Dr Sarah Muttitt Information Systems Division MOH Holdings Pty Ltd (16/10/08, Plenary session 2)

1. Unleashing the Benefits of a National EHR Dr Sarah Muttitt Chief Information Officer Information Systems Division [email_address] Oct 16, 2008

3. Achieving Positive Health Outcomes with Low Expenditure Affordable healthcare expenditure at about 3-4% of GDP (1% is government spending) Top-ranked overall healthcare system by WHO (6 th overall) - World Health Report 2000 1 st for infant mortality, 8 th in life expectancy, 20 th for health and primary education and 15 th in terms of social parity in health care quality - The Global Competitiveness Report 2006-07 (by WEF) 3 rd in health infrastructure; 4 th in terms of impact of health problems (AIDS, drug, alc abuse etc) on companies - The World Competitiveness Yearbook 2007 (by IMD) 1/3 of JCI-accredited hospitals in Asia are from S’pore - All 7 public hospitals achieved JCI accreditation Clinical expertise recognized internationally with many “Firsts’ Attracted internationally known partners such as Johns Hopkins, St Jude Children’s Research Hospital, Duke University and JCI regional HQ

5. Singapore’s Healthcare Delivery Eco-system Primary Healthcare - 18 Polyclinics (22%) - Private GP Clinics (78%) Secondary & Tertiary Specialist Care - 7 Restructured Hospitals & 6 specialty centers (80%) - 16 Private Hospitals (20%) Public sector Private sector People sector Patients have freedom of choice to choose any providers of care in various sectors Step-down & Long Term Care - Voluntary welfare Organizations (70%) - Private Healthcare Organizations (30%)

7. Healthcare Budget Continuing and Growing Government Investment in Healthcare More capacity Sustained excellence Better capabilities Increasing manpower New or expanded infrastructure Exploitation of IT Integration of Care Medical excellence and specialization Translational and Clinical Research Healthcare financing reforms New governance structures

8. GPs as Long Term Patient Advocates Holistic Patient Centric Care Affordable Ageing-in-Place Active Health Management What a person needs at each stage Preventive Care Individual at home Primary Care Family Physicians Tertiary Care Hospitals Step-Down Care Nursing Homes Community Hospitals Healthcare System Optimization Integration of Care and Right-siting Hospice Community Care

9. Public Healthcare Sector MOH Holdings National Health Group SingHealth Group

11. iN2015 Healthcare & Biomedical Sciences EMRX in Clusters GP Clinic Management Systems GP CDMP IT Capabilities EMRX extension to Community Hospitals These national initiatives have opened the clinical community to the potential clinical & operational benefits of HIE & greater coordination of Health IT at the national level.

19. MOHH Master HIT Planning HIT master planning will support the national agenda for an Electronic Health Record by 2010 by facilitating strategic alignment at various Levels of the Healthcare System Organization Specific IT Capabilities Strategic Alignment National EHR & Related Integrative Projects

20. Clinical Leadership Clinical Quality & Informatics Partnership Co-chairs CIO MOHH Snr Dir Healthcare Performance Group MOH

29. Timeline Overview Integration of Workstreams Identity Management EHR Business Case 2009-13 Block Budget for HIT GP IT Adoption Strategy Community Hospitals EMR National eHealth Portal Research Informatics Strategy National Drug Dictionary IT for new ‘hassle-free’ hospital Leverage national IT infrastructure & systems

30. ISD Timelines & Deliverables 3-year Projection FY08 Clinical & Business Strategy Information Architecture FY09 Funding Model Data Stds Implementation FY10 National EHR Phase 1 Implementation Constitute advisory groups, taskforces Develop allocative funding projections for each functional area Longitudinal health record with summarized, aggregate data Articulate clinical priorities, informatics roadmap & enterprise architecture Monitor data standards implementations True semantic interoperability through standards based data model Develop core business, clinical-usage scenarios Develop business, clinical usage scenarios for emerging clinical services (e.g. AIC) Robust, extensible access controls & security framework Initiate harmonization activities for key data standards Centralized, scalable infrastructure Develop data privacy, security policies Dovetail with ongoing implementations Involve ongoing implementations in harmonization activities

32. Thank You [email_address]