BLOG on IT/IS in Healthcare & Life Sciences Joerg Schwarz on Healthcare [Health + Care]

This week I'm at the Arabhealth conference in Dubai. Impressive statistics: More than 2,300 exhibitors in 11 halls of the international convention center. This easily trumps in size recent international HIMSS health care events in Singapore and Vienna (World of Health IT).

At $100 US per barrel of Oil it is not surprising that the Gulf region economies are booming and have money to invest in social services like health care. It is also not surprising that global health care solution providers like Siemens, Agfa, GE and Carestream (all of them are, of course, Sun partners) will have significant representation at the show. But what I find remarkable is that HCA and The Cleveland Clinic are here, two large US based health care providers, and Singapore Health is a Platinum sponsor. These are the indicators that health care is not anymore only local; Health care goes global.

Two years ago, at a round table discussion in Singapore, I learned that the Singapore government decided to leverage their health care infrastructure for service export by way of attracting foreign consumers to Singapore. And Singapore wouldn't be Singapore if they wouldn't implement their plan. So here they are, attracting wealthy consumers from the gulf region to Singapore. Wealthy is an assumption, because it is doubtful Singapore will seek cost leadership - that is clearly market segment for  India and Thailand, both with their own programs for health care service to foreigners. 

The Cleveland Clinic and HCA have representation in the Gulf region, which is another aspect of globalization - instead of attracting patients to the US, they export their competence and deliver locally.

In either case of globalization - service or competence export - IT/IS plays an import role, both as an obstacle and as an enabler. Globalization in the general economy is unthinkable w/o IS systems and standardization. A company like Vizio is capable of building a global supply chain because they can rely on cheap communication and data exchange that allows demand sensitive manufacturing. The reality in Health care is very different. Many Hospitals struggle with full semantic interoperability within their own clinical systems. Health Information Exchanges struggle because they have to map many different, proprietary data standards together to get a full view of the patient that would allow optimal quality of care. And that is within one economy and regulatory system. Imagine data exchange between care provider in the US and Singapore or Thailand or India, because a patient decided to get surgery there.

If globalization in health care should become a reality, we need global standards. Fortunately, there are already ontologies like ICD10 and document architecture standards like HL7 CDA2. If care providers could rely on data generated and administered by different IS systems seamlessly, globalization would be possible in healthcare, just like it is in the rest of the economy. Why would we want this? If you're in the Porter & Teisberg camp (and I am), the answer is easy. Globalization drives competition on price and quality. As long as a local provider can charge a premium for low quality service, just because the consumer lacks information or access to better priced service elsewhere, there is no economic incentive to improve quality. Globalization has driven cost down in many areas of the economy, and it could do so in Healthcare also.

We see at Arabhealth the harbingers of globalization, with global vendors, care providers and service exporters. We now have to prepare IS infrastructure to deliver on the promise of globalization, and that means we need globally inter-operable ontologies and data architectures.