Global News - Pilot Test on ICD10 by WHO-FIC-IFHIMA in Indonesia (See page 11)

The Link for Health Records/Information Management around the World

Issue No 12, January 2013

- IFHIMA President’s Message Margaret Skurka 2

- Health Information Management Training in Ethiopia Sheila Carlon 4

- Health Information Managers’ Association of Nigeria (HIMAN) Adeleke Ibrahim Taiwo 5

- AMRO-Kenya is rejoining IFHIMA 6

- Transition from Medical Record Practitioners to Health Information Technology Professionals: Iranian Perspective Mehrdad Farzandipour, Zahra Meidani, Maryam Nazadi 7

- Future Health Systems - Young Researcher Award - Proud moment, India Miss.Divya K Bhati 10

- Indonesia Pilot Test – ICD-10 Morbidity Coding Gemela Hatta 11

- ICD-11 Revision Robert Jakob, Dr. Bedirhan Üstün 13

- Report on the General Assembly of the International Medical Informatics Association (IMIA) Yukiko Yokobori 14

- The special Relation of HIM - between Canada and Korea Joon H. Hong 16

- The Transition from Health Information Management to eHealth Information Management to Support eHealth and the Patient - Centred Approach Lorraine Nicholson FHRIM 18

- Advancing eHealth in Europe: Empowering Patients, Supporting Health Professionals - A Conference held in Brussels on 28th November 2012 Lorraine Nicholson 23

- Calendar of events 28

- Publishing information 29

Global News

International Federation of Health Information Management Associations A Non-Governmental Organization in official relations with the World Health Organization (WHO)

formerly known as IFHRO

Issue Number 12 ■ January 2013

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IFHIMA President’s Message January 2013

Margaret Skurka MS, RHIA, CCS, FAHIMA

President of IFHIMA Email: [email protected]

Greetings to all of you reading this issue of the Global News.

As the president of IFHIMA, I’m happy to communicate again with you. We are cur-rently only 4 ½ months away from the 17th Congress of IFHIMA, to be held in Mon-treal, Canada on May 13-15, 2013. I hope you’ve registered for the Congress and are making plans for your travel and accom-modations. The Canadian HIM Association is planning an excellent meeting and you’ll find information about it all over the web site. https://www.echima.ca

IFHIMA has had a busy year in 2012. The Executive Board met face to face in Braunschweig, Germany in conjunction with the German HIM meeting in Septem-ber. We had a full agenda, and full attend-ance by every board member. Highlights included a lengthy discussion on details of the upcoming Congress as well as work on the HIM Africa Initiative coordinated by Lorraine Nicholson, and full reports from all the Regional Directors on the Executive Board. We also always do a financial review.

We engaged in a Strategic Planning dis-cussion for the next 3 years and devel-oped a document outlining our focus. This will be distributed throughout the meeting in Montreal, including at the General As-

sembly, and the opening session. We will discuss and provide information on our 3 strategic directions including:

Membership

Advocacy for the Profession and Or-ganization

Knowledge Domain including

o HIM Education and Competencies

o The Electronic Health Record

o Data Quality Management and

o Updated position papers.

IFHIMA Board members have been busy representing the organization to various meetings throughout the world. Yukiko Yokobori recently attended the General Assembly of the International Medical In-formatics Association meeting in Beijing. Lorraine Nicholson, Past President, trav-eled to Nigeria and delivered several presentations to the Health Information Managers Association of Nigeria (HIMAN). HIMAN sponsored this trip for Lorraine, as past president of IFHIMA, to attend and present at their meeting. Nigeria has re-joined IFHIMA. Welcome again Nigeria! Lorraine is also doing extensive work pro-moting IFHIMA throughout Africa and we hope to see many delegates from African nations in Montreal.

I was invited to speak at the Chinese Na-tional Medical Record Management Con-ference in Guiyang, China in September. I also delivered a presentation to coding staff and many HIM students at a hospital in Beijing. It was an excellent trip spon-sored by the Chinese Association. I also traveled to Brasilia, Brazil to attend the annual meeting of the WHO-FIC, repre-senting IFHIMA. Specifically, I am a mem-ber of the Education and Implementation Committee (EIC) with Yukiko Yokobori and Joon Hong. Yukiko and I attended the meeting in Brazil, but Joon was unable to attend this year. Joon has been very busy working on the Morbidity Coding Exam


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Project with Carol Lewis. Reports will be given in Montreal. There is good work be-ing done promoting quality ICD and ICF coding throughout the world.

Thanks to all of you who participated in our first on line IFHIMA Member Ques-tionnaire. All board members contributed to the development of the questionnaire and with the help of AHIMA, Darley Pe-tersen our Membership Chair, and Julie Wolter, our Webmaster, the survey was posted and distributed. 107 of you partici-pated and gave us valuable feedback. We will publish the results this spring, once the board has digested the information and made some decisions based on the content.

All of our board members are busy pro-moting HIM in their respective regions. A big thank you goes out also to Angelika, Marci, Joon, Stuart, and Sallyanne.

Angelika Haendel assumes the presidency of IFHIMA at the conclusion of the meeting in Montreal. Marci MacDonald is repre-senting The Americas and is very involved in the planning of the Congress in her country.

Joon Hong has been working with Indone-sia as they just completed a pilot test for morbidity coding in that country. Over 100 individuals sat for that exam. Great work Indonesia!! Stuart Green represents Eu-rope on the Board and has also taken on an active role as Chair of IFHIMA Europe

and their work throughout various coun-tries.

Sallyanne Wissmann represents the Western Pacific and is also President of the Australian HIM association. She trav-eled to the US in September and attended the AHIMA Annual Convention in Chicago. She had great opportunities to meet with AHIMA leadership and contributed so much to the international presence at that meeting. Angelika Haendel also attended that meeting, and we held an International Reception there for international attendees and also held an IFHIMA business meet-ing during the conference.

Thanks to all of you for any contribution of time and talent to IFHIMA. We are suc-cessful only because of the volunteer ef-forts of so many. I am looking forward to hearing from you or seeing you in Montreal.

Follow us on Facebook also.

Best regards,

Margaret

Margaret A. Skurka, MS, RHIA, CCS, FAHIMA President, IFHIMA 2010-2013 Professor and Director, HIM Programs College of Health and Human Services Indiana University Northwest 3400 Broadway Gary, Indiana 46408 UNITED STATES


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Health Information Managment Training in Ethiopia

Sheila Carlon, Ph.D., RHIA, CHPS

HSA Division Director Regis University 3333 Regis Blvd.

Denver, CO 80221, USA [email protected]

In 2008 the Ministry of Health and a Non-Governmental Organization (NGO) along with Tulane University’s Global Health Direc-tor, Dr. Wuleta Lemma, initiated an ambi-tious project to launch the field of Health Information Technology into the country of Ethiopia. They recognized this need while doing some epidemiological studies in rural areas and noted the lack of organized medi-cal information about the people they saw and could not find the documentation upon subsequent visits. Dr. Lemma, who trained in the US, decided to enlist the help of AHIMA as she was familiar with the medical records systems in the US.

When she contacted AHIMA, she found that I was already working in Ethiopia at a rural hospital! So she contacted me and

coincidentally I was leaving for Ethiopia the following week.

During that visit we finalized an action plan to set the program plan in place, develop the curriculum with the Ministry of Educa-tion (MOE) and write all of the coursework for delivery. I returned several times during 2008 and 2009.

The program was launched formally in 2010 and in 2012; the first graduates completed the Health Information Techni-cian (HIT) Program (at the Community College level).

Since this profession did not exist in the country prior to this initiative and there were no “in country experts” I taught the nursing faculty about Health Information Management (HIM); coding, making charts, filing, etc. The nurses actually loved the courses and the content and were excited to teach it. The picture ac-companying this article is Teshome Wakiji-ra (Program Coordinator), Dr. Yodit (Pro-ject Manager) and presenting Certificates of Completion of the HIM Training to the Nursing Professors in 2010.

The next steps in this program are to re-fine the curriculum as the Ministry of Edu-cation now wants all two year college cur-riculum to be taught in an “integrated” fashion and to develop a national organi-zation like AHIMA for Ethiopia with a link to IFHIMA for students and program grad-uates to belong to and use for a resource in the field.

Health Science Teachers receiving HIT Training Certificates


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Health Information Managers’ Association of Nigeria (HIMAN)

2012 ELECTION

Adeleke Ibrahim Taiwo,

Federal Medical Centre, Bida, Nigeria

I have the Presidential mandate to announce the result of our election conducted during the recent HIMAN Annual National Confer-ence held between 27th and 30th August 2012 at the National Sickle Cell Foundation, Surulere, Lagos.

The Conference returned the following:

1. Wole Ajayi B.Sc., MLS, FHIMAN as the National President

2. Kayode Adepoju B.Sc., MMP, FHIMAN as the National Secretary

3. Seye Ogundele B.Sc., BBA, MHIM, RHIM as National Financial Secretary

4. Razaaq Adio B.Sc., MHIM, RHIM as the National Publicity Secretary

5. Georgina Aloysius B.Sc., RHIM as Assis-tant National Secretary

The Conference also elected the following new officers:

6. Garba Babale B.Sc., RN, MILR, MHP, FHIMAN as National Vice President.

7. Adebayo Oluwatoki AHR, MHIM as Na-tional Treasurer

8. Felicia Sekooni AHR, PGDE, MBA, M.Sc.as Chair, Career Development

The Conference also appointed:

9. Rosemary Attiogbey as the Ex Officio

We also wish to announce the appointment of our erstwhile National Vice President Alhaj Muhammad Mamikupa Ibrahim AHR as the first substantive Registrar of the Health Rec-ords Officers Registration Board of Nigeria.


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Welcome to Kenya

IFHIMA is delighted to announce that the Association of Medical Records Officers of Kenya (AMRO-Kenya) is rejoining IFHIMA after an absence of a few years and we ex-tend a very warm welcome to the National Chairman, Mr. Livingstone Muyonga, his Executive Committee and all members of the Association. Other members of the Executive Committee are as follows:

National Chairman: Mr. Livingstone Muyonga

Vice National Chairman: Ms. Yvvone Achieng Secretary General & CEO: Mr. Philip Wambua Musina Vice Secretary: Mr. David Kiminta Treasurer: Mr. Tom Gacuku National Organizing Secretary: Ms. Nancy Deya

Kenya has been involved with the Federation for many years having become a national member in 1980 and Mr. Robert Wamalwa was a former Regional IFHIMA Director for Africa 2007 – 2010. IFHIMA is very pleased to welcome AMRO-Kenya back into the IFHIMA Family of Nations and we look for-ward to formally welcoming the Kenyan Na-tional Director to the 17th General Assembly of the Federation in Montréal, Canada on Sunday May 12th, 2013.

Lorraine Nicholson Immediate Past President of IFHIMA [email protected]


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Transition from Medical Record Practitioners to Health Information

Technology Professionals: Iranian Perspective

Early History of Medical Record Educa-tion in Iran

The Health Information Management (HIM) profession in Iran was created to collect and preserve information related to patient care. The first schools for the education of HIM profession were approved in 1971 in Teh-ran. It was a two year associate degree pro-gram and established in the Institute of Hos-pital Sciences. Graduated students could complete a two year course subsequently and got their bachelors degree. Parallel with the formation of the Ministry of Health and Medical Education previously called the Ministry of Health, numerous Medical Uni-versities throughout the country launched and schools offering formal educational

programs increased. Growth has contin-ued and by the year 2000 nearly 18 uni-versities offered associate, baccalaureate, and masters degrees.

At that time, associate and baccalaureate programs were provided under the head-ing of “medical record” and for masters programs they were called “medical record education”.

The improvement of Medical education amplified HIM professionals endeavors and a PhD level of medical record pro-grams entitled ”Health Information Man-agement” was approved in 1998. At that time, the Iran University of Medical Sci-ences was a pioneer training HIM profes-sionals at the Master and PhD level. To-day, the masters programs in medical rec-ord education are offered in Kashan, Shi-raz, Esfahan, Tehran and, Tabriz Universi-ties of Medical Sciences. A PhD in HIM is also provided at the Medical Universities of Tehran and Shahid Beheshti.1-2

Formation of Iranian Medical Record Association

The Iranian Medical Record Association (IMRA) was founded in 1991 to exert a leadership role in the effective management of health data and medical records. The IMRA board of directors includes the presi-dent, vice president, consultant, secretary and treasurer.

IMRA is committed to advancing the HIM profession by:

Formulation of medical record policies and standards

Compiling the HIM Body of Knowledge

Providing professional development opportunities to members through the organization of conferences, publica-tion of the Bulletin of IMRA, organiza-tion of meetings, etc.

Communicating effectively with mem-bers, healthcare policy makers and

Mehrdad Farzandipour Assistant Professor, Department of Health Information Management/ Technology, Kashan University of Medical Sciences, Kashan, Iran.

Maryam Nazadi Niasar Bachelor of Health Information Technology,

Department of Health Information Man-agement/Technology, Kashan University of

Medical Sciences. Kashan, Iran

Mehrdad Farzandipour Assistant Professor, Department of Health Information Management/ Technology, Kashan University of Medical Sciences, Kashan, Iran.

Mehrdad Farzandipour Associate Professor, Department of

Health Information Management/ Technology, Kashan University of Medical Sciences. Kashan, Iran.

Zahra Meidani Assistant Professor, Department of Health Information Management/ Technology, Kashan University of Medical Sciences. Kashan, Iran email: [email protected]


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medical record practitionesr through-out the country

Representing the unique role of HIM to the medical community

Due to the paradigm shift that occurred in HIM education in Iran and to keep pace with other HIM leader organizations including IFHIMA, AHIMA, CHIMA, HIMAA, etc IMRA was renamed the Iranian Health Information Management Association (IHIMA) in 2011.3

HIM profession in its second wave

Through the advances in information tech-nology and the emergence of the new post graduate informatics discipline in terms of medical informatics a paradigm shift oc-curred in medical record education in Iran during 2008.4 Being responsive to the needs of the HIM profession in the digital environment requires a more highly quali-fied and developed HIM workforce. This will be achieved through concentrated training and education in information tech-nology. To enter the HIM profession into its second wave, medical record education went through an enormous transformation and now HIM education is provided under headings of Health Information Technolo-gy (HIT) at both baccalaureate and mas-ters degree levels, and the existing diplo-ma course was eventually phased out. HIT Courses focus more on computer hard-ware, software, information systems de-velopment and evaluation and the use the computers to fulfil HIM traditional roles.4

HIT education preparation considers core subjects around health information tech-nology, medical informatics and health information management and promises to prepare HIM professionals for the elec-tronic environment.4 Currently, the Board

of Health Information Technology at the Ministry of Health and Medical Education is revising HIM education to prepare for a PhD program.

Filling the Knowledge Gap: Transition from Medical Record to Health Infor-mation Technology As previously mentioned, medical record education programs were replaced with health information technology programs. In order to fill the existing knowledge gap between former medical record practition-ers and those who are going to take lead-ership role in Health Information Tech-nology we conducted an educational needs assessment survey in Kashan.4

In the transition of traditional health care systems towards electronic systems, com-puter and information system capabilities were the cause of most dilemmas for med-ical records staff; the findings of the study revealed that the introductory training in the use of software for admissions to hos-pital including scheduling and reporting systems and hospital information system accounts were the first priority for admis-sion clerks. Statistics staff listed training in the use of statistical software as their first priority to improve their performance. In order to identify knowledge, skills, and abilities that employees will need to fill existing knowledge gap, Kashan Universi-ty of Medical Sciences intends to conduct a national survey among hospitals’ medi-cal record staff. We need to apply an as-sessment survey in order to learn about the issues and challenges that medical record staff faces to help us to design an effective educational campaign in Iran.

HIM Education: A global Consideration

Assistant professor Meidani in her study revealed that the HIM curriculum suffered from numerous challenges and drawbacks to highlight the necessity for a well-organized global educational campaign:


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Information management was limited

to the hospital setting and did not cover public health and personal health dimension of information man-agement.6-10

The HIM curriculum focused on basic

computing and capabilities for infor-mation processing sciences in com-parison with newly emerging infor-matics disciplines. 6-10

Squeezing a diverse field of practic-

es into one curriculum does not en-sure HIM professionals’ expansion of knowledge that is needed to equip them with specific skills and compe-tencies. HIM education concentrates on fact-transfer and information-re-call which is the lowest level of train-ing (e.g., introduction to consumer health informatics).6-10

Therefore, HIM professionals must expand their role through progression to the Mas-ter's level education and they must stay up to date with developments in information systems and medical computing. In a transformation of this magnitude, part-nership with the International Federation of Health Information Management Associa-tions (IFHIMA), and national associations including the American Health Information Management Association (AHIMA), Health Information Management Association of Au-stralia (HIMAA), health information related societies e.g. Healthcare Information and Management Systems Society (HIMSS), academia and key government will play a critical role in transforming HIM education.11

References 1. Hajavi A, Sarbaz M, Moradi N. Medical record (3, 4).Tehran; Computer world electronic publishing and information. 2002.

2. Ghazi saeedi M, Davarpanah A, Safdari R. Health infor-mation management. Tehran; Iran National Library, 2005.

3. Iranian Health Information Management Association (IHI-MA). Available at: ihima.gov.ir

4. Health Information Technology Curriculum. Iran Ministry of Health and Medical Education; Deputy of Ministry for Education. Available at: dme.behdasht.gov.ir/

5. The University of Tennessee Health Science Center. Master of Health Informatics and Information Management. 2011. Available at www.uthsc.edu/allied/him/masters (last accessed November 2011).

6. La Trobe University. Master of Health Information Manage-ment. 2011. Available at www.latrobe.edu.au/handbook/2012/postgraduate/health-sciences (last accessed November 2011).

7. Curtin University of Technology. Master of Health Information Management.2011. Available at

8. University of Illinois at Chicago. Health Informatics and Health Information Management. 2011. Available at http://healthinformatics.uic.edu/healthinformatics/health-informatics-degree-course (last accessed November 2011).

9. The College of St. Scholastica. Master of Science in Health Information Management. 2011. Available at www.css.edu/academics/catalog/graduate-catalog/graduate-curriculum/school-of-health-sciences (last accessed November 2011).

10. Temple University College of Health Professions and Social Work. Health informatics/health information management. 2011. Available at http://chpsw.temple.edu/him (last accessed November 2011).

11. Meidani Z, Sadoughi F, Ahmadi M, Maleki MR, Zohoor A, Saddik B. National health information infrastructure model: a milestone for health information management education rea-lignment. Telemed J E Health. 2012 Jul; 18(6):475-83.

http://student.handbook.curtin.edu.au/courses/31/313455.html (last accessed November 2011).


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Future Health Systems Young Researcher Award

Proud moment, India

Divya K Bhati Research scholar -Institute of

Health Management Research,IIHMR,India [email protected]

Background

Future Health Systems (FHS) is a research consortium working to improve access, af-fordability and quality of health services for the poor. FHS is a partnership of leading research institutes from across the globe working in low-income countries (Bangla-desh, Uganda), middle-income countries (China, India) and fragile states (Afghani-stan) to build resilient health systems for the future, funded mainly by the UK Department of International Development (DFID). John Hopkins Bloomberg School of Public Health (JHSPH), USA being the leading manage-ment of FHS works with other partners such as China National Health Development Re-search Center, or CNHDRC, (formerly known as the China Health Economics Institute), ICDDR,B (Bangladesh), Institute of Devel-opment studies (UK), IIHMR (India), Mak-erere University (Uganda) and UOI (Nigeria).

The main theme of FHS is child health, communities, complex adaptive systems, health markets, informal providers, Malar-ia, Maternal health, policy processes and research methods.

FHS grant award:

FHS offers grants for research proposals submitted by junior staff of partner institu-tions or students. Awards made to junior staff have a value of US$5,000-US$10,000 with 3-6 awards.

Proud moment: Young Researcher grant award:

This year out of 20 rich proposals submit-ted by four countries a total four proposals were awarded. Three were from IIHMR, India and one from Makerere University (Uganda). Achieving the second position, it was a proud moment for me and IIHMR to be part of the winning team. Each of us received the grant ($10,000) to carry out the research as planned.

Research study:

The research will mainly focus on the girl child health rights and its violation in the different arid zones of Rajasthan and also the impact of climatic conditions will be assessed with respect to availability, ac-cessibility, affordability and quality of healthcare facilities received by the girl child. Covering four arid zones of Raja-sthan, the study plan is for 16 months. This time period will also cover dissemina-tion work for the betterment of girl child health in the rural Rajasthan. The research grant allocated would be utilized for the activities as decided in the budget plan-ning. So, I am looking forward to this great challenge.


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Indonesia Pilot Test – ICD-10 Morbidity Coding

Gemala Hatta (Indonesia’s Director to IFHIMA)

[email protected]

On the 24th of November 2012 Indonesia conducted the pilot International Morbidity Coding Examination for 105 coders and thus became the 6th country after Korea, Japan, Jamaica, Sri Lanka (Ceylon) and Sweden to do so.

he total numbers in Jakarta (Indonesia) was the highest amongst other countries. Examinees came from many island prov-inces in this archipelago country. The pilot test was seen as a way of promoting the importance of disease classification and accurate coding in Indonesia and was the reason why the Center of Health Infor-mation Management under Surya Institute, established in 2012 and PORMIKI (the Indonesian Professional on Medical Rec-ord and Health Information Organization, established in 1989) were interested in conducting it. The pilot test received inter-national and national support.

The WHO-FIC Education Committee had developed the pilot test and since June 2012 Joon Hong has communicated with me and been so very helpful in answering my questions. In response to my message to her, Sue Walker reported that those colleagues attending the WHO-FIC meet-ing in Brazil were pleased to learn of what we were doing in Indonesia.

In September 2012, I visited Dr. Jane Soepardi the Head of Health Data Center of our MOH and explained WHO classifi-cation system, the importance of ICPC (International Classification of Primary Care), and ICD- 10. That meeting im-pressed her and was followed with a much bigger meeting on the 9th of October 2012, attended by her colleagues two Directors of MOH: Dr. Chairul Nasution, the Director of Referral Health Care (2000 hospitals under his authority) and Dr. Dedy Kus-wenda, Director of Basic Health Care (7000 primary health care centers under his authority). The MOH also invited a lady doctor and staff from the WHO Office in Jakarta, a doctor from National Institute on Health Research and Development, sev-eral officials from Health Data Center who initiated the meeting. Also joining the meeting were many staff representing their divisions in the MOH and Gunarto from PORMIKI. During the meeting, I also men-tioned the up-coming pilot test (PT) on ICD-10 – morbidity conducted by WHO-FIC-IFHIMA.

The 9th of October 2012 meeting with around 25 persons was a fruitful one. Many new faces had not known before about WHO classification system. The WHO doctor said she never heard before about ICD 10 morbidity Pilot Test (PT) conducted by WHO-FIC-IFHIMA. It was true, PT was a new thing for her and also to other MOH officials.

To get a deeper conversation, the week after, on the 15th of October 2012, I met for around 30 minutes with Dr. Supriyantoro, the Director General of Health Services, in his MOH’s office accompanied by the Di-rector of Medical Technician and Nursing (MTN). The DG was pleased with what would be done a month later. He even suggested it is better if the WHO-FIC-IFHIMA does a collaboration project with our MOH. The suggestion is a good point. I think developing countries should be


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treated differently and helped to put prac-tices into reality.

A brochure on PT and trainings (see cover at the end of this paper) was prepared and sent to hospitals in Indonesia. The bro-chure announced the pilot test on the 24th of November and two separate classes 19th to 22nd November on medical termi-nology and ICD-10 on line electronic ver-sion.

On the 23rd of November 2012 the training participants went for a recreational visit to a herbal plantation used for herbal cos-metics.

Pilot test will always be very important to all MOHs whose coders in their countries take part in PTs and especially to us (HIM practitioners). With the great opportunity to join Pilot Test, coders learn the very im-portant lesson in joining international ex-am. Thus Pilot Test is really good oppor-tunity to evaluate and improve their coding

competence, primarily for their own sake and also for the benefit of their health insti-tutions. The test is very important for us in knowing the level of the coder’s capability. I was so thankful being helped by those authorities who understand the importance of good implementation of classification system in Indonesia.

Thank you to WHO-FIC-IFHIMA for sup-porting us and making the Indonesia Pilot Test a reality.

May 2013 be a fruitful year!

.

105 Indonesian Examinees on Pilot Test ICD 10 morbidity - WHO-FIC-IFHIMA - conducted in 8 classes – Jakarta, Indonesia - 24th of November


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Published in „mdi; Forum der Medizin_Dokumentation und Medizin_Informatik“ Germany, issue 3_2012 Page 85


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Report on the General Assembly of the International Medical Infor-

matics Association (IMIA)

Yukiko Yokobori

Director Southeast Asia [email protected]

October 23, 2012 Crowne Plaza Beijing Sun Palace

Participating Member Countries: 18 coun-tries (Switzerland, Brazil, Germany, UK, USA, Japan, Taiwan, China, Thailand, Italy, Canada, South Africa, Australia, the Nether-lands, South Korea, Greece, Chile, Iran, and others); a total of around 35 participants. 1. IFHIMA’s accomplishments

I met with the IMIA President, Past Presi-dent, President-Elect, and IMIA CEO, and presented each with the IFHIMA brochure and my IFHIMA business card. The Presi-dent said he hoped to see further collabora-tion between IFHIMA and IMIA. I also had opportunities to interact with various na-tional members present at the IMIA Gen-eral Assembly, in particular exchanging in-formation with some of the national mem-bers who were also members of the WHO-FIC Network and with those representing Japan.

As a proxy of IFHIMA, I participated in the voting at the General Assembly.

2. Impressions of the meeting

The General Assembly ran smoothly in line with the agenda. Some of the items that were discussed and my impressions are as follows:

・Accreditation ceremony for IMIA-accre-dited programs

Certificates of IMIA’s accreditation were conferred upon the representatives, pre-sent at the GA, of a master’s program in Finland (the only health informatics pro-gram in Finland) and a vocational program in Chile. (IMIA’s accreditation is valid for five years, after which it can be renewed.)

Accredited programs may carry an authori-tative label of “Accredited by the Internation-al Medical Informatics Association.” As the accreditation has significant promotional value for the entities managing the accredit-ed programs, I think there are great benefits to be had from the accreditation for both the accredited programs and IMIA.

・Task Force on developing the History of International Medical Informatics

IMIA is promoting activities to write IMIA’s history using a wiki format. The task force asked the GA for information on their re-spective countries and reliable contacts. It plans to complete the task by 2016 or 2017 in time for the 50th anniversary of IMIA.

Prof. Dr. Antoine Geissbuhler, IMIA President

Dr. Lincoln de Assis Moura Jr., President-elect


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IFHIMA has the “History of IFHIMA” project. The use of wiki is an interesting idea that may merit consideration by IFHIMA. It would allow editing by multiple writers, especially for articles on, for instance, “relations be-tween IFHIMA and its member countries.”

・Strategic plan updating

As the IFHIMA Executive Board is aware, IMIA will be requesting comments on its strategic plan in the next few months from all members. The comments will go to the IMIA Board for discussion, and the updated strategic plan will be presented before the IMIA GA in 2013 for approval. As IFHIMA is trying out similar approaches for the re-structuring of our strategic plan, I would be interested in following up on the outcomes of the updating of IMIA’s strategic plan.

Summary

The IMIA General Assembly was held a day before the opening of the conference of the Asia Pacific Association for Medical Informatics (APAMI), the regional member of IMIA representing the Asia-Pacific re-gion. Unfortunately, my schedule did not allow me to attend this conference.

IMIA operates on an ample budget and has as many as 58 member societies (basically, one Member Society from each country). There were apparently many more organiza-tions willing to join IMIA. A ceremony was conducted during the GA to present plaques to new members. I had the impression that this kind of presentation not only shows re-spect for each member society, but also rein-forces IMIA’s standing within each society.

Although it was the first time for me to at-tend an informatics meeting, I came away with a positive impression of IMIA steadily promoting a range of projects on very good finances. The boundaries of health infor-mation management (HIM) vary depending on countries and even among hospitals within a country. Rather than adopt a com-peting view of “informatics” versus “HIM,” I think it is important to further promote co-operation between the two.

I am convinced that both sides do recog-nize the importance of HIM work in the future years to come. I also realize the need for IFHIMA to have a common inter-national definition on HIM work.

Members of IMIA General Assembly

Dr. Peter J. Murray, CEO

Prof. Reinhold Haux, Past President


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The Special Relation of HIM between Canada and Korea

Joon H. Hong

WHO-FIC Education and Implementation Committee, IFHIMA Regional Director [email protected]

Western medicine was first introduced to Korea in 1885 by an American mission-ary Dr. Allen but the medical record sys-tem was not systematized until 1962 when a Canadian missionary doctor be-gan work in Wonjoo Christian Hospital. Dr. Florence J. Murray, born in 1894 in Picton Landing, Halifax, Nova Scotia, Canada, graduated from Dalhousie Med-ical College in Halifax, Nova Scotia, and came to Korea in 1921 at the age of 27 as a missionary medical doctor. She worked very hard to cure patients in many cities in Korea. She had served as the superintendent of two hospitals and established sanitaria for tuberculosis and leprosy patients, innovative develop-ments in Korea at the time. She experi-enced many dangerous situations in her activities as a medical doctor and a Chris-tian missionary under the Japanese re-gime in Korea.

After her retirement as a medical doctor, she began to work in the medical record department in Wonjoo Christian Hospital in 1962. She set up the medical record sys-tem by making a patient index and morbid-ity coding by SNDO (Standard Nomencla-ture of Diseases and Operations) for all the patients and their records since 1959, the year of opening the hospital. She fin-

ished the work in 1964 and moved to Sev-erance Hospital in Seoul as the director of the medical record department in 1965. Severance is a large teaching hospital attached to Yonsei University. She not only set up the medical record system but also started a medical record librarian pro-gram at the Yonsei Institute for Medical Technology. She took out all the records since 1952 and did the patient index, dis-ease and procedure coding and indexing. She instituted a unit numbering system and developed many record forms. At the institute she taught medical terminology, anatomy, physiology, and a medical rec-ord management (MRM) system that in-cluded a unit numbering system, patient index, morbidity coding, medical record control, developing medical record format, etc. That was the first official program teaching MRM in Korea. She sent three of her students to Halifax, Canada to study MRM and to train them to be MRM instruc-tors in Korea.

At that time, physicians and nurses wrote medical records in English, the second language for Koreans. She taught correct English to the physicians and nurses and also taught them to make complete and accurate medical records to improve the quality of documentation.

Moreover, she conducted MRM work-shops nationally to teach the people work-ing in medical record departments/ sec-tions in hospitals. Those workshops were the only chance for people to learn MRM because at that time there was no HIM education program except the Yonsei pro-gram which was only a postgraduate pro-gram. On her strong suggestion to organ-ize a HIM association, the “Korean Medi-cal Record Professionals Association” was organized in 1966 and recognized in 1977 as the “Korean Medical Record Associa-tion (KMRA)” by the Korean government.


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She often said to the doctors: “if you do not complete medical records accurately within the designated time, you fail to per-form your duty as a medical doctor.” She also said: “the easiest way of measuring the quality of a hospital is to evaluate its medical record department.” She strongly advised the superintendent of Severance Hospital to organize a medical record committee and she held committee meet-ings regularly to discuss important issues regarding medical records of the hospital. Thus Dr. Murray laid the foundation stone of HIM in Korea.

After she set up the MRM system and an education program at Severance Hospital and at Yonsei Institute, she completely retired from her work and left Korea in 1969. She contributed greatly as both a medical doctor and a Christian missionary through her life in Korea. The Korean gov-ernment conferred on her the Distin-guished Service Medal twice. In 1985, the Yonsei University alumni donated a Kore-an pagoda, on the corner of Queen's Park Crescent and Charles Street W. in Toron-to, in memory of Dr. Murray and two other missionary doctors from Canada.

Dr. Murray handed over her position to another missionary, Mrs. Rita B. Steeds, who came from Winnipeg, Manitoba to Korea in 1969. She continued the work Dr. Murray had been doing and also taught MRM to the students at Yonsei Institute. As a licensed medical record administrator she developed the MRM system at Sever-ance Hospital and the teaching program at Yonsei Institute. She left Korea in 1973.

After she left, three of Dr. Murray’s old students who studied MRM in Halifax con-tinued working in MRM in Korea and taught the students at the Yonsei Institute.

Dr. Murray and Mrs. Steeds passed away many years ago but the seeds they plant-ed in Korea have born great fruit. We have a large association, the KMRA, with more than 2000 active members. There are more than 60 two or three-year programs and 30 four-year programs teaching HIM in Korea. All of the HIMs in Korea owe our present HIM situation to these two Canadian mis-sionaries who devoted their efforts to the establishment of the HIM education system in our country.

Dr. Florence J. Murray Mrs. Rita B. Steeds

Dr. Murray wearing Korean traditional costume

Korean pagoda in Toronto


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The Transition from Health Infor-mation Management to eHealth

Information Management to Sup-port eHealth and the Patient-

Centred Approach

Based on a presentation delivered at eHealth Week 2012, Copenhagen

on 8th May 2012 (Session Continuity of Care Extended)

Lorraine Nicholson Immediate Past President of IFHIMA

[email protected]

eHealth and the Scope of eHealth

eHealth (also written e-health) is a rela-tively recent term for healthcare practice supported by electronic processes and communication. eHealth is concerned with promoting, empowering and facilitating health and wellbeing for individuals, fami-lies and communities, and the enhance-ment of professional clinical practice through the use of information manage-ment and information and communication technology (ICT). eHealth is not just about technology - it is about finding, using, re-cording, managing, and transmitting infor-mation to support health care delivery; in particular to make decisions about patient care. Computers and other ICT devices are merely the technology that enables this to happen. The term ‘eHealth’ can encompass a range of services or systems that are at the edge of medicine/ health-care and information technology, includ-ing:

Electronic health records: enabling the communication of patient data be-tween different healthcare profession-als (GPs, specialists etc.);

Telemedicine: physical and psycho-logical treatments at a distance;

Consumer health informatics: use of electronic resources on medical topics by healthy individuals or patients;

Health knowledge management: e.g. in an overview of latest medical jour-nals, best practice guidelines or epi-demiological tracking (examples in-clude physician resources such as Medscape and MDLinx);

Virtual healthcare teams: consisting of healthcare professionals who col-laborate and share information on pa-tients through digital equipment (for transmural care);

mHealth or m-Health: includes the use of mobile devices in collecting ag-gregate and patient level health data, providing healthcare information to practitioners, researchers, and pa-tients, real-time monitoring of patient vitals, and direct provision of care (via mobile telemedicine);

Medical research using Grids: pow-erful computing and data management capabilities to handle large amounts of heterogeneous data.

Healthcare Information Systems: also often refer to software solutions for appointment scheduling, patient da-ta management, work schedule man-agement and other administrative tasks surrounding health.

(Wikipedia http://en.wikipedia.org/wiki/EHealth ) The necessity of making the transition

Health Information Management (HIM) is the practice of maintenance and care of health records by traditional (paper-based)


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and electronic means in hospitals, physi-cian's office clinics, GP surgeries, health departments, health insurance companies, and other facilities that provide health care or maintenance of health records. The effective sharing of patient information to facilitate care delivery from multiple pro-viders (an integrated care model) the use of traditional paper-based systems is diffi-cult. eHealth integrated care models re-quire the sharing of data from multiple sources, each holding an electronic record

for the patient. These records must be brought together to eliminate “silos” of in-formation to facilitate the delivery of high quality, safe and effective care in the pa-tient’s home environment. Therefore HIM will need to become eHIM to support the Patient-Centred Approach and in order to offer HIM expertise to Health Information Technology (HIT), the profession must train more HIM professionals in both tradi-tional and emerging practice.

The eHealth integrated care model shown in the diagram below illustrates the sharing of data from multiple sources where there is an electronic record for the patient and the necessary connectivity between the different systems is represented by the blue line.

(Hofdijk, Jacob, Casemix Advisor, Ministry of Health, “Introduction to the Silo Crossing Integrated Care

Approach”, Presentation at eHealth Week 2012, Copenhagen, Denmark, 8th May 2012 - Session MR18, OC4 – Continuity of Care Extended)

Using health IT effectively using this model supports citizens in managing their own health and well-being and it helps them become more active participants in their own care and the services delivered to them. It supports citizens with long-term conditions and improves availability of in-formation for health and social care work-ers to help them improve the quality of

care provided, it improves safety for citi-zens taking medication and supports the integration of care for patients with com-plex health and social care needs.

There is a need to develop electronic sys-tems that link multiple health and social care providers, which has resulted in an increased need for interoperable systems. Interoperability requires common data

GP

Community Nurse

Hospital

Care/Nursing Home

Physiotherapy

Pharmacy

Laboratory

Dentist Optician Specialist Clinics

Health Care

Personal Support

Housing

Community Services Home Safety

SocialCare

Learning Needs

Lei‐sure

Voluntary Services

Private sector support

Diagram after P. Hill

Chiropody


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standards and definitions and HL7 and several other organisations have been working diligently in this respect but there is still work to be done. Despite the availa-bility of SNOMED many suppliers are still not using it in the systems that they offer to healthcare provider organisations and there are still some problems in achieving seamless interfaces between different supplier’s systems. One of the factors blocking the use of eHealth tools from more widespread acceptance and use is concern about privacy and confidentiality issues relating to data in patient health records, and particularly in respect of the EHR (Electronic Health Record). Each medical and clinical specialty has its own terminology and diagnostic tools and in order to standardise the exchange of in-formation, different coding schemes such as SNOMED may be used in combination with international medical standards.

SNOMED CT (Systematized Nomencla-ture of Medicine -- Clinical Terms), is a systematically organised computer pro-cessable collection of medical terms pro-viding codes, terms, synonyms and defini-tions covering diseases, findings, proce-dures, microorganisms, substances, etc. It allows a consistent way to index, store, retrieve, and aggregate clinical data across specialties and sites of care. It also helps in organizing the content of medi-cal/health records, reducing the variability in the way data is captured, encoded and used for clinical care of patients and for research. The primary purpose of SNOMED CT is to support the effective clinical recording of data with the aim of improving patient care and it is available in more than fifty countries around the world. (Wikipedia http://en.wikipedia.org/wiki/EHealth

Workforce Challenges

In 2003 the American Health Information Management Association (AHIMA) estab-lished an eHIM taskforce, which identified

seven major factors affecting healthcare: rising costs, an ageing and mobile popula-tion, a lack of data standards, growth of technology, shrinking HIM work force, the need for consumer education, and chang-ing public imperatives. All seven remain central, but former task force members single out three in the forefront today: work force, technology, and data standards. (Bloomrosen, Meryl. "eHIM: From Vision to Reality." Journal of AHIMA 76, no.9 (October 2005): 36-41)

Work force challenges haven't changed since 2003 and, in order to offer HIM ex-pertise to Health Information Technology (HIT), the profession must train more HIM professionals in both traditional and emer-ging eHIM practice to make them profi-cient in the use of new electronic systems to help make continuity of care and the delivery of patient-centred health and so-cial care services a reality. Core eHIM competencies need to be identified and education and training aligned with those competencies e.g. the Health Informatics Career Framework underpinned by Na-tional Occupational Standards in the UK and the "Framework for HIM Education in an Electronic Environment" in the USA, which articulate entry and exit points for HIM professionals at various academic and operational levels.

Education for Citizens - Patient em-powerment and chronic disease man-agement

Several members of the AHIMA eHIM taskforce suggested a revised vision for eHealth supported by eHIM might there-fore be: "The future state of health infor-mation is electronic, consumer-centered, comprehensive, longitudinal, accessible, credible, and secure. Ownership of health information is a shared responsibility be-tween the consumer (citizen) and the pro-vider“. (Bloomrosen, Meryl. "eHIM: From Vi-sion to Reality." Journal of AHIMA 76, no.9 (October 2005): 36-41)


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Well structured electronic health records (EHR’s) are an essential component of eHealth delivery. Health and social care consumers and patients (citizens), and where appropriate their carers, need to assume greater responsibility for their own health and care management supported by eHealth technologies. Consumers, pa-tients and carers therefore need to have some basic understanding and knowledge to make the best possible use of these new technologies, which will, in turn, im-prove the quality of care that they receive thereby improving their quality of life.

If citizens are to be actively involved in and take shared responsibility for the health and social care that they receive they will also need to be educated in the use of new technology and also to have in-creased awareness about their disease or condition. Diabetic patients, for instance, already have a well defined set of terms and actions, which makes standard com-munication and information exchange eas-ier, whether the exchange is initiated by the patient or the caregiver. Organisations such as Diabetes UK provide diabetics with the facts about diabetes and the in-formation they need to manage the condi-tion from diagnosis to the realities of eve-ryday living.

There is also an “app” (application) for iPhone users to take the daily chore out of logging levels such as blood glucose, car-bohydrates and calories and to enable diabetics to share their data with the pro-fessionals who are providing care. Medi-care in the USA, as another example, of-fers consumers provider-specific infor-mation online about outcomes in treatment for congestive heart failure, acute myocar-dial infarctions, and pneumonia to help them make informed choices about where they receive treatment and care.

What do eHealth and the Patient-Centred Approach mean for patients with complex needs?

The effective use of Health IT supports patients (citizens) to manage their own health and well-being, especially those with long-term conditions, and enables them to become more active participants in their own care and the health and social care services provided to them. It also improves availability of information for health and social care workers to improve the safety and quality of care they deliver, improves safety for those taking medica-tion by eliminating errors and supports the integration of care for patients with multi-ple problems. eHealth and the patient-centred approach will deliver holistic treatment and care for patients with com-plex needs to provide harmonised health and social care services that meet their individual needs.

eHealth services are purely an enabling mechanism, not a replacement for neces-sary interpersonal interaction between patients and their care providers, to deliver services tailored to an individual’s specific needs and a pattern of care delivery that they find most effective in their own sur-roundings. There is a need to link electron-ic systems from multiple health and social care providers (using interoperable sys-tems) to support the integrated care ap-proach and interoperability requires the use of common data standards and defini-tions and a common terminology such as SNOMED CT.

Data Sharing and Information Exchange Issues for eHealth and eHIM

The appropriate exchange of health infor-mation will be the foundation of eHIM practices for the future. There will be new and effective way of exchanging infor-mation through interoperable Health In-formation Exchange (HIE) networks and it will be important to mobilise healthcare information electronically across organiza-


22

tions within a region or community - a standards-based EHR is the foundation on which HIE will be built. The role of the Health Information Manager is the man-agement of Information in Health and the EHR will unite them professionally. With data sharing amongst multiple providers of care there will be privacy concerns regard-ing patient records, mainly related to con-fidentiality of data. Standards and defini-tions must be standardised to ensure that information is shared effectively and se-curely between providers and standardisa-tion of terminology will be crucial to facili-tate effective communication, information exchange and data sharing. There must be a sound infrastructure for data sharing utilising data sharing protocols, codes of practice etc.

The Challenge for the Health Infor-mation Management Profession

The transition from HIM to eHIM is a very big professional issue for all Health Infor-mation Managers around the world. Un-doubtedly education and support for HIM Professionals will be crucial to enable them to successfully make the transition from Health Information Managers to eHealth Information Managers in order for them to become part of a competent future workforce. Identification of core eHIM competencies is an important first step together with the development of new ways of learning. In order to respond ap-propriately to the educational challenge HIM educators themselves will need to be able to access advanced education which is focused on eHIM to help them develop new teaching strategies and inform their teaching practices in order to develop new ways of learning for their students.

Attracting the right calibre of students through targeted recruitment strategies will also be important to ensure that new teaching practices and new ways of learn-ing achieve their potential in full and pro-duce eHealth Information Managers with

the right skills and knowledge to effectively manage health information going forward. The development of applied and interac-tive ways of learning to allow students to work with the actual technology that they will encounter in the workplace will ensure that they become proficient in the use of these technologies for example, the Virtual eHIM Learning Laboratory in the USA. eHIM conferences and other educational opportunities must also be developed and delivered to assist existing HIM profes-sionals make the necessary transition from traditional HIM practice to the new ways of working in an electronic environment. In-combination these measures will provide an appropriately educated and skilled eHIM workforce for the future and, as po-tential patients, each and every one of us will benefit because good health outcomes depend on the availability and use of good quality health information.

…and finally, what should Health In-formation Managers be doing on a per-sonal level?

Wherever they live and work in the world and regardless of the level of deployment of health IT in their locality, Health Infor-mation Managers should embrace the changes to their role rather than resisting them, they should be focused in their pro-fessional practices and committed to con-tinuous learning. By taking the initiative and assuming the responsibility for making the requisite personal and professional changes Health Information Managers will successfully make the essential transition to become eHealth Information Managers! References: 1. (Wikipedia http://en.wikipedia.org/wiki/EHealth ) 2. Bloomrosen, Meryl. "eHIM: From Vision to Reality." Journal

of AHIMA 76, no.9 (October 2005): 36-41 3. Hofdijk, Jacob, Casemix Advisor, Ministry of Health, “Intro-

duction to the Silo Crossing Integrated Care Approach”, Presentation at eHealth Week 2012, Copenhagen, Den-mark, 8th May 2012 - Session MR18, OC4 – Continuity of Care Extended.


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Advancing eHealth in Europe: Empowering Patients, Supporting

Health Professionals A Conference held in Brussels

on 28th November 2012

Lorraine Nicholson

Immediate Past President IFHIMA & Member of IFHIMA Europe

I attended the “Advancing eHealth in Eu-rope; Empowering Patients, Supporting Health Professionals" conference held in Brussels on Wednesday 28th November 2012 to represent IFHIMA and IFHIMA Europe. I was pleased to be awarded a free registration through the Institute of Health Records and Information Manage-ment (IHRIM UK) of which I am a member and I extend my thanks to the Institute for this excellent opportunity. The conference was organised by the International Centre for Parliamentary Studies (ICPS) in part-nership with Medtronic and Telefonica. The IPCS is based in London in the United Kingdom and it exists to promote effective policy making and good governance through better interaction between Parlia-ments, Governments and other stakehold-ers in society.

Approximately 40 participants attended from many countries in the European Un-ion together with representatives from the ICT (Information and Communication Technologies) industry. The session was chaired by Malcolm J. Fisk, Co Director of the Age Research Centre at the Health Design and Technology Institute at Coven-

try University, Advisor to the Welsh Gov-ernment, member of the Quality Standards Advisory Committee at the National Insti-tute for Health and Clinical Excellence (NICE) and Former Chair of the Telecare Services Association. There were six presentations each followed by an interac-tive discussion session. The presentations were as follows:

Improving Quality and Access to E-Health for Patients and Healthcare Pro-fessionals in Europe - Tapani Piha, head of Unit, European Commission Di-rectorate for Health and Consumer

Valcronic: Optimising the Efficiency and Quality of Health Services in Valencia - Luis Eduardo Rosado Breton, Health Minister of Valencia

Putting the Puzzle Together - Jose Perdomo Lorenzo, Global Managing Di-rector E-Health and Security, Tele-fonica Digital

Continuity of Healthcare in Europe - Nicola Bedlington, Executive Director of the European Patient Forum & Birgit Beger, Secretary General, Standing Committee of European Doctors (CPME)

Integrated Solutions in Healthcare – an E-Health Plan for Europe - Professor Martin Cowie, Dept. of Clinical Cardiol-ogy, Imperial College, London & Con-sultant Cardiologist at the Royal Bromp-ton Hospital, London & Angelo de Ro-sa, Head of Strategy & Business De-velopment, Medtronic

Increasing Confidence and Acceptance of E-Health and Cross-Border Health-care in Europe - Representative of Gisele Roesems Kerremans, Deputy Head of Unit, ICT for Health, DG Infor-mation Society and Media, European Commission

The interactive discussion sessions were wide-ranging and interesting and they covered many different initiatives that were


24

highlighted during the presentations. The main initiatives that were discussed to-gether with some background information about each initiative are shown below:

The focus of the conference was “Advanc-ing e-Health in Europe”. The European Commission has been investing in eHealth research for over 20 years. Since 2004, when the first eHealth Action Plan was launched, it has also been developing tar-geted policy initiatives aimed at fostering widespread adoption of eHealth technolo-gies across the EU.

More recently, the Commission launched the European Innovation Partnership on Active and Healthy Ageing to bring togeth-er the public and private sectors, re-searchers, health practitioners, patients and carers with the aim of adding two years to the average number of healthy life years in the EU by 2020. In the second half of 2012 the Commission is due to pre-sent the eHealth Action Plan 2012 - 2020 to scale-up eHealth for empowerment, efficiency and innovation.

The eHealth Task Force

On 7th May 2012 at e-Health Week in Co-penhagen a high-level group of eHealth experts warned that Europeans would only be able to benefit from the affordable, less intrusive and more personalised health-care which ICT can bring if agreement is reached on how to use health data. This group, the 'eHealth Task Force', headed by the President of Estonia, Toomas Hen-drik Ilves, delivered this and other recom-mendations for redesigning health in Eu-rope. The eHealth Task Force was estab-lished a year ago to advise the Commis-sion on how to unlock the potential of eHealth for safer, better and more efficient healthcare in Europe. The report of the Task Force 'Redesigning health in Europe for 2020' identified “five levers for change” which are as follows:

1) My data, my decisions

2) Liberate the date

3) Revolutionise health

4) Include everyone

The recommendations are

1. A new legal basis for health data in Europe Create a legal framework and space to manage the massive amounts of health-related data and implement safeguards so that citizens can use health applications ("apps") with the confidence that their data will be han-dled appropriately.

2. Create a “beacon group” of Member States and regions committed to open data and eHealth The beacon group should include pio-neers in eHealth applications.

3. Support health literacy Health data needs to be available in a form that patients can understand and more needs to be done to explain to people how integrating appropriately anonymised data into a central system can improve their healthcare.

4. Use the power of data eHealth applications must be proven to be worthy of users' trust. Only then will users make their data available for feedback on preventive care or for benchmarking and monitoring per-formance of health systems.

5. Re-orient EU funding and policies Specific eHealth budget lines need to be responsive to enable the develop-ment of good ideas into fast prototyp-ing and testing. Transparency should be required from health institutions through their procurement and funding criteria.


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The Task Force's recommendations will feed into eHealth-related EU initiatives, including the eHealth Network, which is being established according to the provi-sions of the Directive on Patients' Rights in Cross Border Healthcare, which was passed by Europe in 2011. Member States will be required to adopt the neces-sary laws, regulations and administrative provisions by 25th October 2013.

E-Health Action Plan (eHAP) 2012 – 2020

The eHAP 2012 - 2020 aims to provide a longer term vision for eHealth in Europe by consolidating the actions already con-tained in the Commission’s wider eHealth effort, namely the EU 2020 strategy and its flagship initiatives Digital Agenda for Eu-rope and Innovation Union (the latter en-compassing also the European Innovation Partnership on Active and Healthy Age-ing), the eHealth Governance Initiative, as well as a number of high profile events and activities in support of eHealth. The eHAP 2012 - 2020 focuses on the attain-ment of four objectives:

1. to increase awareness of the benefits and opportunities of eHealth, and em-power citizens, patients and healthcare professionals;

2. to address issues currently impeding eHealth interoperability;

3. to improve legal certainty for health; and

4. to support innovation and research in eHealth and the development of a com-petitive European and global market.

The European Commission launched a public consultation on the second eHealth Action Plan 2012 - 2020, which was being drafted for release at the end of 2012. The consultation took the form of a question-naire but the European Public Health Alli-ance (EPHA) took the opportunity to sub-mit a more detailed response in letter

form, following an internal consultation with its members.

E-Health Governance Initiative (eHGI)

The European eHealth Governance Initia-tive (eHGI) supports cooperation between Member States at Political Governance levels and eHealth Stakeholders. The eH-GI ultimately aims to improve the health status of European citizens, the quality and continuity of care and the sustainabil-ity of European health systems. Improving eHealth governance, through the coordi-nation of the Member States and the Eu-ropean eHealth policies, will enable the building of an interoperable eHealth struc-ture within the EU. The eHGI will work very closely with the High-Level-eHealth-Governance-Group (State Secretaries and Director Generals) to ensure effective links and synergies between political decision-making and the outputs of more technical-ly oriented work.

The overall objective of the initiative is to help shape the eHealth political agenda at EU level, with a specific focus on interop-erability. Member States aim to achieve interoperability and increase the quality and efficiency of care by strengthening their cooperation at a high political level in order to get support in the deployment of eHealth services across borders. The pro-ject is expected to create a European co-ordination platform, contributing to a single European eHealth area through stream-lined policy, uptake, trust, and awareness in the use of ICT in health care sector. An interoperability roadmap, which is a strat-egy to build eHealth networks within Member States and Europe-wide, is one of the main health policy instruments for de-cision making in the eHealth domain. The project will also speed up the adoption process of encryption and electronic sig-natures through building a security and data protection framework, to address identification, the need for authentication and role-based authorization for enhanced


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security in the health care sector between health care professionals and patients. The eHGI will make a valuable contribu-tion to the EU-wide implementation of EU objectives set out in the Digital Agenda; Directive on the Application of Patients’ Rights in Cross Border Healthcare and within the European Innovation Partner-ship on Active and Healthy Ageing.

The European Patients’ Forum (EPF) is a member of the Executive Committee and is co-leader of the Work Package dedicat-ed to Trust and Acceptability the general objective of which is to provide stakehold-ers' representatives with the means and the opportunities to discuss and identify possible ways to enhance users’ trust and acceptability of eHealth. The final aim is to make proposals to the representatives of EU Member States representatives and the European Commission on how the needs of users should best be taken into account in the development of European and national eHealth strategies. The eHGI will support the establishment of a Euro-pean eHealth environment for the benefit of European patients, i.e. support and guidance for implementation, deployment and use of eHealth services throughout national health care systems, increasing patient safety and quality and enabling better use of health care resources.

Chain of Trust Project (European Pa-tient's Forum - EPF)

The "Chain of Trust" project, which is led by the European Patients’ Forum (EPF) commenced in January 2011 with the overall objective of assessing the perspec-tive of main end users of telehealth ser-vices across the EU to see if and how views have evolved since the initial de-ployment of telehealth and what barriers there still are to building confidence in and acceptance of this innovative type of ser-vices. Ultimately the project will aim to strengthen levels of awareness and trust amongst key stakeholders. The findings

and recommendations will provide a unique tool to inform policy- and decision-making at various levels. The Chain of Trust project is co-funded by the Public Health Programme of the European Union managed by the Executive Agency for Health and Consumers (EAHC). The pro-ject consortium comprises the following partners: European Patients’ Forum (EPF, pro-

ject leader)

Standing Committee of European Doc-tors (CPME)

Pharmaceutical Group of the European Union (PGEU)

European Federation of Nurses Asso-ciations (EFN)

Norwegian Centre for Telemedicine and Integrated Care (NST)

Latvian Umbrella Body for Disability Organisations (SUSTENTO).

EPF is the coordinator of this project and the Forum has a strong role in all activities relating to the collection of knowledge on users’ perspectives on telehealth, with a focus on patients’ views. The Forum is also leading work relating to awareness-raising of user perspectives both EU-wise and nationally and is in charge of organis-ing the final project conference scheduled for January 2013. For the first time ever, a project will assess the perspective of the main end-users of telehealth services, i.e. patients, doctors, nurses and pharmacists across the EU. In so doing the Chain of Trust project is expected to make a strong contribution in terms of positioning users at the centre of telehealth policy debates and fostering more patient-centered tele-health services in Europe.

TeleSCoPE: Telehealth Services Code of Practice for Europe

TeleSCoPE directly reports to the Europe-an Commission on telemedicine for the


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benefit of patients, healthcare systems and society. The primary objective of Tel-eSCoPE is to develop a comprehensive Code of Practice for Telehealth Services i.e. relating to that aspect of telemedicine delivered in the home and normally medi-ated through ICT. The project directly sup-ports EC Action Point (in COM2008:689) to “improve confidence in and acceptance of telemedicine“. It also contributes to oth-er Action Points to collect “good practice on deployment of telemedicine ser-vices“and to address issues for Member States around accreditation, privacy and data protection.

The TeleSCoPE project is partially funded by the European Commission's Health programme, which is the European Com-mission's main instrument for implement-ing the EU health strategy. The pro-gramme aims, through projects and other funded activities, to improve the level of physical and mental health and well-being of EU citizens and to reduce health ine-qualities throughout the Community. The objectives of the current programme are: To improve citizens' health security

To promote health, including the reduc-tion of health inequalities

To generate and disseminate health information and knowledge

The programme will be launched at Med-e-Tel in Luxembourg 10th -12th April 2013. Med-e-Tel (The Internatio-nal eHealth, Telemedicine and Health ICT Forum for Education, Networking and Business) is an official event of the International Society for Telemedicine & eHealth (ISfTeH), which is an inter-national federation of national member associations, which represent their country's Telemedicine and eHealth stakeholders. In conclusion…

The whole day was interesting and very informative. Networking sessions were held during coffee breaks, the lunch break and after the close of the conference. They were an integral part of the confer-ence programme and were very useful and interesting. I came away from the con-ference with lots of new information and many valuable updates on projects and initiatives that were the subject of presen-tations during eHealth Week in Copenha-gen in May 2012.

http://health.parlicentre.eu/


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Calendar of Events 13th – 15th May 2013: 17th IFHIMA Congress Montréal, Canada http://www.ifhimacongress2013.com/ 28th – 30th October 2013-01-18 85th AHIMA Convention and Exhibit Atlanta, Georgia, USA http://www.ahima.org/events/convention/default.aspx

Early Bird Registration deadline extended to February 28th, 2013

Now more than ever, it is critical to em-power yourself and be a part of the con-versation as the role of HIM™ evolves. CHIMA is very excited to be hosting the upcoming 17th Congress of International Federation of Health Information Man-agement Associations (IFHIMA) – May 13-15, 2013, Montréal, Québec, Canada. The IFHIMA Congress brings together health information management and health informatics professionals from around the world. An international attendance of ap-proximately 1,200 delegates is anticipated from approximately 19 countries. This congress promises to engage and inform delegates by mobilizing the HIM voice and identifying global HIM trends in the areas of:

Electronic Health Information/Record

Emerging Roles and HIM Workforce Transformation

Data Quality

Privacy, Confidentiality and Access

Developing Countries Challenges, Achievements and Opportunities

Now is our opportunity to come together and share experiences, best practices and discuss the future of the HIM™ profession as it continues to evolve with the ever-changing health care system. Register online at http://www.ifhimacongress2013.com before February 28th to take advantage of the Early Bird rate.


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Editorial Board: Cameron Barnes, Australia Angelika Haendel, Germany Marci MacDonald, Canada Lorraine Nicholson, UK Darley Petersen, Denmark Margaret Skurka, USA

Global News Advisory Board Ulli Hoffmann Germany Carol Lewis, USA Phyllis Watson, Australia

PS: If you do not wish to receive further IFHIMA/IFHIMA messages or editions of Global News please let us know and we will remove you from the mailing list ([email protected]).

Disclaimer: Contributions to Global News are welcomed from members and non-members of IFHIMA and articles should be typed and sent by e-mail to the Editor, Angelika Haendel [email protected] for consideration for publication. Responsibility for referencing in any article rests with the author. Readers should note that opinions expressed in articles in Glob-al News are those of the authors and do not necessarily represent the position of IFHIMA.

Documents

Global News - Pilot Test on ICD10 by WHO-FIC-IFHIMA in Indonesia (See page 11)