‘EHR is all over the planet…’

1. ‘EHR is all over the planet…’ Croatia: Developing a National HIN (G1) Canada – Infoway set up to design and procure National EHR - $1.2 billion of government backing for regional EHR projects Sweden: Developing a National EHR Netherlands: Regional EHR projects (focused on GPs) Russia: 15 Diagnostic Centers project in progress. Plans being developed for national HER for 145 million people. Ireland: Procurement contracting has started to drive national EHR effort China: Plans to develop a national EHR Germany: One regional deal underway. Future EHR efforts are expected to be regional England: EHR initiative in process, PACS project is imminent USA – Federal ONC NHIN contract underway. Multiple State initiatives for RHIOS. Still emergent – national EHR by 2014 Hong Kong: Territory wide Patient Master Index Spain: Regional initiatives are being considered Singapore: EMR system tender expected Q1 2005 SEE: Bulgaria, Romania, Turkey and Serbia all developing national eHealth strategies. France: EHR mandated by 2007. National RFP has been issued Mexico: No EHR but aim for HL7 Integration Opportunity Status Current Work Italy: EHR regional initiatives have begun Australia: HealthConnect is developing a National Information Network Malaysia: Lifetime Health Record (LRH) by 2010 Planning Brazil: National Health Card Project. Chile: National RFP for EHR project is expected soon Monitor Considering EHR Argentina: 1st adoption of a digital radiography solution- 2004 South Africa: No EHR – but infrastructure being developed New Zealand: National EHR system in place (complete) Data N/A or No EHR Presence * Target opportunities identified by text in red Source: Accenture + Oracle HTB Overview 2005Aug09

2. 80% of your time and money HERE IS THE VALUE! …Same Approach… National Registers Health Portals HC Pro Identit MS Privacy Consent & Control Patient Identity MS Public Health Reporting National or Regional Framework Clinical Document Registry Vigilance Alerts Anonymous Patient Info Clinical Data Repository P4P Clinical Trials Hospitals, GPs, Labs, CIC Payer Inspired from Rene Spronk HTB Overview 2005Aug09

3. …Industry Perspectives… Portal/Security/Mobility An EHR is: EMPI Applications Business Processes Business Intelligence CDR(s) Terminology Services Terminology loaders Terminology mapping Purchase terminologies Interface Engine HL7/DICOM mapping Message Oriented Middleware Services Oriented Architecture HTB Overview 2005Aug09

4. Industry Expectations • Learn about the others (US, Canada, Australia, UK, Belgium, Andalucia, Lombardia, Austria, Denmark) – highly replicable market • Involve key decision makers (real buyers!) from Germany, Italy, Spain, UK, France because their decisions will shape the market • Adopt 2 or 3 technical frameworks worldwide compliant with EHR certification criteria (EuroREC, CCHIT) • These frameworks for EHRs will • increase the market size ($50Bn US, $8Bn EMEA in 2004) x2 by 2010 • speed EHR implementation (average 5-10 years) including EMR in hospitals • create a new HC IT industry on the top of these frameworks (existing like Cerner, McKesson, GE, Philips, Siemens, Isoft, Agfa and new players like Ocean Informatics, ScandiHealth, OrionHealth, Initiate, Custodix, Qmedit, Apelon, HealthLanguage, HealthOne, Healthe, Seebeyond) HTB Overview 2005Aug09

5. Healthcare IT industry… HTB Overview 2005Aug09

6. …Agfa Case (Michael Dahweild) • EDC • Inclusion triggers for trial participant detection • Consent forms • Enrollment • Detailed inclusion and exclusion criteria • Trial protocols • Case Report Forms (CRF) • Synchronisation with trial database • Feasability studies • Definition of inclusion agents for retrospective analysis of EPRs • Result representation of eligible cases HTB Overview 2005Aug09