April 2000 - Healthcare Informatics

A GLOBAL PERSPECTIVE OF HEALTH INFORMATICS TODAY AND TOMORROW

We're living in exciting times for medical informatics," says an enthusiastic Lun Kwok Chan, Ph.D, associate professor of medical informatics at the National University of Singapore. But for Lun, who also is president-elect of the International Medical Informatics Association (IMIA), it would not be an overstatement to suggest that excitement, particularly with information technology, has been a way of life.

Throughout his career Lun, known by his Western colleagues as "K.C.," has received numerous awards and recognition from regional and international organizations. His early performance in undergraduate school earned him the prestigious Royal Exhibition Overseas Science Research Scholarship, which offered a fully paid stipend to pursue graduate work anywhere in the British Commonwealth.

Lun chose the University of Birmingham in Great Britain. As he pursued a Ph.D in biometrical genetics, he also acquired computer skills and forecast the pairing of information systems and emerging technologies with medical science as a critical focus in healthcare.

After receiving his Ph.D, Lun went on to pursue an M.Sc in medical demography at the London School of Hygiene and Tropical Medicine. This was followed by an appointment as a China Medical Board Fellow in medical informatics at the University of Tokyo's Hospital Computer Center.

Lun returned to the National University of Singapore in 1984, where he has developed his role with health informatics on both a regional and global scale.

A wired country
Although Singapore is small--247 square miles, including 50 islands that are connected by a causeway to the tip of the Malay peninsula--this former British colony, Lun says, is "probably the only fully wired country in the world."

He says that government IT initiatives in all public sectors of the country are quite forward thinking, and one project, Singapore ONE (One Network for Everyone), is bringing "a new level of interactive, multimedia applications and services to homes, businesses and schools throughout Singapore." Lun predicts that another government program, the Information and Communications Technology (ICT) 21 Master Plan, will transform Singapore into a vibrant global IT capital with an Internet-based economy by 2010.

Lun says the government has made medical informatics a priority by establishing the Medical Informatics Programme (MIP) at the National University of Singapore. Developed through joint funding from the country's National Science and Technology Board and the Ministry of Education, the MIP provides an environment for developing further research capabilities in medical informatics.

While at the university, Lun has been active in a variety of new technologies designed to enhance healthcare delivery. He has received grants of close to $10 million to pursue work in medical informatics, multilingual Web-based information, telemedicine and multimedia virtual Web-based health programs.

Help for developing nations
Lun also is the director of the World Health Organization's (WHO's) Collaborating Center for Health Informatics, which is headquartered at the National University of Singapore. WHO commissioned Lun to help develop a Windows-based software program to aid in the creation of health population studies. The software has been distributed to individuals, research centers, academic institutions and healthcare organizations around the world for beta-testing.

As if that weren't enough to keep him busy, Lun also is an active liaison with a number of other global organizations such as the Center for Disease Control, UNICEF, the Asia Pacific Association for Medical Informatics (APAMI) and the World Bank. These and other groups support public-private partnerships that assist with the development of IT infrastructures in developing and emerging nations.

"I see a very interesting analogy between the 'Demographic Transition' and what I call the 'IT Transition,'" Lun says. The developed countries, as we know them today, Lun explains, took a long time to move from one end of the healthcare scale to the other because they had to wait for the discovery of new drugs and vaccines. Today's developing and emerging countries are experiencing a quicker transition "with respect to mortality because they were able to benefit from the import of drugs and vaccines the developed countries already possessed," he says.

Lun believes this comparison applies to the development of IT in emerging countries. "They can jump-start the use of IT in healthcare because the developed countries have already developed the technology and software," he explains. What took years of R&D to develop now is being sold at affordable prices in countries such as South Africa, Thailand, Vietnam, Bhutan and others.

Some developing countries are using telemedicine and the Internet, Lun says, as a quick fix to remedy the problems of access to healthcare and quality of healthcare. Until recently only effective land-based telephony--which was not available in many developing countries--could help with these problems. Low-cost, low-orbit satellites, microwave and wireless technologies provide access to sophisticated data transfers that bring health services to many underserved areas.

"But it is important for governments and healthcare providers to use technology judiciously and to use the IT solutions in healthcare that are most appropriate to the national economy and population needs," Lun cautions.

He suggests that public-private partnerships are in the interest of both developed and developing countries. Systems integrators and turnkey solutions from European, Asian and North American countries can help push the emerging countries in Asia, Africa and Latin America to the next level of healthcare operations. Lun believes that there is great business potential in these areas to facilitate growth and close the gaps in medically and technologically underserved areas.

A world view
Lun's depth of experience demonstrates his commitment to IT.

Thus, taking the helm of IMIA in 2001 "will be a natural transition" because Lun already has demonstrated "extraordinary management abilities," says former IMIA president Marion Ball, Ph.D, who now heads up the U.S. membership through the American Medical Informatics Association (AMIA).

Lun's view of health informatics is one of a global perspective and he believes that aside from the capabilities of information transfer and dissemination, medical informatics--particularly Internet-based communication--is an important new paradigm that gives the patient access to information and communication previously available only to physicians. This new patient empowerment, he says, will change the historical "parent-child" relationship between doctors and patients to a more equitable landscape of communication.

"This is a dramatic transition from the days when patients passively accepted all physician information as indisputable fact," Lun says. The result, he predicts, will be a higher level of care.

Lun says he considers it an "honor to take on a leadership role" in IMIA and that his selection demonstrates how truly international the organization has become. "IMIA is a membership of countries and regions; there are no individual memberships," he says. "Therefore, we have the capability to truly get involved on a global level with objectives that serve a common goal of promoting universally beneficial health informatics programs."

APAMI is Asia's official representative body for IMIA. Lun, who helped establish APAMI and served as its president from 1994 to 1997, says the boom in Asia's growth promoted the formation of this group. APAMI now includes 14 countries in the Pacific Rim from Japan to New Zealand.

Barbara Hesselgrave is a healthcare writer in Luray, Va.

INTERNATIONAL WEB SITES

Asia Pacific Advanced Network Medical Informatics Working Group (APAN)
http://bullseye.aims.org.sg/apan/index.html

Asia Pacific Medical Informatics Association (APAMI)
http://www.apami.org/

Asian & Pacific Islander American Health Forum
http://www.asiaconnect.com.my/aphm/index.html

Asian Medical News Online
http://www.amn.com/frontpage.htm

Association for Informatics in Medicine Singapore (AIMS)
http://www.aims.org.sg/

China Health and Medicine
http://www.imicams.ac.cn/

China Medical Informatics Association (CMIA)
http://www.cmia.org.cn/

Diagnostic Imaging Asia Pacific (News)
http://www.di-asia-pacific.com/homepage.htm

Health One (Health Portal/English, Chinese, Malay)
http://www.health1.nus.edu.sg/

HealthWho (Internet Portal Singapore)
http://www.healthwho.com/

Hong Kong Medical Web
http://www.medicine.org.hk/home.htm

Japan Association for Medical Informatics (JAMI)
http://www.osaka-med.ac.jp/jami.html

Malaysian Medical Association (MMA)
http://www.mma.org.my/

Malaysian Pharmaceutical Society
http://www.w3xs.com/mps/index.html

Medical Association of South East Asian Nations (MASEAN)
http://www.aims.org.sg/masean/

Millennium Hope (Cancer Web Malaysia)
http://www.bplab.com.my/main/links.html

Ministry of Health Singapore
http://www.gov.sg/moh/

Philippine Medical Association
http://www.aims.org.sg/masean/philippines/

Singapore Anaesthesia Web (SAW)
http://www.aims.org.sg/saw/

Singapore Medical Association (SMA)
http://www.sma.org.sg/

UNESCO principal resource for Asia Pacific Region (PROAP) is the site of regional programs for communication, information and informatics throughout Asia and the Pacific.
http://www.unescobkk.org/

Vietnam General Association Of Medicine And Pharmacy
http://www.aims.org.sg/masean/vietnam/

Virtual Hospital Taiwan
http://taiwan.vh.org/International/taiwan.html

World Health Organization Western Pacific Region
http://www.who.org.ph/

INTERNATIONAL CALENDAR OF EVENTS

June 18-23, World Congress of Medical Technology Vancouver Convention & Exhibition Centre, Canada. Venue West Conference Services Ltd: (604) 681-5226.

June 19-21, InterMed 2000. National Trade Centre, Exhibition Place Toronto. MPE Events: (514) 731-1015, http://www.mpe.ca/intermed.

June 21-24, Security of the Distributed Electronic Patient Record. Victoria, Canada. International Medical Informatics Association Working Group 4 (IMIA WG4): +31 (0) 7136 21984, http://hinf.uvic.ca/imia_wg4.

June 22, Telemedicine and NHS in the 21st Century. Royal Society of Medicine, London. Telemedicine Forum of the Royal Society of Medicine (RSM): +44 (0) 171 290 2988, telemed@roysocmed.ac.uk.

June 24-27, INFOcus 2000. Vancouver Trade and Convention Centre. Canada's Health Informatics Association (COACH): (403) 489-4553, coach@v-wave.com, http://www.coachorg.com/.

July 2-4, International Congress for Medical Librarians, Queen Elizabeth II Conference Centre, London. Library Association Enterprises: http://www.icml.org/.

August 7-11, Asia Pacific Online Health Network Conference (APOHN), Brisbane, Australia. Centre for Online Health: enquiries-coh@dstc.edu.au, http://www.coh.uq.edu.au/.

August 23-27, ITCH 2000: An International Conference Addressing Information Technology In Community Health. University of Victoria, BC, Canada. School of Health Information Science: (250) 721-8576, his@hsd.uvic.ca.

August 27-September 1, MIE 2000 and GMDS 2000, Hannover, Germany. European Federation for Medical Informatics and the German Society for Medical Documentation and Statistics: engel@gsf.de.

August 29-31, HOSPIMedica Asia 2000, Singapore, Messe Dusseldorf Asia Pte Ltd: 65 332 9620.

September 1-3, Telehealth Kuala Lumpur 2000. Kuala Lumpur, Malaysia. Malaysian Health Informatics Association (MHIA): 603 6167788, jmohan@pc.jaring.my.

September 13-16, 3rd Nordic Congress on Telemedicine. Copenhagen, Denmark. Nordic Council of Ministers: +45 35 45 22 25, dahms@rh.dk.

September 21-23, EuroPACS 2000. Graz, Austria. Institute of Medical Informatics (IMI): ++43 316 385 3590, http://www.kfunigraz.ac.at/imiwww/europacs.

September 28-29, Asia Pacific Association for Medical Informatics Conference 2000, Hong Kong Convention and Exhibition Centre, Hong Kong. Asia Pacific Association for Medical Informatics (APAMI): http://www.apamimic2000.org.hk/.

September 28-29, MEDICOM 2000 Telemedicine Sympo-sium, Remagen/Bonn, Germany, RheinAhrCampus Remagen Department of Mathematics and Technology: ++49 (0) 26 42 / 932 318, http://www.rheinahrcampus.de/medicom/home.html.

October 2-6, 13th International Federation of Health Records Congress. Melbourne, Australia. Health Information Management Association of Australia (HIMAA): +612 98875001, http://www.himaa.%20org.au/.

October 5-7, APAMI-MIC 2000: Hong Kong China IT and Health in the 21st Century. Asia Pacific Association for Medical Informatics (APAMI): apami.mic2000@ha.org.hk.

October 24-26, HIMSS Latin America: Live the Change, Acapulco, Mexico. Health Information Management Systems Society Latin America (HIMSS Latin America): joecwarren@compuserve.com.

November 23-26, Mednet 2000: 5th World Congress on the Internet and Medicine, Vrije Universiteit Brussel, Jette, Belgium. Society for the Internet in Medicine: +32 9240 40 67, geert.thienpont@ramit.be.

December 4-9, ITU Telecom Asia. Hong Kong Exhibition Centre, China. International Telecommunication Union (ITU): +41 22 730 6039, pressinfo@itu.int.