Medical Informatics in TaiwanMedical Informatics in Taiwan

YuYu--Chuan (Jack) Li, M.D., Ph.D.Chuan (Jack) Li, M.D., Ph.D.Chair, Graduate Institute of Medical Informatics, Chair, Graduate Institute of Medical Informatics,

Taipei Medical UniversityTaipei Medical UniversityPresident, Taiwan Association of Medical InformaticsPresident, Taiwan Association of Medical Informatics

Scale of Healthcare in TaiwanScale of Healthcare in Taiwan

Population: 23 millionPopulation: 23 millionInsurance: universal coverage, by National Insurance: universal coverage, by National Health Insurance BureauHealth Insurance BureauOutpatient visits: 300 million/yearOutpatient visits: 300 million/yearInpatient stays: 28 million manInpatient stays: 28 million man--day/yearday/yearBudget: Budget: –– Public:10 billion USD/yearPublic:10 billion USD/year–– Private: 10 billion USD/yearPrivate: 10 billion USD/year

Scale of Healthcare in TaiwanScale of Healthcare in Taiwan(cont.)(cont.)

600 600 hospitalshospitals–– 70% computerized, 50% with some kind of 70% computerized, 50% with some kind of

clinical information systemclinical information system9,000 primary care clinics9,000 primary care clinics–– 70% computerized and 70% computerized and paperlessiblepaperlessible

OutlineOutline

Government effortGovernment effortA growing industryA growing industryAcademicAcademic

Government EffortGovernment Effort

Major Projects from DOHMajor Projects from DOH

Health Smart CardHealth Smart Card–– A 120 million USD, 3A 120 million USD, 3--year projectyear project–– 23 million smart cards for everyone23 million smart cards for everyone–– 2003 2003 →→ store health insurance informationstore health insurance information–– 2004 2004 →→ store vaccination store vaccination hxhx, medication , medication hxhx, ,

ICDICD--99--CM codes, major medical CM codes, major medical examinationsexaminations……etc.etc.

Still debatingStill debating

Major Projects from DOH Major Projects from DOH (cont.)(cont.)

eHealtheHealth Services Project:Services Project:–– A 40 million USD, 4A 40 million USD, 4--year projectyear project–– Medical Information ExchangeMedical Information Exchange

InterInter--hospital exchange of patient information as hospital exchange of patient information as well as providing personal health record to well as providing personal health record to individualsindividuals

–– Adoption of Electronic Patient RecordAdoption of Electronic Patient RecordEncourage hospitals to go paperlessEncourage hospitals to go paperless

Major Projects from DOH Major Projects from DOH (cont.)(cont.)

eHealtheHealth Services Project Services Project (cont.)(cont.)

–– Health Certificate Authority (HCA)Health Certificate Authority (HCA)Issue certificates (using PKI) for all hospitals and Issue certificates (using PKI) for all hospitals and health professionalshealth professionals

–– National Guideline for Healthcare Information National Guideline for Healthcare Information System functional requirementSystem functional requirement

–– Consumer Health Information websites Consumer Health Information websites critiquing and certifyingcritiquing and certifying

–– HIPAA related legislationHIPAA related legislation–– Promotion of standards Promotion of standards →→ HL7, DICOM, IHEHL7, DICOM, IHE

A Growing IndustryA Growing Industry

Medical Informatics Industry Medical Informatics Industry

It is recognized by the Ministry of It is recognized by the Ministry of Economy as a high potential industry in Economy as a high potential industry in BioBio--techtechIt is estimated that the hospitals (not It is estimated that the hospitals (not including the clinics) would spend up to 1 including the clinics) would spend up to 1 billion USD on IT outsourcing in the next 3 billion USD on IT outsourcing in the next 3 yearsyears

Medical Informatics Industry Medical Informatics Industry (cont.)(cont.)

Several big TaiwanSeveral big Taiwan--based companies are based companies are starting to invest on Medical Informatics starting to invest on Medical Informatics projectsprojects–– e.g. Acer, e.g. Acer, TecoTeco electronicselectronics……etc.etc.Invest on standards like IHE, HIS guideline Invest on standards like IHE, HIS guideline in its early phasesin its early phases

Fast Academia DevelopmentFast Academia Development

UniversitiesUniversities

There are now more than ten formal There are now more than ten formal degree granting departments from public degree granting departments from public and private universities offering degrees and private universities offering degrees from undergraduate diploma to Ph.D.from undergraduate diploma to Ph.D.Different Emphasis onDifferent Emphasis on–– Clinical InformaticsClinical Informatics–– BioinformaticsBioinformatics–– Health InformaticsHealth Informatics–– Nursing InformaticsNursing Informatics

Universities Universities (cont.)(cont.)

Prominent examplesProminent examples–– Taipei Medical University (Graduate Institute Taipei Medical University (Graduate Institute

of Medical Informaticsof Medical Informatics--GIMI)GIMI)–– 60 master and Ph.D. students60 master and Ph.D. studentsYangYang--Ming UniversityMing University–– 40 master and Ph.D. students40 master and Ph.D. studentsTsuTsu--Chi UniversityChi University–– Enroll 50 bachelor students every yearEnroll 50 bachelor students every year

Associations and ActivitiesAssociations and Activities

Associations and ActivitiesAssociations and ActivitiesTaiwan Association of Medical Informatics (TAMI)Taiwan Association of Medical Informatics (TAMI)–– established in 1991, now with 500+ voting members, established in 1991, now with 500+ voting members,

all major hospitals and the department of health are all major hospitals and the department of health are current memberscurrent members

–– Holds a major annual conference Holds a major annual conference -- MIST (Medical MIST (Medical Informatics Symposium in Taiwan) every year with Informatics Symposium in Taiwan) every year with 300300--500 attendees500 attendees

–– Act as a liaison in major issues like Health Smart Act as a liaison in major issues like Health Smart Card and Electronic Patient Record between Card and Electronic Patient Record between government agencies and other organizationsgovernment agencies and other organizations

–– Sits in the National Committee on the Development of Sits in the National Committee on the Development of Health and Medical InformaticsHealth and Medical Informatics

Associations and Activities Associations and Activities (cont.)(cont.)

HL7 TaiwanHL7 Taiwan–– Established in 2001, member of HL7 Established in 2001, member of HL7

international affiliate, now with 200+ voting international affiliate, now with 200+ voting membersmembers

DICOM TaiwanDICOM Taiwan–– Established in 2001, member of DICOM Established in 2001, member of DICOM

committeecommittee

FutureFuture

Future ProjectsFuture Projects

eHealtheHealth Services Project (2001~2005)Services Project (2001~2005)National Health Information InfrastructureNational Health Information InfrastructurePatient Safety InformaticsPatient Safety InformaticsMore integration with the Bioinformatics More integration with the Bioinformatics communitycommunity