1. COCIR activities in Healthcare-IT
Kees Smedema
Chairman COCIR IT Committee
Philips Medical Systems

2. Contents Why Healthcare-IT in COCIR? IT Committee: What
IT Committee: How
Examples
Standards
IHE
EHR
EU Commission and Parliament
HINE and COCIR
COCIR Meeting with (Healthcare) IT industry,
Kees Smedema, , 2

3. Why Healthcare-IT in COCIR
Radiology itself is the forerunner in IT and integration in the hospital
IHE started in Radiology
Radiologists are rather “technical”
The radiology/cardiology companies are diversifying through own developments and through acquisitions in the Healthcare-IT domain
Patient monitoring has also become highly IT intensive with many integration challenges
Currently COCIR is the only industry association that also represents the Healthcare-IT industry
COCIR Meeting with (Healthcare) IT industry,
Kees Smedema, , 3

4. IT Committee: What? (1)
Prepare and enlarge the market in Europe for Healthcare-IT
Remove obstacles such as incompatible approaches between countries
Enable new technologies to be introduced on a wider scale
Address the challenges of the rising healthcare costs by supporting better quality and more efficient healthcare delivery
Support healthcare authorities in the use of EU structural funds for healthcare
Avoid regulation that is not effective and efficient, e.g. certification, SW quality regulation
COCIR Meeting with (Healthcare) IT industry,
Kees Smedema, , 4

5. IT Committee: What? (2)
Ensure cost-effective product and solution development and implementation across Europe
Prevent unnecessary differences between European countries
Prevent unnecessary differences between the USA and Europe, so that as much as possible we can have global products and solutions
COCIR Meeting with (Healthcare) IT industry,
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6. IT Committee: How? (1)
Develop a vision on eHealth in Europe and promote this vision
With EU policy makers and the EU Commission
With national Healthcare Authorities
In relevant conferences and other forums
Be THE authoritative European industry association to be consulted for developments in Healthcare-IT
European Commission advice and consulting
Healthcare Policy conferences: Bad Gastein, eHealth
Cooperate with relevant USA and APAC organisations to prevent different approaches
NEMA, EHRVA, HIMSS,
Regulation, privacy/security, EHR, interoperability
COCIR Meeting with (Healthcare) IT industry,
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7. IT Committee: How? (2)
Ensure effective and efficient development and deployment of standards
HL7, DICOM, IHE
Avoid specific European standards
Involve users
Provide relevant education and information
Demonstrations, seminars
Papers (e.g. on safety/security)
Cooperate between members for a common approach
Participation and membership involvement
Preparation of positions
COCIR Meeting with (Healthcare) IT industry,
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8. Example: Standards
“Official” Europe (EU, CEN) emphasize European standards through traditional standards bodies (CEN, ISO)
Emphasis on “the best”, on legal aspects, not on the “most accepted” or “most practical”
EU provides only support for CEN standards, even if other standards are more appropriate
COCIR companies support and participate in consortium standards such as DICOM, HL7
Efficient process with the stakeholders
Often with support from user-organisations (RSNA, HIMSS)
If a good standard is coming from the USA, there is no need to design a different standard.
COCIR Meeting with (Healthcare) IT industry,
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9. Example: IHE
IHE: the most succesful program for healthcare interoperability based on user-vendor cooperation and workflow analysis
Supported by many user organisations
COCIR started IHE-Europe and made IHE truly an international program
Secured European funds
Provides secretariat and co-chair
Organised Connect-a-thons (some 100 companies participating)
Discuss within IT committee how to support this further, e.g. obstacles in certain countries
COCIR Meeting with (Healthcare) IT industry,
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10. Example: EHR in Europe
Some slides taken from COCIR presentation to the European Internet Foundation (EIF)
EIF is forum of Members of European Parliament for new technology developments.
EIF decided to organise a meeting on eHealth
Presentations were given by Cisco, Siemens, Philips, COCIR
COCIR Meeting with (Healthcare) IT industry,
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11. The Healthcare Industry in Europe
European healthcare industry has worldwide a strong position
Europe can also become world leader in Healthcare IT industry
This requires one market for healthcare-IT systems, not 25.
COCIR Meeting with (Healthcare) IT industry,
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12. Required for a healthy Healthcare-IT industry
A common policy across the member states for Interoperability between different Healthcare-IT systems, especially for the Electronic Health Record (EHR)
enables access to EHR from any place in Europe, thus leading to better clinical decisions
decreases healthcare costs by having uniform interfaces in all countries (less customisation required)
reduces product complexity, while improving quality. This enables the necessary economy of scale for the European Healthcare-IT industry to be competitive in a world market
accelerates deployment of Healthcare-IT in Europe
COCIR Meeting with (Healthcare) IT industry,
Kees Smedema, , 12

13. Standards for Interoperability?
So far the Healthcare industry has organised standardisation in consortia together with users: DICOM, HL7, …
De facto open standards adopted worldwide
No intervention from healthcare authorities or standards organisations
Practice-oriented interoperability profiles developed by IHE
National Governments now start own eHealth programs:
E.g. UK NPfIT program, Denmark’s EHR, France’s EHR, Netherlands GP summary are all separate programs without any coordination
COCIR Meeting with (Healthcare) IT industry,
Kees Smedema, , 13

14. What does EU? Unfortunately, the EU has no mandate in healthcare
EU eHealth Action Plan offers only guidelines
Despite EU eHealth conferences and programs, nothing substantial takes place between EU Member States to align their roadmaps
Cooperation between INFSO, SANCO, ENTR is very weak
COCIR Meeting with (Healthcare) IT industry,
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15. Interoperability Standards in Healthcare
Until 2003: Industry-User Consortia for worldwide standards. No national programs
Now: Member States are setting their own programs and standards
EU is absent: no mandate
Many different solutions
COCIR Meeting with (Healthcare) IT industry,
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16. Europe needs an EU interoperability program
Use model of IHE (Integrating the Healthcare Enterprise)
6 years of positive worldwide experience
Priority-setting by all stakeholders together: vendors, users, but also policymakers, patients, insurers, …
Use of existing standards as much as possible
Yearly improvement, efficient process, great impact
Education, promotion, local deployment
Appoint one person, one DG to champion this (compare US, UK)
Emphasis on
Pushing national authorities to provide the right (and harmonized) boundary conditions for the infrastructure
Pushing standards organisations to provide the missing pieces
COCIR Meeting with (Healthcare) IT industry,
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17. Involvement of EU policymakers is key
Member States have to be persuaded to accept a stronger role for the EU in Healthcare-IT
especially regarding interoperability
The EU Commission has to
Re-organise internally in order to take a leading role
Establish a (high level) forum to set priorities and roadmap towards EHR and interoperability by directly involving stakeholders (on its way)
Re-consider its standardisation policy for healthcare-IT; supporting consortia is often more efficient than funding standards organisations
MEPs should actively encourage this policy wherever possible with all policy tools at their disposal
Only together we can make a difference.
Healthcare IT vendors are looking forward working with you !
COCIR Meeting with (Healthcare) IT industry,
Kees Smedema, , 17

18. Results of the EIF Meeting
Clear vision about what industry expects from EU was really appreciated by MEP’s as well as by other EU officials (there were many)
Closer contact with Commissioner Reding (we were invited to send our vision to her)
Invitations to hearings of MEP’s
Strengthened COCIR position to be THE industry voice in the EHR debate.
COCIR Meeting with (Healthcare) IT industry,
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19. Recent Commission activities in EHR and interoperability
Formed an eHealth Working Group (eHWG) with representatives from healthcare authorities
Formed a Stakeholders Group (eHSG) with representatives from users, industry, and others
Asked eHSG to come with proposals for a European Roadmap on, initially, Patient Summaries, Patient ids, ..
Modelled after IHE, and on COCIR’s advice
COCIR is the vendor co-chair
COCIR Meeting with (Healthcare) IT industry,
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20. HINE
HINE has an excellent market-research program for the developing Healthcare-IT market in Europe, and this should be continued
HINE has not a clear governance structure
What is done in the name of HINE?
HINE is not an industry association, but is sometimes acting like one, causing confusion
Companies in HINE not represented in COCIR, so “if we invite COCIR and HINE we have a good industry representation”
Examples:
HIMSS, Stakeholders Group, meetings with Commission Services, Healthcare Authorities, ….
COCIR Meeting with (Healthcare) IT industry,
Kees Smedema, , 20

21. COCIR and HINE: re-enforce each other!
The Healthcare-IT industry position in Europe can be improved by strengthening COCIR
Less confusion
More influence
HINE should strictly be a marketing research organisation, with a better governance structure
A “treaty” between HINE and COCIR strengthens both organisations
What are the conclusions from the market research?
What is therefore our message towards EU, MS?
COCIR Meeting with (Healthcare) IT industry,
Kees Smedema, , 21

22. Questions
Do you agree that the influence of the Healthcare-IT industry in Europe can be improved by having only one industry association, which is COCIR?
Do you agree that HINE should focus on market research?
Can you imagine an agreement between HINE and COCIR about using HINE’s information for improving COCIR messages?
COCIR Meeting with (Healthcare) IT industry,
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