Health Information Exchange and e-Health—Creating Sustainable Healthcare SystemsAsia Pacific Region 2010

A Frost & Sullivan White Paperin Partnership with HP Enterprise Services

2 Frost & Sullivan

TABLE OF CONTENTS

Executive Summary......................................................................................... 3

Sustainability ................................................................................................... 4

We Are All Stakeholders ................................................................................... 4

Health Information Exchange ......................................................................... 5

Underlying Challenge ...................................................................................... 5

Transforming Health Data into Knowledge-Driven Solutions ......................... 6

Key Issues and Healthcare Sustainability in Asia Pacific Countries ................ 6

Maintaining a Sustainable Health System ....................................................... 6

Juggling Healthcare Initiatives......................................................................... 7

Health Information Exchange and e-Health .................................................... 7

Viewing e-Health as an Enterprise System ...................................................... 7

Issues ............................................................................................................... 7

Convergence of e-Health and Health IT Priorities .......................................... 7

Leveraging Health Data................................................................................... 8

Access to Health Data..................................................................................... 8

Health Data Exchange .................................................................................... 9

Near-Term Opportunities ................................................................................ 9

Enabling Public Health Initiatives ................................................................... 9

Consumer Empowerment................................................................................ 10

Stakeholder Roles ............................................................................................ 10

Barriers to Consumer Empowerment ............................................................... 10

Associated Benefits.......................................................................................... 10

Overview ......................................................................................................... 11

Transforming Health Data into Knowledge-Driven Solutions .......................... 11

Future Directions ............................................................................................ 12

Paradigm Shift ................................................................................................. 12

Sustainability................................................................................................... 12

New Business Models ...................................................................................... 13

Principal Drivers .............................................................................................. 14

Access and Security ......................................................................................... 14

Consumer Empowerment ................................................................................. 14

Acknowledgement of Collaborating Organizations......................................... 15

A sustainable health system relies on our ability to transform health data into knowledgeand knowledge into action to achieve cost-effective health outcomes on individual andpopulation levels. A sustainable healthcare system is one that meets current consumerdemands without reducing its capacity to provide for future generations.

Advances in information and communication technologies have progressed enough toenable the electronic exchange of health data between service providers, consumers, and community stakeholders. The exchange of health information facilitates prevention,wellness, and chronic disease management. Health information exchange (HIE) is madepossible through e-health, the electronic exchange of patient data via health information networks.

EXECUTIVE SUMMARY

A country’s economic growth is interminably intertwined with the health of its population. A critical point is reached, however, when healthcare spending becomes aneconomic burden to individuals, communities, governments, and society at large. At thatjuncture, the sustainability of a country’s healthcare system is threatened and its economicgrowth endangered.

The underlying challenge is to offer the right healthcare product/service to the right person atthe right place and time at the right price to achieve optimal health outcomes. HIE and e-health can meet this challenge as advancements in information, communication, and medicaltechnologies have dovetailed to create the tools. The missing element is a definitiveprocess—one that HP describes as a 360-Degree Healthcare Continuum.

In 2010, Frost & Sullivan and HP sponsored a global exercise to lay the foundation for anopen dialogue on e-health, HIE, and sustainability. In focus groups and surveys, C-levelexecutives—representing a cross-section of stakeholders—shared their insights on keyissues, priorities, and processes, leveraging health data and consumer empowerment in theirindividual countries.

In the Asia Pacific region, findings reflected the unique stakeholder environment in whichthese executives contend in 14 countries. These decision-makers cited healthcare financing,consumer demand for healthcare services exceeding the supply, and access to care aspredominant issues—those most important to achieving a sustainable health system in theirindividual countries.

The decision-makers viewed e-health as an enterprise-wide capability, with electronicmedical/health/personal records, online medical information, and public health monitoringcritical to establishing HIE’s intrinsic role in achieving better health outcomes. Stakeholdercollaboration in planning and policy-making was vital in measuring ROI in terms of societalcosts and benefits versus total health.

HIE is an intermediate endpoint leading to sustainable health systems.

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SUSTAINABILITY

There is a strong relationship between population health and economic growth anddevelopment. A healthy population may be considered a prerequisite for economicproductivity, prosperity, and sustainability.

Health spurs community economic development directly and indirectly. Direct economicdevelopment results from healthcare services delivered by medical and non-medicalproviders. Those services would be paid for by consumers and private and governmentthird-party payers, with the latter bringing new dollars into the community. Indirecteconomic growth results from productivity levels driven by a healthy population.

We Are All Stakeholders

We reach a critical point when spending on health and health-related conditions becomesa significant economic burden for individuals, families, businesses, and society at large. Theoperative words are “significant economic burden.” Spending is driven by a complex mazeof consumer demographics, expectations, and care-seeking behaviors on one hand; providersettings, practice protocols, and use of technologies for screening, diagnosis, treatment, andhealth maintenance are on the other hand. Economic burden relates to value—ability to pay,willingness to pay, and expected outcomes. Expected outcomes are measured in terms ofsafer care and healthier, productive lives.

As stakeholders, we all share in the responsibility to maintain a sustainable health systemand a productive economy. Contributions to maintaining a sustainable health system takedifferent forms. For example, individuals are responsible for living healthy lifestyles andadopting healthy behaviors to maintain and/or improve health. Employers are responsiblefor providing a safe and healthy work environment; they may offer benefits such as healthand/or disability plans, prevention and wellness programs, and paid leaves.

Government policy-makers and agencies are responsible for regulating and monitoringpublic health safety, funding entitlement programs, approving new medical/drugtechnologies, and so on. Government and private third-party health insurers, as payers,focus on risk, actuaries, reimbursement, costs, and cost efficiencies. In varying degrees, eachstakeholder is concerned with health and healthcare spending related to prevention andwellness, access to care, quality of care, and the inherent value in maintaining a betterquality of life.

Stakeholder collaboration now has the potential to positively ease the complex maze ofhealthcare spending. Advances in information and communication technologies have mergedwith medical device innovations to capture real-time health data across physical boundaries.These technologies, with the essential infrastructure (broadband and/or private networks),provide the mechanisms to achieve sustainable health systems. Stakeholder utilization andcollaboration will provide the means via health information exchange.

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Health Information Exchange

HP describes the health information exchange process as a critical part of the 360-DegreeHealthcare Continuum—“moving pieces” centered on the following core priorities:knowledge distribution, consumer empowerment, performance improvement, streamlinedbusiness practices, and leveraged infrastructure and applications (see Figure 1).

The Continuum accommodates diversity in healthcare financing (government versusprivate), access to care (multiple entry points), electronic practices (automated processes to manage workflows, communications, and recordkeeping), and provision of care(in-person and real-time virtualization). It is solution-based to build and reinforcestakeholder trust; provide measurable, cost-effective results; and demonstrate value.

The Continuum, however, does not infer linear functions. It involves a dynamic flow of health data that need to be transformed into knowledge to devise solutions—solutions to achieve cost-effective health outcomes on individual and population levels tofoster sustainability.

Figure 1: The 360-Degree Healthcare Continuum

Source: HP

Underlying Challenge

The challenge is not technology-oriented or technology-driven. The underlying challenge isin restructuring stakeholder relationships to support health information exchange thatgenerates health solutions. The underlying challenge is to provide health solutions that offerthe right product/service to the right person at the right place and time at the right price.

To this end, HP and Frost & Sullivan partnered to explore and lay the foundation for an international dialogue on health system sustainability, e-health, and health

PopulationHealth

Analysis Communityand Family

SupportSystems

CustomerContact

Systems andServices

PaymentSystems and

Incentives

HealthInformation

and ElectronicHealth

Records

PharmacyManagement

CareManagement

BenefitDesign andConsulting

Services

Quality andBenchmarking

Public HealthSystems

Eligibilityand

EnrollmentServices

360-DegreeHealthcareContinuum

ConsumerEmpowerment

Streamlined

BusinessProcesses

Knowledge

Distribution

Performance

Improvem

ent

Leve

rage

dApplic

atio

ns

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information exchange in North America, Europe, Middle East, and Africa (EMEA), and theAsia Pacific countries.

TRANSFORMING HEALTH DATA INTO KNOWLEDGE-DRIVEN SOLUTIONS

In 2010, C-level executive stakeholders—representing government and privateorganizations, healthcare providers (hospitals and physicians), third-party payers, andassociations (physician and consumer)—were invited to share their perspectives, insights,and plans by participating in an online survey. Questions focused on the five elements inHP’s 360-Degree Healthcare Continuum.

One-hundred twelve organizations completed the survey. Findings were analyzedindependently and then compared to similar questions posed to chief information officers (CIOs) during a series of focus groups and interviews conducted by Frost & Sullivanindustry analysts in our North America, EMEA, and Asia Pacific offices in late 2009 andearly 2010.

This paper focuses on the insights and perceptions shared by 28 C-level executives from sixAsia Pacific countries (Australia, Cambodia, India, Indonesia, Malaysia, and People’s Republicof China). This number comprises 11 survey respondents and 17 CIOs from the region whoparticipated in focus groups and interviews. Survey respondents included ministers ofhealth, hospital providers, and government healthcare agencies/payers. The majoritydescribed themselves as “C-level decision-makers.”

Of note, insights and responses appeared to be influenced by the extent of universalhealthcare coverage in each country and the extent of governmental regulations, oversight,and financing of healthcare initiatives.

KEY ISSUES AND HEALTHCARE SYSTEM SUSTAINABILITY IN ASIAPACIFIC COUNTRIES

C-level executives were asked their opinions on issues affecting sustainability of thehealthcare system in their individual countries and what issues their organizations werespecifically addressing. Asia Pacific executives expressed thoughts similar to those of theircounterparts from North America and the EMEA countries.

Comments focused on cost management, consumer demand outstripping the supply of health services, access to care, and manpower constraints. In developing countries, health information technology (IT) was mentioned as a function of government policy and planning, requiring a national commitment and financial support to build a country-wide infrastructure.

Maintaining a Sustainable Health System

Recent Frost & Sullivan interviews of key healthcare thought leaders support publishedfindings that access to care, prevention and wellness activities, quality of healthcare, andcost management are the four principal ingredients to maintaining a sustainable healthsystem whether or not universal health coverage has been implemented. Survey

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KEY ISSUES

“… costmanagement—cutdown of the expensefrom governmentinsurance foundation…”

People’s Republicof China

“… demand exceedssupply; access to carethrough secondarycare hospitals;reimbursementthrough medicalinsurance …”

India

“… demand due topopulation aging andcommunityexpectations; costcontrol; workforceshortages …”

Australia

participants were asked to rank these factors on a four-point scale of importance, with “4”being most important. Cost management received the highest average ranking (3.8),followed by prevention and wellness (3.6), access to care (3.5), and quality of care (3.4).Their counterparts in North America and the EMEA countries ranked quality of care asmost important.

Juggling Healthcare Initiatives

C-level executives were asked what advice they would give to those struggling to balancehealthcare initiatives to improve access to care and patient outcomes (quality healthcare)with cost-management directives. Survey respondents and focus group participants werereluctant to share their insights. Only ministers of health and government officialsresponded, advising that “healthcare quality comes at a cost,” while recognizing that eachcountry and region faces different challenges.

HEALTH INFORMATION EXCHANGE AND E-HEALTH

Viewing e-Health as an Enterprise System

Sixty-five percent of Asia Pacific survey respondents believed that e-health was bestdescribed as an enterprise system that did not follow a linear adoption and utilizationpathway. Of note, 75 percent of participants believed electronic medical records, electronichealth records, and public health monitoring were basic minimum requirements for asustainable health system. Less than half (46 percent) believed administrative functions suchas eligibility, claims, and processing were essential (see Figure 2).

Figure 2: Minimum e-health components for health system sustainability

Issues

C-level executives broadly described issues related to e-health and health informationtechnology in their survey responses and focus group discussions. Human manpowerconsiderations (capacity and motivation), affordability, and system development were more of a concern than policy planning and data integrity. Unlike North American and EMEA survey participants, Asia Pacific respondents did not consider outcomedemonstration an issue.

Convergence of e-Health and Health IT Priorities

Survey participants did not distinguish between e-health and health information priorities over the next 12 to 18 months. The need for government support was a central

Electronic Medical RecordsElectronic Health Records75%

Physician Education & Training63%

Clinical Decision Support63%

Online Medical Information50%

Comparison ofPatient Outcomes

Public Health Monitoring

Prevention & Wellness Activities

Personal Health Records

Clinical Workflow

Eligibility Claims & Processing50%

75%

63%

56%

50%

50%

EMRs and EHRs and Public Health Monitoring were

considered essential e-Health components

for a sustainable health system.

Frost & Sullivan 7

theme. In the less-developed countries, establishing hospital information systems wasviewed as critical.

Figure 3: e-Health priorities

LEVERAGING HEALTH DATA

Access to Health Data

As in North America and the EMEA countries, the debate over who should have access tohealth data continues. Concerns center on maintaining data integrity, security, andconfidentiality and the place of “raw” health data in a personal health record. Surveyrespondents were asked to select from nine groups those who should have open access tohealth data.

Figure 4: Access to health data results

Clear lines were drawn. More than 85 percent of participants believed hospitals should have open access to health data, with 71 percent extending open access to patients, primarycare doctors, and medical specialists. No one felt that non-medical health providers shouldhave access.

0% 10%

Non-medical Healthcare Providers

20% 30% 40% 50% 60% 70% 80% 90% 100%

0%

Private Insurance Companies 14%

Government Agencies

29%Healthy Consumers

43%

Caregivers 57%

Public Health Agencies 57%

Primary Care Doctors 71%

Medical Specialists 71%

Patients 71%

Hospitals 86%

Thumbs Down

Thumbs Up

IT

ITIT e-Health

e-Health

e-Health

IT

IT APPs Expansion

EMR/EHR Implementation

Policy and Planning

Integration and Collaboration

Adoption and Utilization

Adoption and Utilization

Infrastructure Expansion

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Health Data Exchange

In a similar vein, there are countless debates on who should be responsible for sharing,storing, and maintaining health data and then “control” after health information is shared.Should there be industry standards for health data exchange? Should data be shared in realtime? How does one accommodate integration demands?

Using a seven-point scale to gauge level of responsibility, survey respondents believednational and local/regional government agencies should have a more responsible role thanhealthcare providers in sharing, storing, and maintaining health data. This finding was indirect contrast to that of North American and EMEA respondents.

Figure 5: Health data exchange results

Near-Term Opportunities

Frost & Sullivan conducted focus group discussions that support published research findingsshowing multiple ways health data can be leveraged to improve and facilitate access to care,quality of care, and cost-management activities in the near term. These include chronicdisease management, clinical decision support, consumer empowerment, consumer healthpromotion, healthcare policy development, patient safety, public health programs, andoperational efficiencies.

Survey respondents believed leveraging health data for healthcare policy development,patient safety, and public health programs could have a greater impact than chronic diseasemanagement, clinical decision support, and consumer awareness. The process could befacilitated with clear governance and concerted action by all stakeholders.

Enabling Public Health Initiatives

In terms of public health initiatives, respondents felt health data could be leveraged to equally support evidence-based medicine, serve to target health policy priorities, and support health promotion more than to design and develop behavioral health andwellness programs.

1 2

Internet Provider

3 4 5 6 7

2.0

Each Patient 2.2

Private Company 3.5

Health Info. Network of Hospitals 4.8

Each Patient’s Healthcare Provider 5.0

Local/Regional Govt. Agency 6.0

National Government Agency 6.0

Thumbs Down

Thumbs Up

Frost & Sullivan 9

CONSUMER EMPOWERMENT

On one level, healthcare economists have suggested that the absence of consumerinvolvement has contributed to rising healthcare costs and led individuals to ignore theirhealth. On another level, “consumer connectivity” has been aligned with higher treatmentplan compliance and less risky health behaviors.

Stakeholder Roles

Organizations have engaged in four main activities to encourage individuals to take controlof their health: developing employee health education programs, developing consumerhealth literacy programs, sponsoring wellness activities (for example, weight control andnutrition programs), and sponsoring online blogs and health portals.

Asia Pacific survey respondents suggested that developing consumer health literacyprograms and sponsoring wellness activities would be given higher priority in theirorganization. Frost & Sullivan believes this finding is consistent with the governmentrepresentation of the participants and the lower health literacy levels of the populationsthat the majority of executives serve.

Barriers to Consumer Empowerment

Healthcare providers have suggested that there are a number of barriers to consumerempowerment, including: computer literacy, Internet access, health literacy, mobile phoneaccess, and the movement of consumers between health organizations.

When asked to rank these four barriers, survey participants were most concerned with health literacy and least concerned with mobile phone access. This finding wasconsistent across the North American and EMEA regions. It also supports other researchhighlighting the significance of the consumers’ understanding of “data” versus having anabundance of data.

Associated Benefits

Survey respondents were in agreement that consumer empowerment would fosterconsumer awareness of healthy behaviors and lead to more participation in preventionactivities. As a result, consumers would make healthier lifestyle choices and possibly bemore compliant with treatment protocols. The net effect would be improved quality of care.

Our principal research objective was to explore and lay the foundation for an internationaldialogue on health system sustainability, e-health, and health information exchange,recognizing two important factors. First, the convergence of advances in information,communication, and medical device technologies enabling the electronic exchange of healthdata between service providers, consumers, and community stakeholders is a relatively newphenomenon. Second, the intrinsic value of the research findings would be found in how theinformation was used by stakeholders to support HIE and the transformation of health datainto solutions to create and maintain sustainable healthcare systems.

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In the Asia Pacific countries, ministers of health recognize the process of transforminghealth data into knowledge to achieve tangible, cost-effective health outcomes as works inprogress. Developed countries (such as Australia and New Zealand) are moving towardmore advanced stages of development and implementation than developing countries (forexample, India and China). In the developing countries, there are competing demands forlimited government financial resources to support healthcare initiatives.

Overview

Australia, New Zealand, Cambodia, India, Indonesia, and China have distinctive populations,cultures, political and economic dynamics, and divergent healthcare systems. Within thisframework, national governments initially funded infrastructure development to provide andsupport access to healthcare for rural populations in their individual countries. Envision“Lego Lands” (ecosystems) of health and healthcare activities and practices supported byseparate paper and electronic processes and modes of communication. Within eachcountry, region-specific Lego modules may be under consideration, in development, invarying stages of implementation, or in operation as HIT silos.

Transforming Health Data into Knowledge-Driven Solutions

Frost & Sullivan has found that HIT planning and decision-making in the Asia Pacificcountries are tempered by ROI expectations based on societal cost/benefit ratios. Adoptionand utilization of electronic processes vary by the scope of universal healthcare servicesand payment for services by provider (hospital versus physician specialty) and by practicesetting. The Asia Pacific countries face challenges similar to those faced by individual statesin the United States. There, some are more advanced than others, state government fundingis limited, and collaborative partnerships are being pursued to help create sustainablehealth systems.

In India, for example, 50 percent of the population is younger than 25 years of age, and 42percent of the population (500 million people) lives below the global poverty line on lessthan US $1.25 per day. Although the Indian constitution acknowledges each state’s primaryduty as improving the level of nutrition and health of its residents, 80 percent of healthcaremanpower resources and services are in the private sector and located in the cities. Inaddition to marketing itself to the middle and upper classes in India, private healthorganizations have targeted medical tourist populations. About 450,000 foreign patientsvisit India annually for medical treatment.

After the SAARS epidemic, the Chinese government recognized the importance of havingan integrated health IT infrastructure in the country’s 18,000+ hospitals and 5,000+outpatient clinics. Yet the government allocated less than 1 percent (an estimated $700million) of its national health budget on health IT in 2004. In 2009, IBM opened HealthcareIndustry Solution Labs in China to work with the Chinese to enact widespread healthcarereform initiatives, including software integration solutions.

In Australia, 2010 healthcare reform established the National Health and HospitalsNetwork, which will be funded nationally but run locally. The Commonwealth will assume

Frost & Sullivan 11

100 percent funding and policy responsibility for general practice, primary care, and agecare services. Medical Locals will be set up to coordinate services in local areas. Data onaccess to care, performance, safety, and quality of care will be measured and shared to driveimprovements across the system. In a 2009 global survey of primary care physicians, morethan 90 percent of practices in Australia and New Zealand reported having advancedelectronic health information capacity (14 functions).

FUTURE DIRECTIONS

Paradigm Shift

The health system of the future demands a paradigm shift as stakeholders move fromfragmented health information systems to an integrated and automated exchange of healthinformation in real time and as silos of health IT resources dissolve.

Frost & Sullivan envisions connectivity across Asia Pacific countries as government-fundedprimary care services are supplemented by more private insurance offerings for specialtyprocedures and attract medical tourism. Connectivity will be fostered by stakeholderpartnerships forged to deliver health, wellness, and healthcare services. Telehealth andtelemedicine programs will become a mainstay of health systems, and medical tourism willbe funded as a new industry and economic growth opportunity.

Connectivity also will be fueled by real-time exchange of health information, withconsumers taking a proactive, responsible role in improving or maintaining their health.Personalized medicine will weave its root in chronic disease management as monitoringmoves into the community and home. Electronic personal health records (e-PHRs) willshare equal prominence with electronic medical records (EMRs).

Figure 6: Health system of the future

Sustainability

A sustainable health system is dependent upon its capacity to absorb current and futuredemands for its capabilities. Sustainable health systems will be achieved as “results-management” policies replace “cost-savings” directives. Return on investment (ROI) will bemeasured in terms of total costs versus total value.

Invasive

Provider Centric

Centralized—Hospital

One Size Fits All

Therapeutics/Diagnostics/Devices

Treating Sickness

Fragmented

Diagnosis & Treatment

Focus

Monitor

Approach

Objective

Health Information

Less Invasive, Preventative,Image Based

Patient Centric

De-Centralized-Shift to Community

Personalized Medicine

“Theranostics’Tools

Preventing Sickness—”Wellness”

Integrated & Automated

From... To...

Frost & Sullivan 12

A sustainable health system is one that provides the right service (prevention, screening,diagnosis, or treatment) to the right person at the right time in the right venue at the rightcost. This will be based on health data exchanged between integrated national, regional, andlocal health information networks.

In turn, integrated health information networks achieve sustainability through collaborationand stakeholder partnerships in which the benefits derived justify the investment. Althoughthere are relatively few network providers, there are hundreds of hardware and softwarevendors that offer a variety of legacy-compatible systems and application modules thatcontribute to an integrated network of EMRs, EHRs, and PHRs. Most of these offerings are“customized” to meet individual provider needs and preferences.

As healthcare providers across segments move to establish or expand their health ITapplications and data integration activities, decision-makers will be looking for solutionsthat are quantitative and predictive in informing their business decisions—not transactionalpurchases. Frost & Sullivan believes providers will turn to vendors that offer planningservices and solutions derived from cross-industry strategic partnerships that will spurimplementation, adoption, and utilization and help dissolve health IT silos.

For example, the HP Digital Hospital is a holistic approach to integrate and manageinformation, medical, communication, and building technologies to improve processes,enhance safety, and improve quality of care.

New Business Models

Frost & Sullivan Asia Pacific industry analysts reported an increase in cross-industrymergers and acquisitions as vendors move from offering fragmented products to integratedsolutions. Traditional communication and telecommunication providers believe the healthindustry offers new opportunities. Traditional health providers are looking to shareinvestment risk and increase market share.

One example is HP’s acquisition of EDS. This created an entity that serves organizationsacross the health and life sciences value chain to improve business and health outcomesthrough the capture, management, and integration of information. By providing an extensive,integrated portfolio of products, solutions, services, and partnerships, HP has enabledhealth and life sciences organizations to lower costs, speed innovation, function moreefficiently, and improve the quality of care. As a result, HP is positioned as a valuedtechnology leader, providing the healthcare marketplace with innovative solutions thatimprove operational efficiencies while delivering a higher quality of care.

On another level, the HP Digital Hospital solution uses a holistic approach to integrate andmanage information, medical, communication and building technologies to improveprocesses, enhance safety, improve quality of care, and enable customized healthcare. HP’sDigital Hospital was born out of a groundbreaking project delivered by HP, Cisco andIMATIS at St. Olavs Hospital (Trondheim, Norway).

Frost & Sullivan 13

Principal Drivers

Frost & Sullivan analysts have ranked, in order of impact, four principal drivers for e-healthand HIE in the Asia Pacific region: government directives for greater operational efficienciesin hospitals; desire to improve quality of care and public safety; government andtransindustry collaboration to expand infrastructure and spur EMR/EHR adoption; andprivate/public collaboration to expand telemedicine and medical tourism.

The degree of impact will reflect each country’s evaluation of the ROI and estimatedinvestment risk associated with different solutions.

Access and Security

Health systems of the future will require health information networks that have real-time,intuitive, automated processes to distinguish access permit levels among users, identifysecurity breaches, and implement immediate corrective actions. The HIE module of the HPCare Network Solution uses standard security protocols that support user authorization,authentication, non-repudiation, encryption, and administration.

Privacy management measures support opt-in/opt-out and provider-specific privacy models,hold patient privacy preferences, and hold business rules for restricting databases onsensitive data classes. Identity management measures validate providers’ credentials toaccess data; provide delegated administration to link the same clinician to multipleorganizations; provide role-based access to give users different capabilities within a clinicalsetting; validate members’ access to clinical records; and serve as an extension of theexisting provider/citizen portal security.

Consumer Empowerment

At an accelerated rate, individuals will assume more ownership of their health data in orderto navigate through the dynamic maze of modern healthcare to choose the “right” product.Medical providers will continue to adopt more patient-centric approaches in diagnosis,treatment, and care management.

Government and private payers will focus on more consumer-oriented benefit plans andhealth promotion activities, including support of employer-sponsored wellness programs.Consumers will need simple ways to process and assimilate this information.

The need for information and transparency is greatest when an individual or family member has been hospitalized. The HP Digital Hospital provides an innovative solution:Each patient bed is equipped with a patient portal, providing interactive entertainment andeducation, along with bedside computing and communication. Healthcare self-service kiosksare also available.

Frost & Sullivan 14

SUMMARY

A new age in health information exchange has emerged that enables stakeholders in Asia Pacific countries to collaborate and create sustainable health care systems.Information, communication and medical technologies have converged to provide the tools.The challenge is to devise the process. As an intitial step, C-level stakeholders from six Asia Pacific countries have shared their insights and perspectives to build a foundation thatwill bring the right product/service to the right person at the right place and time at the rightprice to achieve optimal health outcomes.

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ACKNOWLEDGEMENT OF COLLABORATING ORGANIZATIONS

Frost & Sullivan 16

NORTH AMERICACANADA Alberta Health and Wellness

Alzheimer Society B.C.

Brain Injury Association of NS

Cancer Care Nova Scotia

Central East Local Health Integration Network

Eastern Health

Covenant Health (Edmonton)

Headwaters Health Care Centre

Interior Health Authority

Local Health Integration Network

London Health Sciences Centre

Manitoba Blue Cross

National Indian & Inuit CHR Organization

UNITED STATESAcute Care, Inc.

Arizona Association of Community Health Centers

Baptist Health System

Barnes-Kasson Hospital

Baylor UT Houston Center AIDS Research

Bowdle Health Care

Broadstone Memorial Hospital

Cass Regional Medical Center

DCH Health System

Florida Agency for Health Care Administration

Good Samaritan Hospital

Hawaii Primary Care Assn.

Healthcare Care Access San Antonio

North Simcoe Muskoka Local Health Integration Network

Regina-Qu’Appelle Health Region

SAHO

Saskatoon Health Region

South East Local Health Integration Network

Spina Bifida & Hydrocephalus Canada

Stanton Territorial Health Authority

Sunrise Health Region

Trillium Health Centre

Western Health

MEXICOMedicina a Distancia

UMAE HTO 21 IMISS

EMEAAIMAR (Italy)

EACCI (Europe)

European Fundraising Assn. (Belgium)

Herzog Hospital (Israel)

Institute of Social Medicine (Macedonia)

Ministry of Health (Cyprus)

Ministry of Health (Romania)

NHS 24 (UK)

NHS Yorkshire and the Humber (UK)

Nuffield Hospital (UK)

Obafemi Awolowo University (Nigeria)

Técnicas de Salud (Spain)

University of KwaZulu-Natal (South Africa)

Humana, Inc.

Indian Health Service

Iowa Medicaid Enterprise

Kaiser Permanente (2)

Maine Primary Care Assn.

Martin Memorial Mayo Clinic

McLaren Regional Medical Center

National Center for Health Care Informatics

Oklahoma Healthcare Authority

Palo Alto Medical Assn.

Permian Regional Medical Assn.

Regence BlueCross BlueShield

Rhode Island Health Center Assn.

Riverwood Healthcare Center

Signature Hospital Corporation

Society of Hospital Medicine

State of Colorado

St. Joseph–Martin

Saint Luke’s Health System

St. Mary’s of Michigan

St. Vincent’s Health Services

TennCare

Texas Benefit

VA Puget Sound HealthCare System

WakeMed

Welch Community Hospital

Frost & Sullivan 17

ASIA/PACIFICAIIMS (India)

Apollo Hospitals Enterprise, Ltd. (India)

Asia Gateway China

Center for Health Systems and Policy Research and Development (Indonesia)

CICH, University of Melbourne (Australia)DHHS (Australia)

Ministry o Health (Cambodia)

Ministry of Health (India)

Sichuan Provincial Hospital for Women and Children (China)

South Australia Health (Australia)

Zhongshan Hospital (China)

18

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