International Cooperation to Achieve Comparable Measures of Health ICT Adoption and Use

1. International Cooperation to Achieve Comparable Measures of Health ICT Adoption and Use Elettra.Ronchi@oecd.org EU-US Workshop Cooperation on e-Health , Copenhagen, 7 May, 2012

2. Overview of Presentation • International Benchmarking at the OECD • Why Comparable Measures of Health ICTs ? • Overview of activities to date • Our Approach-Proposed measures • Next steps

3. Benchmarking ICTs at the OECD • Significant Body of work since 1998 (OECD Working Party on Indicators for the Information Society ) • Work brings together experts from national statistics offices • Aim: to provide countries with reliable statistics to compare ICT development and policies

4. Benchmarking ICTs at the OECD • To improve comparability among countries, the OECD has developed two model surveys: • ICT access and use by business (2001) • ICT access and use by household and individual (2002) • A ‘Model Survey’ is composed of separate, self-contained modules to ensure flexibility and adaptability to a rapidly changing environment.

5. ICT access and use by households

6. Basic indicators on health-related use

7. ICT use by businesses

8. Benchmarking Health Care Systems • Significant Body of work ongoing since 1991 • Aim: to provide countries with reliable statistics to compare the Performance of their Health Systems and Policies

9. OECD Health Data • Database released annually since 1991 • 1,200 series, with selected long-term series from 1960 onwards. • Indicators that are • Relevant to the description of health systems, • Sufficiently consistent to enable cross-national comparisons • Available in a significant number of countries

10. Health expenditure as a share of GDP in OECD Countries % 1. Total expenditure excluding investments. Source: OECD Health Data 2011.

11. Health Care Quality Indicators • Started in 2003. Largest international effort to track health care quality indicators. • Subgroups working on : cancer care (screening, survival)- acute care (case fatality rates following AMI and stroke)-primary care (potentially preventable hospital admissions)-mental health care (unplanned hospital re-admissions)-patient safety (procedural complications)

12. Variations in cancer survival rates 5-year relative survival rate of patients diagnosed with breast cancer in 2000-2002 Source:EUROCARE-4 study , US SEER programme, OECD HCQI data collection

13. Why Comparable Measures of Health ICTs? • Each country is investing heavily in health ICT • While the contexts vary, motivation is the same (Better care that is more efficiently delivered) • Significant challenges to effectively using ICTs • Cost, disruption, technical and work-flow challenges • Challenges, facilitators often similar across countries

14. Why Comparable Measures of Health ICTs? • Without benchmarking, limited ability to learn • Understanding how others are doing helpful • Can allow countries to learn from one another • Allows countries to focus on topics of highest priority • Efforts to measure and benchmark to date have not been adequately granular

15. Activities to date • Health ICT benchmarking efforts started in 2008 • International consensus reached at a 2010 meeting held back-to-back with the World of Health IT conference in Barcelona. • Meeting sponsored by the Ministry of Health of Spain in collaboration with the European Commission. • Review of recent national and international initiatives- led by Prof Ashish Jha (Harvard) • Sponsored by the U.S. Office of the National CoordinatorforHealth Information Technology and the Commonwealth Fund. • An international OECD workshop held in Paris, on January 30-31, 2012. • Workshop held by the OECD- sponsored by the U.S. Office of the National CoordinatorforHealth Information Technology.

16. What is our approach? • Focus on activities, not terminology • Focus on four broad areas: • Provider-centric electronic record • EMR, EHR, EPR, etc. • Patient-centric electronic record • Personal Health Record • Health Information Exchange • Sharing of clinical data between providers • across institutions (not within institution) • TeleHealth • Telehome care /Telemedicine events (remote monitoring)

17. What is our approach? • Focus on availability and use of health ICT • Not yet enough data on clinical impact • Focus on two clinical settings • Ambulatory care • Hospital care • (others are also critically important-but these two settings represent shared priorities)

18. Proposed initial measures

19. Proposed measures • Why these measures? • These are high priority with best evidence for impact • Widely measured and prioritized by countries • Not meant to be exhaustive

20. Next Steps • A Task Force including seventeen OECD countries and four non-OECD countries was established. • International cooperation with the WHO and European Commission • A complete draft questionnaire of proposed measures : Expected in the second half of 2012 • Work to be led by the OECD in collaboration with Harvard (Dr Ashish Jha) with the support of the Commonwealth Fund • Second meeting of countries to be co-convened by the EC and the OECD early in 2013

21. Thank Youelettra.ronchi@oecd.org