefer and get right medicine! • Government issued an IC card for everyone
Nursing Care Institution
HIMSS EMRAM (Adoption Model)
Stage 7 Stage 6
Complete EMR; CCD transactions to share data; Data warehousing; Data continuity with ED, ambulatory, OP Physician documentation (structured templates), full CDSS (variance & compliance), full R-PACS Closed loop medication administration
– Healthcare Promotion 健康促進 – Precision medicine 準確有效的醫療 – Payment system 醫保系統
Personal Health Information Application Scenario NHIP
Diet Record
Exercise Record BP, BS Record
2013中国卫生信息技 术交流大会 
Roadmap for ICT Development in Taiwan
行政院
3
Cloud Computing in Healthcare 「健康雲」規劃
◎ 【1-1】個人健康照護資訊 整合雲端服務 [執行單位] 醫學資訊學會 ◎ 【2-1】診所病歷雲端備份服務 [執行單位] 衛生署醫事處、工研院
Promote development of Value-added health applications
Mobile Services
m-Taiwan（2005~）
Promote development of health informatics applications
Health Insurance IC Card
Application Trend
Development Trend of Taiwan Health Systems
NHIP & U-Taiwan （2008~）
Ubiquitous e-Service Tele Medicare Electronic Medical Record Personal Healthcare Record
The project of Accelerating the implementation of EMR system in medical institutions
Taiwan Health Informatics Initiative
Implementation and promotion of EMR
Smart Health Care Project: Speed up the deployment of EMR
2008
2009
2010
2011
2012
2013
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Electronic Medical Record Exchange and Integration
ＣＨＩＳＣ．ＮＥＴ－国内医疗信息化行业内最大的资源共享平台与线上交流平台
Roadmap of Health Information Technology in Taiwan 台湾医疗信息化发展路线图
徐建业Chien-Yeh Hsu, Ph.D. Taipei Medical University Graduate Institute of Medical Informatics 台北医学大学，医学信息研究所 Taiwan Association for Medical Informatics TAMI 台湾医学信息学会 2013 cyhsu@tmu.edu.tw 1
醫院
Health Management Institution
Health Management Institution
Health Information Exchange Platform
網域
Nursing Care Institution
Personal Health Data Bank
Health Information ExchBaidu Nhomakorabeange Platform