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Thailand 4.0 and Thailand's Public Health

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  • Thailand 4.0 .

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  • Outline

    Thailand 4.0

    Healthcare 4.0

    Referral Center 4.0

    The Way Forward

  • Thailand 4.0

    Image Source: https://www.youtube.com/watch?v=OEfY3rQZpNo

    https://www.youtube.com/watch?v=OEfY3rQZpNo

  • Thailand 1.0

    Image Source: https://www.youtube.com/watch?v=OEfY3rQZpNo

    https://www.youtube.com/watch?v=OEfY3rQZpNo

  • Thailand 2.0

    Image Source: https://www.youtube.com/watch?v=OEfY3rQZpNo

    https://www.youtube.com/watch?v=OEfY3rQZpNo

  • Thailand 3.0

    Image Source: https://www.youtube.com/watch?v=OEfY3rQZpNo

    https://www.youtube.com/watch?v=OEfY3rQZpNo

  • Thailand 3.0

    Image Source: https://www.youtube.com/watch?v=OEfY3rQZpNo

    https://www.youtube.com/watch?v=OEfY3rQZpNo

  • Thailands Middle Income Trap

    Image Source: https://www.youtube.com/watch?v=OEfY3rQZpNo

    https://www.youtube.com/watch?v=OEfY3rQZpNo

  • Thailand 4.0

    Image Source: https://www.youtube.com/watch?v=OEfY3rQZpNo

    https://www.youtube.com/watch?v=OEfY3rQZpNo

  • Thailand 4.0

    Image Source: https://www.youtube.com/watch?v=OEfY3rQZpNo

    https://www.youtube.com/watch?v=OEfY3rQZpNo

  • Thailand 4.0

    Image Source: https://www.youtube.com/watch?v=OEfY3rQZpNo

    https://www.youtube.com/watch?v=OEfY3rQZpNo

  • Thailand 4.0

    Image Source: https://www.youtube.com/watch?v=OEfY3rQZpNo

    https://www.youtube.com/watch?v=OEfY3rQZpNo

  • Thailand 4.0

    Image Source: https://www.youtube.com/watch?v=OEfY3rQZpNo

    https://www.youtube.com/watch?v=OEfY3rQZpNo

  • Healthcare 4.0?

  • Healthcare 1.0

    Healthcare 1.0 - 4.0 Image & Caption Source: http://kanchanapisek.or.th/kp6/sub/book/book.php?book=33&chap=8&page=t33-8-detail.htmlhttp://kanchanapisek.or.th/kp6/sub/book/book.php?book=33&chap=8&page=t33-8-infodetail02.html

    ( )

    http://kanchanapisek.or.th/kp6/sub/book/book.php?book=33&chap=8&page=t33-8-detail.htmlhttp://kanchanapisek.or.th/kp6/sub/book/book.php?book=33&chap=8&page=t33-8-infodetail02.html

  • Healthcare 2.0

    Healthcare 1.0 - 4.0 Image Source: http://www.mcot.net/site/content?id=51065d70150ba027570000a6#.V5k98vl96Hs

    http://www.mcot.net/site/content?id=51065d70150ba027570000a6#.V5k98vl96Hs

  • Healthcare 3.0

    Healthcare 1.0 - 4.0 Image Source: http://e-learning.ha.or.th/moodle/webha/index.php/newsth/news-releases-th/item/426-2559

    http://e-learning.ha.or.th/moodle/webha/index.php/newsth/news-releases-th/item/426-2559

  • Healthcare 4.0 Smart Healthcare & Smart Hospital

    Healthcare 1.0 - 4.0 Image Source: Nawanan Theera-Ampornpunt, PowerPoint slide template from SmileTemplates.com

  • Smart Healthcare?

  • Smart Healthcare For Policymakers?

    Image Source: http://healthdata.moph.go.th/kpi/2557/ProvinceKpiTopicListAll.php?provincecode=99

    http://healthdata.moph.go.th/kpi/2557/ProvinceKpiTopicListAll.php?provincecode=99

  • Smart Healthcare For Clinicians?

    Image Source: http://www.medscape.com/viewarticle/780298

    http://www.medscape.com/viewarticle/780298

  • Smart Healthcare For Patients & Consumers?

    Image Source: Agence France-Presse/Getty Images

  • Smart Healthcare ?

    Image Source: http://cdn2.hubspot.net/hub/134568/file-1208368053-jpg/6-blind-men-hans.jpg

    http://cdn2.hubspot.net/hub/134568/file-1208368053-jpg/6-blind-men-hans.jpg

  • Digitizing Healthcare ?

    Image Source: http://www.bloomberg.com/bw/stories/2005-03-27/cover-image-the-digital-hospital

    http://www.bloomberg.com/bw/stories/2005-03-27/cover-image-the-digital-hospital

  • To computerize the hospital

    To go paperless

    To become a Digital Hospital

    To Have EHRs

    ICT . ?

  • Dont implement technology just for technologys sake.

    Dont make use of excellent technology. Make excellent use of technology.(Tangwongsan, Supachai. Personal communication, 2005.)

    Health care IT is not a panacea for all that ails medicine. (Hersh, 2004)

    Some Smart Quotes

  • Tip #1: Stop Your Drooling Reflex!!

  • Tip #2: Focus on Information & Process Improvement,

    Not Technology

  • Digital Hospital Paperless Hospital

    ?

  • Smart Hospital

  • Smart Hospital Digital

    Paperless Hospital ?

  • https://www.microsoft.com/en-us/download/details.aspx?id=12801

    Microsoft Health Future Vision

  • https://www.youtube.com/watch?v=gxz9ZVvduGc

    Connecting People to a Healthy Future With Personalized Care Kaiser Permanente

  • Back to something simple...

  • To treat & to care for their patients to their best abilities, given limited time & resources

    Image Source: http://en.wikipedia.org/wiki/File:Newborn_Examination_1967.jpg (Nevit Dilmen)

    What Clinicians Want

  • High-quality and timely information meaningful for monitoring & evaluation of health systems and policymaking

    What Policymakers Want

  • A safe, effective care that focus on us, the patients, and our needs

    What Patients Want

  • Safe ()

    Timely ()

    Effective ()

    Patient-Centered()

    Efficient ()

    Equitable ()Institute of Medicine, Committee on Quality of Health Care in America. Crossing the quality chasm:

    a new health system for the 21st century. Washington, DC: National Academy Press; 2001. 337 p.

    Quality of Care

  • Information is Everywhere in Healthcare

  • 40

    40

    WHO (2009)

    Components of Health System

  • 41

    41

    WHO (2009)

    WHO Health System Framework

  • SafeDrug allergies

    Medication Reconciliation

    TimelyComplete information at point of care

    EffectiveBetter clinical decision-making

    Being Smart in Healthcare

  • Patient-Centered

    Empowerment & better self-care

    Efficient

    Faster care

    Time & cost savings

    Reducing unnecessary tests

    Equitable

    Access to providers & knowledge

    Being Smart in Healthcare

  • (IOM, 2001)(IOM, 2000) (IOM, 2011)

    Landmark Reports by U.S. Institute of Medicine

  • To Err is Human (IOM, 2000) reported that: 44,000 to 98,000 people die in U.S. hospitals

    each year as a result of preventable medical mistakes

    Mistakes cost U.S. hospitals $17 billion to $29 billion yearly

    Individual errors are not the main problemFaulty systems, processes, and other conditions

    lead to preventable errors

    Patient Safety

  • Humans are not perfect and are bound to make errors

    Highlight problems in U.S. health care system that systematically contributes to medical errors and poor quality

    Recommends reform

    Health IT plays a role in improving patient safety

    Summary of These Reports

  • Image Source: (Left) http://docwhisperer.wordpress.com/2007/05/31/sleepy-heads/ (Right) http://graphics8.nytimes.com/images/2008/12/05/health/chen_600.jpg

    To Err is Human 1: Attention

  • Image Source: Suthan Srisangkaew, Department of Pathology, Facutly of Medicine Ramathibodi Hospital

    To Err is Human 2: Memory

  • Medication Errors

    Drug Allergies

    Drug Interactions

    Ineffective or inappropriate treatment

    Redundant orders

    Failure to follow clinical practice guidelines

    Common Errors

  • External Memory

    Knowledge Data

    Long Term Memory

    Knowledge Data

    Inference

    DECISION

    PATIENT

    Perception

    Attention

    WorkingMemory

    CLINICIAN

    Elson, Faughnan & Connelly (1997)

    Clinical Decision Making

  • Example of Alerts & Reminders

    Reducing Errors through Alerts & Reminders

  • Guideline adherence Better documentation Practitioner decision making or

    process of care Medication safety Patient surveillance & monitoring Patient education/reminder

    Documented Values of Health IT

  • Tip #3: Link IT Values to Quality (Including Safety)

  • Health

    Information

    Technology

    Goal

    Value-Add

    Tools

    Health IT: ?

  • Hospital Information System (HIS) Computerized Physician Order Entry (CPOE)

    Electronic Health Records (EHRs)

    Picture Archiving and Communication System

    (PACS)

    Various Forms of Health IT

  • m-Health

    Health Information Exchange (HIE)

    Biosurveillance

    Telemedicine & Telehealth

    Images from Apple Inc., Geekzone.co.nz, Google, PubMed.gov, and American Telecare, Inc.

    Personal Health Records (PHRs)

    Health IT Beyond Hospitals

  • Ordering Transcription Dispensing Administration

    CPOEAutomatic Medication Dispensing

    Electronic Medication

    Administration Records (e-MAR)

    BarcodedMedication

    Administration

    BarcodedMedication Dispensing

    Health IT for Medication Safety

  • Maturity Health Information

  • Referral System 1.0

  • Referral System 2.0

    manual

    Refer .

  • Referral System 3.0

    Image Sources: http://im-hospital.blogspot.com/2012/01/step-1-refer-link.html https://www.youtube.com/watch?v=nR5pbWSzv1c

    http://im-hospital.blogspot.com/2012/01/step-1-refer-link.htmlhttps://www.youtube.com/watch?v=nR5pbWSzv1c

  • Referral System 4.0