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Australia - Positive Disruption: Healthcare, Ageing & Participation in the Age of Technology

According to this report, Australia is on the cusp of two disruptive transformations: rapid population aging and a technological revolution. In response, the report makes recommendations concerning targeted investments in healthcare technologies to rectify system inefficiencies and outmoded practices. The introduction of information system protocols to mandate interoperability across government is a key recommendation.

International - International profiles of health care systems 2015

This publication presents overviews of the health care systems of Australia, Canada, China, Denmark, England, France, Germany, India, Israel, Italy, Japan, the Netherlands, New Zealand, Norway, Singapore, Sweden, Switzerland, and the United States. Each overview covers health insurance, public and private financing, health system organization and governance, health care quality and coordination, disparities, efficiency and integration, use of information technology and evidence-based practice, cost containment, and recent reforms and innovations.

Australia - Efficiency in Health

Issued by Australia’s Productivity Commission, this paper identifies ways to improve the operation of Australia’s healthcare system through small-scale reforms that leave institutional structures alone. The authors find deficiencies in health technology assessment, clinical guideline implementation, provider financial incentives and funding for preventive care. They state that health workforce scopes of practice are limited by current regulations.

International - International Profiles of Health Care Systems, 2014

This publication presents overviews of the healthcare systems of Australia, Canada, Denmark, England, France, Germany, Italy, Japan, the Netherlands, New Zealand, Norway, Singapore, Sweden, Switzerland, and the US. Each overview covers insurance, financing, organization, care quality, cost containment, efficiency and integration, and use of information technology and evidence-based practice. Data is provided on key health system characteristics and performance indicators.

International - A New Resource for Exploring Health Care around the World

This website presents profiles of healthcare systems in 18 countries in Europe, North America, and Asia, along with Australia. Readers can compare health system organization and insurance, financing, quality, coordination, efficiency, integration, information technology use, evidence-based practice, cost containment and recent reforms and innovations.

Canada - A better basket of services. Brief submitted as part of a public consultation on public coverage of health and social services

This brief was produced as part of the public consultation launched in August 2015 by the Commissioner for health and well-being of Quebec (CEBS) regarding public coverage of health and social services. This consultation covers the basket of services covered by public health insurance to reflect changing needs of the population, changing technology and limited financial resources.

Switzerland - Reducing the number of inefficient and ineffective medical procedures

The Swiss Confederation believes that the healthcare procedures that are neither effective nor efficient account for 20% of healthcare costs. The Federal Council intends to systematically reassess the utility of health technology and medical services, identify inefficient offerings and exclude these from reimbursement in compulsory health insurance.

UK - Map of technology and data in health and care

This interactive map produced by The King's Fund brings together case studies highlighting some of the places that are experimenting with and implementing new technologies to achieve better health outcomes or more efficient care. The case studies, mostly from England, have been explored in King's Fund reports or presented at their conferences. They include digital access to mental health care, diabetes digital coaching, and telehealth monitoring.

UK - Digital requirements for new primary care models

Drawing on case studies of new health technology use, this briefing examines how technology can enable primary care in the UK to better solve funding issues, workforce shortages, and demands for improved quality of care. The briefing examines innovations such as shared health records, patient portals for appointment booking, remote consultations and telehealth.

Lunch hour conferences 2015

By Michel Perreault, psychologist-researcher, Douglas Mental Health University Institute, associate professor, Psychiatry Department, Université McGill Hélène Provencher, professor, Nursing Faculty, Université Laval, researcher, Groupe de recherche sur l'Inclusion sociale, l'Organisation des services et l'Évaluation en santé mentale (GRIOSE-SM), CSSS de la Vieille-Capitale This conference will address the added value question of the intervention focusing on the contribution of peer helpers in care and services network, particularly in the area of mental health. The major findings from two research projects supported by the MSSS will be presented, one about the peer helpers intervention to facilitate access to clinical treatment for people with anxiety disorders with the support group Phobies-Zéro and the other one addressing the peer helpers integration in teams of support in the community for people with severe mental disorders proposed by the “Peer Helpers Network Program” associated with the Association québécoise pour la réadaptation psychosociale. Peer helpers accompany researchers…

International - Exploring international acute care models

This British report examines international acute service line models to gather information on potential care models for the UK National Health Service (NHS). Its insights include: the value of ‘risk tiers’ for maternity and pediatric services; the role of GPs in providing urgent care out-of-hours; and the importance of technology, especially for remote care delivery.

USA - Report to the President. Better Health Care and Lower Costs: Accelerating Improvement through Systems Engineering

This report from the President's Council of Advisors on Science and Technology identifies a comprehensive set of actions for enhancing health care across the US through greater use of systems-engineering principles. The council regards the fee-for-service payment model as the major barrier to using systems methods and tools in health care, and recognizes health data and health information technology as crucial to implementing and achieving benefits with systems methods.

USA - Connecting Health and Care for the Nation: A 10-Year Vision to Achieve an Interoperable Health IT Infrastructure

The Office of the National Coordinator for Health Information Technology recognizes, in this document, the progress made in implementing a health IT infrastructure in the US. It also presents a vision of the work that remains to be done to achieve the next stage: a learning health system built on interoperable health IT products that allow for constant improvement. The National Coordinator aims to achieve this progress by 2024, and enumerates the guiding principles it will follow along with milestones it hopes to reach at 3, 6 and 10 years.

UK - Recipes for sustainable healthcare

The Sustainable Healthcare Steering Group, led by the College of Medicine and supported by AbbVie, brings experts together to identify ways to empower people with long-term health conditions to actively manage their health needs. In this report, the Steering Group recommends action in three main areas: Embedding a person-centred approach; helping individuals to navigate the healthcare system; and using technology to improve the delivery of services and care closer to home.

UK - Horizon 2035: International responses to big picture challenges

Published by the Centre for Workforce Intelligence, this report provides short, digestible analysis of international examples that might help to meet big picture challenges facing the health and care workforce challenges in England. Among the areas of interest are the retention of home care workers, the role of informal caregivers, the adoption of technology and the impact of 24/7 services. Changes or planned changes in Australia, Germany, Japan, the Netherlands, Sweden and the US are described.

Canada - Canada’s lagging healthcare productivity: Lost efficiencies and missed economic opportunities

Distributed by Canadian Health Policy (CHP), this paper discusses lost efficiencies and missed economic opportunities caused by lagging productivity in Canada’s healthcare sector. The paper discusses factors that affect productivity growth, such as organizational culture, incentives and technology.

Canada - Health Quality Ontario Unveils New Data on Existing Health Interventions and Highlights Areas for Change in the Province's Health Care System

Health Quality Ontario (HQO) has released the 4th edition of its Ontario Health Technology Maps Project Report. It looks at the adoption of evidence-based medical and surgical procedures and laboratory tests and provides information to healthcare professionals on variations in care across the province, and on changes needed to improve the quality of health care for Ontarians.

UK - CMO Professor Dame Sally Davies makes 14 recommendations to improve public mental health services

This report looks at the epidemiology of mental health in the UK, the quality of evidence, possible future innovations in science and technology, and the economic case for good mental health. It also outlines the importance of treating mental health as equal to physical health. The Chief Medical Officer's recommendations target changes required from specific organizations in the UK.

UK - Personalised health and care 2020

The UK Health Department has developed an action plan to reduce the cost of British health care and improve care quality by using data and technology to give patients more control over their health. Based on evidence from patient organizations and other stakeholders, the action plan focuses on immediate priorities for the delivery of personalized digital health care services by 2020.

International - The challenge of budgeting for healthcare programmes

This article argues that health system fiscal sustainability is a political issue and dismisses talk of unaffordable spending due to trends like aging and technology as either inaccurate or unhelpful. The author says public support for health care means that a business budgeting approach may not be appropriate for health systems.

Canada - Aspiring to a new standard of healthcare for Canada

This paper maintains that Canadian healthcare can be transformed using health information technology and highlights international examples of relevant programs. The paper explores the impact of existing incentive programs in Canada’s provinces and presents a three-stage model for better care.

Ireland - Review of Measures to Reduce Costs in the Private Health Insurance Market 2014

Prepared by the Irish Health Insurance Authority, this review of cost reduction measures in Ireland’s private insurance market analyzes claims data and assesses cost drivers for health insurance. It looks, in particular, at the effects of medical technology and innovation. Submissions from relevant stakeholders are included.

USA - Investing in Global Health Systems: Sustaining Gains, Transforming Lives

This Institute of Medicine (IOM) report looks at how health system improvements can increase health, reduce poverty, and make donor investment in health sustainable in the world’s poorest countries. The report outlines a broad donor strategy that can make effective use of the US comparative advantage in science and technology to improve health internationally.

USA - Beacon Communities Share Strategies for Using Health Information Technology in New eGEMs Special Issue

The online journal, eGEMS, has published a special issue on lessons learned from eight ‘Beacon Communities’ that are using information technology (IT) to achieve better health care at lower costs. Beacon Communities are part of a program by the Office of the US National Coordinator for Health IT to strengthen health IT infrastructure, reduce costs and improve care quality.

Europe - Priorities for health systems strengthening in the WHO European Region

In this issue, the European Observatory on Health Systems and Policies explores how Member States are strengthening their health systems. Articles look at priorities for strengthening people-centred health systems; moving towards universal health coverage; enhancing the health workforce; ensuring equitable access to cost-effective medicines and technology; and improving health information systems.

Canada - The Naylor Report and Health Policy: Canada Needs a New Model

The federal government should recognize the limited success of past attempts to achieve healthcare reform with conditional transfers to the provinces and instead focus more on independent initiatives, according to a new C.D. Howe Institute report. In “The Naylor Report and Health Policy: Canada Needs a New Model,” authors Åke Blomqvist and Colin Busby suggest a variety of initiatives including the promotion of better information technology dissemination to providers and patients, and more systematic cost-effectiveness evaluations of new drugs and devices.

Canada - Connected Health Information in Canada: A Benefits Evaluation Study

With investment in electronic health records, clinicians are beginning to have better access to patient information across the healthcare system. This Infoway study reveals the financial and time-saving benefits for patients, providers, the health system and the economy. Connected health information currently contributes $1 billion worth of health system value that can be captured and reallocated every year.

UK - The Promise of Healthtech

This report examines how digital innovators are transforming the National Health Service (NHS) via the development and adoption of cloud computing, 3-D printing and genomics. The authors surveyed hundreds of private health technology start-up companies to determine key barriers to new technology acquisition by the NHS. Slow procurement policies, undefined safety standards, limited digital skills, poor interoperability and lack of clarity about evidence were all factors.

UK - Scotland's Digital Health and Care Strategy - Enabling, Connecting and Empowering

Scotland’s government has developed a digital health and care strategy to maximize the use of information technology (IT) to reshape and improve health services, support person-centred care, and improve outcomes. The new strategy will focus on four key priority areas: information governance, service transformation, workforce capability, and a clearly delineated transition process.

Europe - Leapfrogging health systems responses to noncommunicable diseases

This special edition of EuroHealth features two articles on ways to buttress and speed up European health system response to non-communicable diseases (NCDs). One article proposes policy responses to NCDs, while the other concentrates on interventions involving rapid adoption of innovation. Both articles explore areas that play an important role in tackling chronic conditions: public health, primary care, the health workforce, and information technology.

The Netherlands - First products Dutch Public Health Foresight study available in English

In 2017, the Dutch National Institute for Public Health (RIVM) began releasing results from the Dutch Public Health Foresight Study, which analyzes trends in population health in the Netherlands up to 2040. Three reports concerning healthcare demand, technology, and the wider determinants of health have now been translated and are available in English.

UK - Patients to get breakthrough technologies and treatments up to 4 years earlier through new accelerated access scheme

The British government has announced that the National Health Service (NHS) will fast-track breakthrough medicines and technologies, speeding up the time it takes for patients to benefit from ground-breaking products for cancer, dementia and diabetes. From April 2018, the new accelerated access scheme will make some products available up to four years sooner.

France: improving the efficiency of the health-care system

France’s health-care system offers high-quality care according to a new report from the OECD. Average health outcomes are good, public satisfaction with the health-care system is high, and average household out-of-pocket expenditures are low. As in other OECD countries, technology is expanding possibilities for life extension and quality, and spending is rising steadily, while an ageing population requires substantially more and different services. The main challenges are to promote prevention and cost-efficient behaviour by care providers, tackle the high spending on pharmaceuticals, strengthen the role of health insurers as purchasing agents and secure cost containment.

Ireland - Report Shows Digital Technology Could Play Important Role In Mental Healthcare In Ireland

A report by Ireland’s national coalition on mental health has found that digital technology can play an important role. The report provides an overview of eMental Health applications designed for people with common mental health conditions such as anxiety and depression, as well as applications for people with severe persistent conditions.

Canada - Access to Digital Health e-Services Helps Canadians Avoid Unnecessary Trips to Doctors and Delivers Significant Value to the Health Care System

This study by Canada Health Infoway considers that both Canadians and the health system benefit when patients access online personal health records and use digital health services. The study finds that digital health technology adoption saves Canada up to $150 million annually by avoiding the costs associated with trips to doctors' offices.

UK - Matt Hancock launches tech vision to build the most advanced health and care system in the world

The UK Ministry of Health and Social Care has released plans for a new generation of digital services to meet the multifaceted needs of the National Health Service (NHS). Minimum technical standards for digital and information technology systems will be introduced, with an emphasis on compatibility across data platforms, infrastructure and application program interfaces.

Canada - Aligning Outcomes and Spending. Canadian Experiences with Value-Based Healthcare

Value-based healthcare (VBHC) is a delivery model in which provider financing and budgets are based on patient health outcomes instead of the volume of services, processes, and products. This briefing reviews surveys, case studies and the scientific literature to explore the application of VBHC in health care across Canada. It focuses on the use of VBHC in new care models, innovative digital technology, and care integration.

UK - Health Secretary launches 'Prevention is better than cure' vision

The Department of Health and Social Care has published its vision for future approaches to prevention. Plans include halving childhood obesity; increasing mental health services for pregnant women; offering whole-genome sequencing to cancer patients; and diagnosing 75% of cancers at stages 1 and 2. Predictive prevention approaches will use digital technology to offer targeted health advice.

The Netherlands - Horizon scan of medical technologies. Technologies with an expected impact on the organisation and expenditure of healthcare

Focusing on expected demand for health care, Dutch researchers conducted a ‘horizon scan’ to identify emerging medical technologies that will best meet future medical and societal needs. The study considers impacts on the organization of health care, and on benefits and costs, of such innovative technologies as multi-device eHealth, personalized nanotechnology, robotic elder care support and the 3D printing of surgical implants.

UK - New guidance to help NHS patients benefit from digital technology

The National Health Service (NHS) has issued a new code of conduct for artificial intelligence (AI) and other data-driven technologies. The code encourages companies to adhere to a set of principles that will protect patient data and make sure only the best technologies are used by the NHS to bring real benefits to patients.

Canada - Healthcare system needs to catch up to the requirements of the Google Generation

Findings released by the Canadian Medical Association (CMA) show that the so-called Google Generation of young adults are Canada’s most eager adopters of technologies to manage their own health. The CMA warns that to address the impact of this generation, policy changes are urgently needed to scale up technology adoption in health care.

Canada - Canadian healthcare system must brace for a technological revolution

This report on integrating robotics, artificial intelligence (AI) and 3D printing technologies into health care expects these technologies to bring great benefits to patients, physicians, and the healthcare workforce. Prepared by the Senate committee on social affairs, science and technology, it cautions that everyone working in the healthcare sector must prepare for inevitable and radical change.

UK - New care models: harnessing technology

In Britain, challenges related to demand for services, constrained funding and a large workforce have required the National Health Service (NHS) and its local government partners to think differently about the ways health and care services are delivered effectively. This publication explores how digital tools are a key part of an emerging paradigm, and demonstrates how the technology has the potential to revolutionize care delivery.

UK - Fiscal sustainability and public spending on health

This paper examines the determinants of health spending in the UK and implications for spending projections. It finds that income effects are a more important driver of health spending than demographic change, as are cost pressures arising from innovation in health technology.

International - How to do better health reform: a snapshot of change and improvement initiatives in the health systems of 30 countries

This article discusses a book entitled "Healthcare Reform, Quality and Safety: Perspectives, Participants, Partnerships and Prospects in 30 Countries" that analyses the impact of reform initiatives on the quality and safety of care in low, middle, and high-income countries. Reforms in less well-off countries include boosting equity, providing infrastructure, and reducing mortality. Richer countries largely focus on developing new information technology systems and innovative funding models.

UK - New plans to expand the use of digital technology across the NHS

The UK government has announced plans to fast track digital excellence and improve the digital skills of the National Health Service (NHS) workforce. An academy to train NHS staff in digital skills will be established and 12 NHS organizations will be selected to receive £10 million ($17 million Cdn) to deliver innovative digital service.

UK - NHS England offers Trusts over £100 million funding pot to set up centres of global digital excellence

England’s National Health Service (NHS) is inviting its regional and service governance and funding bodies (known as trusts) to apply for £100 million in funding ($170 million Cdn) to become centres of global digital excellence. Twenty-six acute care trusts, already advanced in their use of technology in hospitals, have applied to date.

International - How OECD health systems define the range of good and services to be financed collectively

Universal health coverage has been achieved in nearly all the 35 countries of the OECD. This paper describes how countries delineate the range of benefits covered, including the role of health technology assessment and criteria informing the decision-making process. The paper also looks at the boundaries of healthcare coverage and services for which coverage varies widely.

USA - Meaningful Use legislation led to a 'substantial change' in EHR adoption

This study finds that an incentive program established under the federal 2009 HITECH Act has substantially increased electronic health record (EHR) adoption by American hospitals. The authors say the so-called Meaningful Use legislation could serve as a model to influence health technology adoption in the future.

International - Future Health Index commissioned by Philips reveals significant gap between perception and reality of how global health systems are performing

This study released by global health technology firm Royal Philips has revealed a large gap between the perceptions of health professionals and the general population with regard to future health system performance. The study also finds that the most significant benefits of connected care technology are seen in diagnosis, home care, and chronic disease management.

Europe - The Europeanization of Health Care Coverage Decisions. EU-Regulation, Policy Learning and Cooperation in Decision-Making

This German paper presents two cases of Europeanization in health policy, traditionally controlled by national governments and unaffected by European integration. The first case deals with how European Union (EU) transparency directives have forced member states to establish formal healthcare coverage decision-making procedures. The second case looks at health technology assessment and how the EU has successfully promoted the field.

UK - National Institute for Health Research challenges researchers and medtech specialists in mental health to improve treatment options

Britain’s National Institute for Health Research has launched an Invention for Innovation Challenge Award to address unmet clinical need in mental health. Aimed at research teams and medical technology specialists, the challenge hopes to promote the development of disruptive technologies or interventions that can improve outcomes for people with mental illness.

Canada - Adopting eHealth Solutions: Implementation Strategies

Published by the Registered Nurses’ Association of Ontario, this guideline provides evidence-based recommendations to enhance the capacity of all individuals involved in the implementation of an eHealth solution. Organizations are encouraged to establish suitable infrastructures to support eHealth education needs and facilitate technology-enabled health system transformation.

Canada - Building better health care: Policy opportunities for Ontario

The province of Ontario’s healthcare performance is uncompetitive among international peers, many of which spend less to achieve better outcomes. This paper urges Ontario to confront its main healthcare cost drivers (technology, drugs, increased service utilization and physician compensation), and recommends abolishing the tax subsidy for employer health insurance benefits.

Switzerland - How to conduct public health surveillance? The example of the Observatoire Valaisan de la Santé in Switzerland

This report examines the evolution of health surveillance. The authors review the aims and methods of contemporary health surveillance, taking into account the impact of information technology. They then present the activities of the Valais Health Observatory (OVS), a unique tool for health surveillance used in the region of Valais.

Did changing primary care delivery models change performance? A population based study using health administrative data

Brief analytical summaries or syntheses #24 Did changing primary care delivery models change performance? A population based study using health administrative data Summary Primary care reform in Ontario started with the introduction of new enrolment models, the two largest of which are Family Health Networks (FHNs), a capitation-based model, and Family Health Groups (FHGs), a blended fee-for-service model. The purpose of this study was to evaluate differences in performance between FHNs and FHGs and to compare performance before and after physicians joined these new primary care groups. Background It has been increasingly recognized that health care systems with a strong primary care component are more efficient and better able to handle current and future health care pressures. This has led to several primary care reform strategies in the U.K., Australia, the U.S. and Canada. Common to all of these reform strategies is a movement away from providing service based on…

Assessing initiatives to transform healthcare systems:Lessons for the Canadian healthcare system

Brief analytical summaries or syntheses #25 Assessing initiatives to transform healthcare systems Lessons for the Canadian healthcare system Summary Canada has invested significant financial resources and energy (including numerous federal and provincial commissions) in efforts to make the healthcare system more responsive to evolving needs. Nonetheless, there is general consensus that Canada’s healthcare systems have been too slow to adapt. This paper suggests avenues that governments can take to support the transformation of the healthcare system to provide better care and services. Background This paper suggests that money alone cannot improve healthcare. A clear vision and a coherent set of strategies are required to transform the system and achieve better alignment between the care offered and the care the population needs today (primary healthcare, more effective management of chronic diseases, mental health, etc.). Canada has invested significant financial resources and energy (including numerous federal and provincial commissions) in efforts to…

Australia - Discrimination in a universal health system: Explaining socioeconomic waiting time gaps

One of the goals of any universal health care system is to eliminate discriminatory access on socioeconomic grounds. Waiting times for treatment should reflect patients’ needs, with priority given to urgent cases. This paper from the University of Technology in Sydney finds evidence that wealthier patients get priority in the Australian system, especially among least urgent cases.

Canada — Can We Get Better for Less: Value for Money in Canadian Health Care

Injecting tens of billions of dollars into Canadian hospitals with no value measures in place is an inefficient approach to health care spending, says a report from the Certified General Accountants Association of Canada (CGA-Canada). Before committing to investment in additional physician capacity, hospital beds or diagnostic technology, policy makers could establish consistent and transparent value-for-money measures that reflect access to and quality of care, patient health outcomes and costs, and are monitored and tracked regularly over time and compared across institutions. Uniformly computed and publicly reported value-for-money metrics for all hospitals could enable comparison and allow sharing of best practices.

Europe — Medical Technology and the Production of Health Care

This paper investigates the factors that determine differences across OECD countries in health outcomes, using data on life expectancy at age 65, over the period 1960 to 2007.

A new look at OECD health care systems: Typology, efficiency and policies

Brief analytical summaries or syntheses #19 A new look at OECD health care systems Typology, efficiency and policies Summary This 2011 edition of the OECD’s Economic Policy Reforms features a chapter on health care (Chapter 6), a key contributor to individual wellbeing and an important driver of long-term economic growth. The OECD has assembled a new cross-country comparative data on health policies and health care system efficiency, which shows that there is room in all countries surveyed to improve the effectiveness of their public health care spending. Background Rising health care spending is putting pressure on government budgets. Governments will have to make their health systems more efficient if they are to maintain quality without putting further stress on public finances. The OECD has assembled new comparative data on health policies and health care system efficiency for its member countries. These show that all countries surveyed can improve the effectiveness…

Medical Tourism: Treatments, Markets and Health System Implications: A scoping review

Brief analytical summaries or syntheses #28 Medical Tourism Treatments, Markets and Health System Implications A scoping review Summary This broad OECD review examines what is currently known about the flow of medical tourists between countries and discusses the interaction of the demand for, and supply of, medical tourism services. It highlights the different organisations and groups involved in the industry. It highlights treatment processes (quality, safety and risks) and system-level implications for countries of origin and destination (financial issues, equity and the impact on providers and professionals of medical tourism). Background The global growth in the flow of patients and health professionals as well as medical technology, capital funding and regulatory regimes across national borders has given rise to new patterns of consumption and production of healthcare services over recent decades. A significant new element of a growing trade in healthcare has involved the movement of patients across borders in…

International - International profiles of health care systems

This publication from the Commonwealth Fund presents overviews of health care systems in nine European countries, Japan, Australia, Canada, and the U.S. Each overview covers insurance, financing, organization, quality of care, health disparities, efficiency and integration, information technology usage, use of evidence-based practice, cost containment, and reform and innovation. Summary tables provide data on key characteristics and performance indicators.

International Profiles of Health Care Systems

Brief analytical summaries or syntheses #32 International Profiles of Health Care Systems Summary This publication presents overviews of the health care systems of Australia, Canada, Denmark, England, France, Germany, Japan, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the U.S. Each overview covers health insurance, public and private financing, health system organization, quality of care, health disparities, efficiency and integration, use of health information technology, use of evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views. Background The Commonwealth Fund is a private foundation that promotes a high performance health care system providing better access, improved quality, and greater efficiency. The Fund carries out…

Canada - Time for Transformative Change: A Review of the 2004 Health Accord

Canada is no longer seen as a model of innovation in health care delivery and financing, says this report from the Standing Senate Committee on Social Affairs, Science and Technology. The committee’s review revealed that real systematic transformation of health care systems across the country had not yet occurred, despite more than a decade of government commitments and increasing investments. The committee made 46 recommendations it believes will truly transform the way health care professionals do business and will achieve lasting reform.

Public reporting on quality and costs. Do report cards and other measures of providers’ performance lead to improved care and better choices by consumers?

Brief analytical summaries or syntheses #39 Public reporting on quality and costs. Do report cards and other measures of providers’ performance lead to improved care and better choices by consumers ? Summary This paper examines whether public reporting of health provider performance leads to better consumer choices and improvements in care. Published in Health Affairs, the paper describes the theory behind public reporting, its evolution over time, and evidence of its ability to improve healthcare quality and lower costs. Background Public reporting is a strategy to address quality and cost in the healthcare system by providing consumers, payers, and healthcare providers, such as doctors and hospitals, with information about the performance of these providers and insurance plans. Public reports can allow for the comparison of costs, quality (such as rates of hospital-acquired infections), and how satisfied patients are with service. Advocates of public reporting believe that it helps consumers make…

USA - Major progress in doctors, hospital use of health information technology

On February 17, 2012, the U.S. Department of Health & Human Services confirmed that the number of American hospitals using health information technology (IT) more than doubled between 2010 and 2012, from 16% to 35%. Healthcare providers who use electronic health records (EHRs) to improve patient care are currently receiving incentive payments.

USA - Obama Administration takes new steps to encourage doctors and hospitals to use health information technology to lower costs, improve quality, create jobs

On November 30, 2011, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius released a report showing that doctors’ adoption of health information technology (IT) doubled in two years. As well, a Centers for Disease Control and Prevention survey found that 52% of office-based physicians in the U.S. now intend to take advantage of the incentive payments available to doctors and hospitals through the Medicare and Medicaid electronic health record (EHR) incentive programs. In addition to improving the health care system, data indicate that the national transition to health IT is creating jobs. Over 50,000 health IT-related jobs have been created since the enactment of the HITECH Act.

A review of telehealth in Scotland

Brief analytical summaries or syntheses #30 A review of telehealth in Scotland Summary This government review, prepared for Scotland’s Auditor General, focuses on National Health Service (NHS) telehealth initiatives that deliver care to patients. It determines that, targeted appropriately, telehealth has the potential to help NHS boards deliver clinical services more efficiently and effectively. Background The use of technology in the NHS has the potential to improve the quality, delivery and efficiency of healthcare services. Telehealth is the provision of healthcare to patients at a distance using a range of technologies, such as mobile phones, internet services, digital televisions, video-conferencing and self-monitoring equipment. Telehealth can offer a number of potential benefits to patients and NHS boards, such as reducing the need to travel to outpatient clinics, providing a quicker diagnosis, and avoiding referrals to hospital for diagnosis or treatment. It also has the potential to help NHS boards deliver clinical…

USA — Review of recent studies shows predominantly positive results for health information technology

A study completed by the Office of the National Coordinator for Health Information Technology (ONC) and published in the journal Health Affairs finds growing evidence of the benefits of health information technology (HIT). Using methods that were employed by two previous independent reviews, the new study finds that 92 percent of articles on HIT reached conclusions that showed overall positive effects of HIT on key aspects of care including quality and efficiency of health care.

Canada – Infoway invests $380 million to help physicians and nurse practitioners implement electronic medical record (EMR) systems

With its newest investment program, Canada Health Infoway (Infoway) is funding Electronic Medical Record (EMR) systems in community-based practices and outpatient settings throughout Canada. Infoway President and CEO, Richard Alvarez, recently provided details about the $380 million fund which is designed to focus investment at the points of care where the benefits of health information technology can deliver immediate value to patients and clinicians.

USA - The use of medical technology in the United States increased dramatically between 1996 and 2006, according to "Health, United States, 2009"

Health, United States, 2009 is the federal government’s 33rd annual report to the President and Congress on the health of all Americans.The report was prepared by the Centers for Disease Control and Prevention’s National Center for Health Statistics from data gathered by state and federal health agencies and through ongoing national surveys. This year's edition features a special section on medical technology, and finds that the rate of magnetic resonance imaging, known as MRI, and computed and positron emission tomography or CT/PET scans, ordered or provided, tripled between 1996 and 2007.

Australia: Review of Health Technology Assessment in Australia

A new report released recently by the Minister for Health and Ageing, Nicola Roxon, and the Minister for Finance and Deregulation, Lindsay Tanner, recommends improvements to the way new health products, procedures and services are assessed for public funding, in line with international best practice.

Denmark - Widespread Adoption of Information Technology in Primary Care Physician Offices in Denmark: A Case Study

Denmark is one of the world’s leading countries in the use of health care tech­nology. This paper asks why this is the case and focuses on the following issues: health care in Denmark, history of health information technology in Denmark, electronic medical records, driving forces to adopt technology, technical aspects of the Danish information technology system, data protection legislation, implications of health information technology for primary care practice, critical success factors in Denmark’s implementation of electronic medical records.

Australia - Council of Australian Governments’ Meeting - Conclusions

COAG agreed that national health reform would be a central priority for 2010. COAG discussed the current pressures on Australia’s healthcare system, and emerging pressures including population ageing, health workforce constraints and rising health costs driven by technology and the increasing burden of chronic disease. COAG agreed that long-term health reform was required to deliver better services for patients, more efficient and safer hospitals, more responsive primary healthcare and an increased focus on preventative health.

USA - Health Care Reform. A Collection of Articles on U.S. Health Care Reform

Victor R. Fuchs is the Stanford economics professor who is the dean of American health economists and is best known for his thoughtful book Who Shall Live? In just the past two years he has written 12 short articles that have appeared in such prestigious publications as the Journal of the American Medical Association (JAMA), New England Journal of Medicine and Health Affairs: Eliminating “Waste” in Health Care, Four Health Care Reforms for 2009, Cost Shifting Does Not Reduce the Cost of Health Care, The Proposed Government Health, Insurance Company — No Substitute for Real Reform, Reforming US Health Care – Key Considerations for the New Administration, Health Reform: Getting The Essentials Right, Health Care Reform — Why So Much Talk and So Little Action?, Three “Inconvenient Truths” about Health Care, The Perfect Storm of Overutilization, Who Really Pays for Health Care? The Myth of Shared Responsibility, What Are The…

USA - On the Rise of Health Spending and Longevity

The authors use a calibrated stochastic life-cycle model of endogenous health spending, asset accumulation and retirement to investigate the causes behind the increase in health spending and life expectancy over the period 1965-2005. They estimate that technological change along with the increase in the generosity of health insurance may explain independently 53% of the rise in health spending (insurance 29% and technology 24%) while income less than 10%.

New Zealand - National Health IT Board - Draft National Health IT Plan

On Friday (23/4) the DRAFT national Health IT plan was introduced at a Partnership Summit for key stakeholders. The National Health IT Board will be completing the national Health IT Plan for Ministerial approval before 30 June 2010. The plan will define and monitor the development of a sustainable, effective nationwide information and technology environment that fosters safety and quality care, is person-centred, is provider-friendly and increases productivity of the system as a whole.

The impact of global processes on health systems in Europe

Brief analytical summaries or syntheses #11 The impact of global processes on health systems in Europe Summary The relationship between globalization and health systems is a complex one, where both positive and negative influences are reported. This unsystematic literature review explores the impact of globalization on European health systems and emphasizes the need for national policy-makers and leaders to consider global processes when designing national health systems. Background The world is changing rapidly with increasing life expectancies and improving child survival rates. Globalization has contributed to economic growth. In addition to global economic integration, globalization entails the mobility of capital, goods, services and labour, and can be said to be part of an ideological process justifying neo-liberal economic policies. Globalization is also a dynamic process of global interconnectedness influenced by a number of driving and constraining forces such as technological developments, political influences, economic pressures, changing ideas, and greater awareness…

UK - £600M NHS back office savings could be redirected to the frontline

£600 million could be available for NHS frontline health services through streamlining the way health organisations run their back offices, an independent review has found. The review of back office efficiency, QIPP National Workstream: Back Office Efficiency and Management Optimisation, looked at ways of streamlining: finance, human resources (HR), information management and technology (IM&T), procurement, estates management, governance and risk, and payroll functions.

International - Value for Money in Health Spending

This publication examines current efforts to improve health care efficiency, including tools that show promise in helping health systems provide the best care for their money, such as pay for performance, co-ordination of care, health technology assessment and clinical guidelines, pharmaceutical reimbursement and risk-sharing agreements and information and communication technology.

New Zealand - Updated National Health IT Plan

A draft National Health IT Plan was released on Friday April 24. Following sector feedback the plan has been updated, and is now available here. A forum discussing the Plan is available for viewing on the HIVE Website. The National Health IT Board has developed New Zealand’s first National Health IT Plan to set priorities for regional and national information technology (IT) investments over a five-year period.

Canada - New health information technology strategy: put money where the patient is

The Canadian Medical Association (CMA) has released a new health information technology (HIT) investment strategy that aims to reboot Canada’s HIT agenda to better focus on supporting front line patient care. Transforming the health care system hinges on building better tools and supports to help health care professionals interact and provide care for patients. To that end, the HIT strategy prioritizes the key clinical and system priorities for investment over the next 3-5 years as follows: chronic disease management; prevention and health promotion; medication management; continuity of care (information flow, access and wait times); patient involvement; and public health reporting.

Time for Transformative Change: A review of 2004 Health Accord

Brief analytical summaries or syntheses #40 Time for Transformative Change A review of 2004 Health Accord Summary Canada is no longer seen as a model of innovation in health care delivery and financing, says this report from the Standing Senate Committee on Social Affairs, Science and Technology. The committee’s review revealed that real systematic transformation of health care systems across the country had not yet occurred, despite more than a decade of government commitments and increasing investments. The committee made 46 recommendations it believes will truly transform the way health care professionals do business and will achieve lasting reform. Background On January 31, 2011, the Minister of Health requested that the Standing Senate Committee on Social Affairs, Science and Technology initiate the second parliamentary review of the 10-Year Plan to Strengthen Health Care (10-Year Plan), an agreement reached by First Ministers on September 16, 2004 that focuses on federal/provincial/territorial (F/P/T)…

Europe - European Vacancy Monitor highlights growing job opportunities in healthcare sector

The European Commission finds that employment in the EU healthcare sector has grown almost 2% annually between 2008 and 2012. This is attributed to the combined effects of an ageing population, advances in technology and treatments, people expecting higher quality service and greater emphasis on preventative care. In 2012 almost one million people were hired to work in health care.

International - International Profiles of Health Care Systems, 2013

This publication presents overviews of health systems in Australia, Canada, Denmark, Great Britain, France, Germany, Japan, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the US. Each overview covers health insurance, public and private financing, system organization and governance, healthcare quality and coordination, efficiency and integration, information technology use and evidence-based practice, cost containment, and recent reforms and innovations.

Canada - Supporting Research and Innovation in Health Technology Sector. Ontario Creates New Council to Study Sector Innovation

This council, established by the Ministry of Research and Innovation, will help to enhance the province's world renowned health technology sector by developing recommendations to identify opportunities for Ontario's small- and medium-sized businesses, adapt best practices of other jurisdictions, and expand the adoption of new technologies across health care settings.

Europe - New Action Plan agreed for innovative cross-border healthcare

European Union (EU) health ministers attending the May 2013 EU Ministerial eHealth Conference in Dublin agreed on a new ehealth action plan and Declaration on eHealth. These aim to prioritize the use of cross-border health information and communications technology (ICT) within the EU.

UK - Jeremy Hunt announces technology fund for hospitals to help improve patient safety

Responding to the Francis report, which called on the National Health Service (NHS) to make better use of technology to improve safe, effective care, Health Secretary Jeremy Hunt announced a new £260 million fund for hospitals. A key target is technology to reduce prescription errors in hospitals.

New Zealand - National Health IT Plan Update 2013/14

This government publication updates New Zealand’s 2010 National Health Information Technology (IT) Plan. It describes four priorities for IT investment: electronic medication management, national clinical solutions, regional information platforms, and community-based integrated care initiatives.

UK - NHS England launches £100m Nursing Technology Fund

As of December 9, 2013, National Health Service (NHS) organisations can bid for part of a £100m fund to buy innovative technology to support nurses, midwives and care staff in improving patient care. It will fund mobile and digital technology that improves communication, allows staff to do their jobs more easily and leads to better experiences for patients. The deadline for the first round of applications is January 15, 2014.

USA - mHealth in China and the United States: How Mobile Technology is Transforming Health Care in the World’s Two Largest Economies

Rising costs, unequal access and aging populations are increasing pressure on many countries’ healthcare systems. This article suggests that policy-makers look to the US and China, where mobile health technology, or mHealth, is boosting productivity, encouraging better data collection and analysis, and helping providers improve affordability, access and treatment. The authors suggest a number of ideas to speed the international adoption of mHealth.

USA - Proposed health IT strategy aims to promote innovation, protect patients, and avoid regulatory duplication

The US Department of Health and Human Services (HHS) has released a report proposing a health information technology (health IT) framework that promotes product innovation while maintaining patient protections and avoiding regulatory duplication. The report recommends clarifying the oversight of health IT to focus on product function and patient risk.

UK - NHS safe staffing: not just a number

Despite the fact that the greatest recurring cost in Britain’s National Health Service (NHS) is its workforce, a system for planning, monitoring and recording NHS staff numbers does not currently exist. This study identifies the clinical, safety, and financial benefits of keeping more robust workforce data. It also describes barriers to the adoption of digital technology for staff rosters, payment, and quality assurance.

Brazil - Learning from emerging economies

This HINNOVIC dossier looks at health innovations in Brazil, which has strong domestic capacity in health technology development and policy initiatives around population needs and health inequalities. Health sector commercial agreements with China and India are examined as are instances where more developed countries are looking to Brazilian models to better meet healthcare needs.

USA - Is This Time Different? The Slowdown in Healthcare Spending

The National Bureau of Economic Research (NBER), in this report, attributes a 10-year slowdown in US healthcare spending to increases in high-deductible insurance plans, the control of Medicaid costs, and slow growth in the diffusion of new technology. However, the report estimates US healthcare costs will grow more robustly over the next two decades at a rate equalling GDP growth plus 1.2%.

International - A governance model for integrated primary/secondary care for the health-reforming first world - results of a systematic review

Internationally, key healthcare reform elements rely on improved integration of care between primary and secondary sectors. This systematic review synthesized 21 studies on elements of integrated primary/secondary healthcare. Elements included: joint planning; integrated information technology; shared clinical priorities; incentives; innovation; population focus; professional development; and patient and community engagement.

Australia - Healthcare: Reform or ration

Produced by the Committee for the Economic Development of Australia (CEDA), this policy document urges changes to the way Australia’s healthcare is funded. The document calls for an end to health system rationing and recommends managed insurance competition, improved generic pharmaceutical pricing and increased funding of health technology research.

USA - HHS announces 2013 agenda to bring down costs and improve quality of care through implementation of health information technology

The US Department of Health and Human Services (HHS) has announced a new agenda to accelerate health information exchange (HIE) and build a secure flow of information across the system. The HHS will emphasize interoperability, implement new rules on data exchange, ensure program security, and work to enhance the effective use of electronic health records.

Australia – Over 150 potentially low-value health care practices: an Australian study

This study from the Medical Journal of Australia describes a method for scanning a range of sources to identify non-pharmaceutical healthcare services of questionable benefit. The study also provides a list of services that warrant further investigation, a move that will aid prioritization in health technology reassessment initiatives.

International - International Profiles of Health Care Systems: Australia, Canada, Denmark, England, France, Germany, Japan, Iceland, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States

This publication from the Commonwealth Fund provides overviews of healthcare systems in 15 countries, giving information on insurance, financing, organization, cost containment, efficiency, quality of care, health disparities, care coordination, and the use of information technology and evidence-based practice. Summary tables provide data on key health system characteristics and performance indicators.

USA - HHS Health IT Safety Plan open for public comment

In December 2012, the US Department of Health and Human Services (HHS) released the Health IT Patient Safety Action and Surveillance Plan, a report on the ways health information technology can eliminate medical errors, improve quality of care, and make health care more efficient. The plan builds on a 2011 report from the Institute of Medicine (IOM).

International - A Survey of Primary Care Doctors in Ten Countries Shows Progress in Use of Health Information Technology

A survey of primary care physicians in 10 countries by the Commonwealth Fund has found progress in the use of electronic medical records (EMRs). Adoption has particularly accelerated in the US, although America still lags behind several countries where EMR use is near-universal. Physicians in every nation surveyed reported challenges with communication and care coordination.

Health policy responses to the financial crisis in Europe

Brief analytical summaries or syntheses #47 Health policy responses to the financial crisis in Europe Summary This August 2012 report by the Health Evidence Network (HEN) identifies key challenges for European health policy makers in the wake of the ongoing financial crisis. The report focuses on responses to essential service cuts and interruptions in revenue streams, as well as on inefficiencies and exacerbations of adverse effects evident in national health systems. Background The global financial crisis that began in 2007 can be classified as a health system shock – that is, an unexpected occurrence originating outside the health system that has a large negative effect on the availability of health system resources or a large positive effect on the demand for health services. Economic shocks present policy-makers with three main challenges Health systems require predictable sources of revenue with which to plan investment, determine budgets and purchase goods and services.…

USA - The Performance Improvement Imperative. Utilizing a Coordinated, Community-Based Approach to Enhance Care and Lower Costs for Chronically Ill Patients

In this paper, the Commonwealth Fund Commission on a High Performance Health System proposes the US create 50 to 100 voluntary “Health Improvement Communities” focused on patients with multiple, high-cost chronic conditions. Through payment reform, enhanced primary care, and health information technology, it maintains that this effort could yield $184 billion in savings.

USA - Aligning Health Information Technology and Delivery System Transformation Efforts: Themes from a Discussion among State and National Leaders

This State Health Policy Briefing describes an April 2012 meeting between US state and national leaders to consider ways in which delivery system transformations can capitalize on information technology and improve health care. Provider and plan measurement, payment reform, care delivery innovation, and consumer engagement are discussed.

A guide to physician integration models for sustainable success

Brief analytical summaries or syntheses #49 A guide to physician integration models for sustainable success Summary As health care delivery and financing shifts from a volume-based to a value-based business model, improved alignment between hospitals and physicians becomes essential. This guide, published by Health Research & Educational Trust, describes the prerequisites for successful hospital-physician integration and offers an overview of integration models currently used in American hospitals and health systems. Background This guide offers an overview of physician integration models currently deployed at hospitals and health systems. These models include a wide array of programs, covering customer service offerings, contractual ventures, joint venture/shared equity arrangements and employment/practice acquisition models. The legal, taxation and regulatory issues surrounding hospital-physician integration are complex and changing. Analysis and results As health care delivery and financing shifts from a volume-based to a value-based business model, provider success will be achieved through offering services with the…

Reducing waste in health care

Brief analytical summaries or syntheses #56 Reducing waste in health care Summary A key target in slowing healthcare spending in the US is the elimination of waste, which is thought to constitute over one third of all American health spending. This policy brief published in Health Affairs focuses on the types of waste in health care and ways to eliminate it. Background Health care spending in the United States is widely deemed to be growing at an unsustainable rate, and policy makers increasingly seek ways to slow that growth or reduce spending overall. A key target is eliminating waste — spending that could be eliminated without harming consumers or reducing the quality of care that people receive and that, according to some estimates, may constitute one-third to nearly one-half of all US health spending. Waste can include spending on services that lack evidence of producing better health outcomes compared to…

International - Machines that go ‘ping’: medical technology and health expenditures in OECD countries

While rising national healthcare expenditures are widely documented, the quantification of underlying cost drivers has proven difficult. This paper looks at data on approved medical devices and confirms the substantial cost-increasing effect of medical technology, which accounts for 50% of historical spending.

Finland - eHealth and eWelfare of Finland - Checkpoint 2011

This report was produced by the National Institute for Health and Welfare, Finland, and FinnTelemedicum, from the results of the national eHealth implementation survey. It describes the status and trends in health care information and communication technology and eHealth usage in Finland in 2011, comparing the results with earlier surveys carried out in 2003, 2005 and 2007.

Europe - Developing a New Understanding of Enabling Health and Wellbeing in Europe – Harmonising Health and Social Care Delivery and Informatics Support to Ensure Holistic Care

Although social care and informal care are essential to improving health and preventing health problems, especially in an aging population, there are still large gaps of knowledge in how best to organise this, and how best to combine it with health care. This position paper from the European Science Foundation aims to present the vision of a new paradigm of integrated care support for citizens’ health through technology-linked social and health care, and identify common ground between consumer, professional and government bodies.

Canada - How do Canadian primary care physicians rate the health system? Survey results from the 2012 Commonwealth Fund International Health Policy Survey of Primary Care Doctors

In this issue of Canadian Health Care Matters, the Health Council of Canada examines survey results that shed light on the potential for improvement in several key areas: access to primary health care, coordination among health care providers, the uptake of information technology in primary care, and initiatives to drive practice improvement.

Health in the Americas. 2012 edition

Brief analytical summaries or syntheses #53 Health in the Americas. 2012 edition Summary In Health in the Americas 2012, the Pan American Sanitary Bureau presents and analyzes health data and information from every country in the Region of the Americas. In drafting the publication, it has used data from many domestic and international, as well as unofficial, sources, trying as much as possible to identify and eliminate any discrepancies. Background Chapter 1 A Century of Public Health in the Americas In the last 110 years, Latin America and the Caribbean have experienced great transformations, from the independence of the Caribbean countries to the construction of modern states, from authoritarian regimes and dictatorships to democracy and the rule of law, and from cycles of economic growth and high productivity to financial crises, economic slow-downs, and massive foreign debt. The Region also has achieved a notable increase in life expectancy and a…

USA - The use of medical technology in the United States increased dramatically between 1996 and 2006, according to "Health, United States, 2009"

Health, United States, 2009 is the federal government’s 33rd annual report to the President and Congress on the health of all Americans. The report was prepared by the Centers for Disease Control and Prevention’s National Center for Health Statistics from data gathered by state and federal health agencies and through ongoing national surveys. This year's edition features a special section on medical technology, and finds that the rate of magnetic resonance imaging, known as MRI, and computed and positron emission tomography or CT/PET scans, ordered or provided, tripled between 1996 and 2007.