The focus for the September issue of “Health Affairs” www.healthaffairs.org is on advancing global healthcare policy and the lessons learned from developing and industrialized nations seeking better care, lower costs, and higher quality.
Worldwide supporters and authors of global healthcare topics were not only from the U.S but from the Qatar Foundation www.qf.org.qa, the World Innovation Summit for Health www.wish,org.qa (WISH), Hamad Medical Corporation www.hamad.qa, Imperial College www.imperial.ac.uk, plus The Commonwealth Fund www.commponwealthfund.org.
The launch of the September issue took place at a briefing held September 8th at the National Press Club in Washington D.C bringing together representatives from the healthcare sector representing academia, healthcare, and the media.
The briefing opened with a discussion moderated by Alan Weil, Editor-Chief, Health Affairs with Lord Ara Darzi, Executive Chair WISH, Qatar Foundation, and Director for the Centre for Health Policy at the Institute of Global Health Innovation http://globalhealthinnovations.org. Darzi highlighted the role WISH is playing to address today’s most pressing global healthcare challenges.
The next speaker on the panel Mark McClellan, MD, PhD a Senior Fellow and Director of the Health Care Innovation and Value Initiative at the Brookings Institution www.brookings.edu described how his article draws on experience and perspectives with accountable care not only in the U.S. but also in the UK, Spain, Singapore, and other diverse healthcare systems. He described how policymakers around the world can use accountable care principles to achieve their reform goals.
One of the studies in the September issue focused on health IT in four countries. Julia Adler-Milstein, PhD, Assistant Professor at the University of Michigan’s School of Information www.si.umich.edu with a joint appointment in the School of Public Health www.sph.umich.edu talked about the health IT study undertaken with her colleagues. The study is titled “A Comparison of How Four Countries Use Health IT to Support Care for people With Chronic Conditions” www.content.healthaffairs.org/content/33/9/1559.full.
The article compares how the U.S and Australia, Canada, and Denmark are using Health Information and Communications Technologies (ICT) as critical tools to provide care. The article went in-depth to report on the lessons learned from the study and the common challenges that the countries face.
The goal for the research was to identify common opportunities for cross national learning tools to help providers in each country leverage new technologies to improve care coordination and help patients manage their own health.
The study summarizes several challenges in treating chronic care. First, the four countries developed strategies to provide chronic care needs but it was all done on a regional basis. However, using a customized approach dealing with local cultural and structural factors can affect healthcare delivery in specific regions but not in the country as a whole.
The second challenge is to coordinate care using health IT effectively. It is important that data electronically follow patients across delivery settings but the countries all had some fragmentation in their delivery systems.
One strategy in handling the problem is to locate patient data in a single repository that can be accessed by care providers. This is being done in Canada and Australia. The second strategy is to share data from point-to-point as in Denmark and the U.S. Each strategy has advantages and disadvantages.
The third challenge is to be able to use telehealth solutions for more than routine care for the chronically ill. Although home monitoring is touted as a benefit, none of the countries studied brought this to scale.
One problem may be the expense for technology and regulations pertaining to licensure, patient consent, and reimbursement that can affect expanding telehealth in the four countries studied. It was also found that in some countries while they use telehealth they have not systematically incorporated the technology with EHRs.
Lastly, engaging patients through the use of health technology means that patients need to have access to online and other electronic resources. This has not been consistently achieved in the four countries studied. However, the countries are making efforts to use newly available clinical information obtained from EHRs so that patients will be able to self-management their data.
The authors of the study also found that while there is widespread use of mobile technology which can be a compelling platform for engaging patients, the patient’s ability to share patient data between mobile solutions and clinical ICTs is still in its infancy which limits the data available to patients and clinicians.