and online services to boost job creation, promote economic prosperity and improve the daily lives of all Europeans.
The development and widespread adoption of ehealth technologies can also contribute to job creation including in new emerging professions,
treatment, care, rehabilitation and health promotion. Changes in lifestyle, empowerment of patients and relatives and better collaboration among the actors at different levels of the care chain are key parts of this process.
for every retired person there will be only 2 people working (the present ratio is 1: 4). While this trend poses extraordinary challenges in terms of adequate assistance to the elderly,
and work semiautonomously, will reduce the physical commitment needed from human carers. At the same time, it will prolong the independent living for the assisted people.
The T-Seniority pilot project developed a solution based on digital TV specifically tailored for elderly people.
the T-Seniority solution has been implemented and currently used in sites in Spain, UK and France,
The smart shoe underwent T-Seniority This project enables the elderly to obtain local and general interest information,
T-Seniority helps to strengthen social relationships and to fight the isolation often experienced by the elderly
2008-2010 CONFIDENCE The system developed works indoors, with small and low cost changes needed in the user's environment.
and specific needs, such as services for online registration of new companies or getting the unemployment rights, are met not yet fully.
the personalisation of services to better respond to users'needs and the promotion of more open, proactive and transparent administrations.
and for citizens to study, work, reside and retire anywhere in the EU. Key to this strategy is the development of large 24 scale pilot projects (LSP).
services and works by the EU public sector is estimated to be almost 20%of EU GDP (2010 figures).
The European services sector accounts for 75%of the EU's GDP and employment, and the 4. 4 million firms in this sector generate 95%of all new jobs.
and planned their next strike. We are facing an asymmetrical threat; unless addressed, this asymmetrical threat will have locked the defenders into a vicious cycle:
give advice and work bi-directionally), near-zero energy buildings and more energy-efficient transport systems.
i e. patients, medical staff and visitors. Hospilot works in two main areas: lighting and HVAC (Heating, Ventilation and Air conditioning),
which account for nearly 80%of all energy use in hospitals. Energy saving is also very important in social housing.
The project builds on existing industry standards from the ICT and the energy sectors and communication and computing capabilities which are widespread in normal houses and working environments.
and works with existing logistics. It has been designed to work for any data centre, Computing style, Monitoring and Automation frameworks
and work with the resulting rate of accidents per million miles traveled or some similar measure.
The idea of a substitution for motor vehicle travel is represented also well by teleworking or eworking (also known as telecommuting in the US)( table 2). In theory this would decrease the amount of travel time
since the provision of a reasonable level of technology would allow the individual worker to work at home
or at a teleworking center that is nearer the worker's residence than his/her usual work place.
Research by Wells and Nelson (2004) suggests that teleworking would have only a minor impact in terms of reducing emissions,
and air-quality benefits of teleworking at the disaggregate level (e g. Lake, 2003), whereas system-wide the impacts are much more modest,
due to relatively small amounts of teleworking and due to long-term (secondary) impacts counteracting the short-term savings (Mokhtarian, 1998).
) There is, however, still some potential for growth of adoption of teleworking given the type of jobs that lend themselves to this practice;
but actual teleworking remains below its potential level. ICT Innovation and Sustainability of the Transport Sector European Journal of Transport and Infrastructure Research 44 Table 2. ICT use by persons and transport demand Type of ICT use
May cause secondary impacts that counteract first impacts (substitution of work travel by not-for-work travel,
and moving further to work). E-office (internet, e-mail, portable computers, tele-servicing) Possibly reduces travel during work.
May cause increase of long distance travel because of more on the move-move working options. E-meeting (tele-and videoconferencing) Reduces travel needs to a limited extent,
The focus would be on 1) short-term effects, like travel for non-work purposes by teleworkers,
The lateral control task works by infrared sensors that measure variation in reflection of the standard markers on the road surface.
Exceptions are impacts of teleworking on travel demand and the impacts of ICT use in the transport system on fatality reduction, particularly off-vehicle speed limitation and in-vehicle driver assistance.
Page 1 Table of contents 1. Executive Summary...3 2. Ireland's Healthcare Challenge...6 2. 1 Where we stand today...
support and advice received from senior officials from the Health Services Executive, the Department of health and Children, the Department of Finance and the Health Information and Quality Authority during the preparation and review of the report.
ICT's Role in Healthcare Transformation Report of the Health ICT Industry Group Page 3 1. Executive Summary Continued progress in critical elements of Ireland's healthcare
comprising internal executives and external experts from the medical, academic and business communities to provide ongoing advice on the exploitation potential of Healthcare IT.
staff levels remain high; there remains frequent duplication of effort; and opportunities for economies of scale have been missed.
Anecdotal and real data demonstrate excessive costs for overtime, medical card payments and drugs compared with European averages.
if the IT systems better supported that work. The lack of standardised systems restricts our ability to deliver information where it's needed
Consultants and clinicians across the country are frustrated by this lack of technology and its impact on day to day operations,
and staff are proud to provide. The expectation that citizens have of healthcare services continues to rise,
They will expect to be involved more closely in planning their own care (or that of their family or dependants) in partnership with medical staff.
and a more satisfying work environment for the staff. Such a system should ICT's Role in Healthcare Transformation Report of the Health ICT Industry Group Page 10 fully exploit the benefits of information
cutting delays and speeding diagnosis. Scheduling systems can help to make the most of scarce resources (staff, beds, theatres, equipment),
independent living and better self management, and should result in fewer emergency admissions. ICT's Role in Healthcare Transformation Report of the Health ICT Industry Group Page 12 4. How ICT can help A recent publication,
or patient flow sheet from the system to help a patient set and meet self management goals;
decrease in test redundancy and unnecessary duplication. When combined with Electronic Transfer of Prescription, it also improves clinical processes for ordering,
improved utilisation of resources (staff and equipment) and leveraged additional benefit from existing ICT investments.
From either a wireless phone or a computer screen on the ward, the medical staff will be able to see some basic details of the patient including the reason for admission,
they are accepted by the ward staff, and a further message is sent to the wireless phone,
The staff on the ward can see that the patient has been accepted using the electronic whiteboard
Fewer unnecessary interruptions for medical staff to take phone calls. Improved patient safety, as the system tracks the patient from first call to the first attendance by a doctor.
including 10,000 private health staff, 220 pharmacies, 80 hospitals, 5 government administration regions, all public health ministries'resort areas and 150,
The claims office were constantly fielding calls from consultants seeking updates on claims relevant to their patients.
SMSA-BH struggled with providing its geographically dispersed medical staff with ways to collaborate, share ideas and quickly call upon the advice of experts in different fields.
Consequently, SMSA-BH patients who needed to seek consultation with specialists had to wait as long as ten days just for an appointment and an average of 15 more days for a diagnosis. SMSA-BH wanted to develop a solution that would enable its personnel to share knowledge
In 2004, SMSA-BH implemented a program called BHTELESAÚDE (BHTELEHEALTH) to promote staff education and support the agency's health professionals.
Direct benefits realised through strategic implementation of ICT Preventative Care Pre-Hospital/Primary Care Sec/Tert/Quat Care Health promotion/screening etc.
the ICT-enabled improvements will enhance the reputation of the service in the eyes of both staff and the public.
Stimulate direct job creation and business opportunities: Provide a stimulus to the 70,000 person, €20bn ICT industry by protecting
comprising internal executives and external experts from the medical, academic and business communities to provide ongoing advice on the exploitation potential of Healthcare IT.
, Jun 2009, G. Hurl, Health Service Executive The Economics of IT and Hospital Performance, 2007, Pricewaterhousecoopers ICT's Role in Healthcare Transformation Report of the Health ICT Industry
and the resulting increase in unit labor costs relative to 1 See the Staff Report for the 2012 Article IV Consultations for Italy (IMF Country Report 12/167) 4
COMTRADE, IMF staff calculations Scale-Intensive industries; where innovations are derived mainly from the exploitation of economies of scale.
COMTRADE, Fund staff calculations. Deviation from EU average, percentage points)- 10-505 10 Science-Based Specialized Supplier Traditional Scale-Based (tech) Scale-Based (resource)- 10-505
Bank of Italy, ECB, IMF staff calculations 9-15-10-505 Costs Prices Supply-Chainbased Real Effective Exchange rates (Cumulative Appreciation, percent
Bayoumi, Saito& Turunen (2013) B. Supply-Chain Based Indicators IMF Staff have developed alternative measures that address the implications of global supply chains on the assessment of price competitiveness.
Past Fund Staff research has emphasized the important role of non-price factors in supporting Italy's export performance (Lissovolik
unit values in Italy are around 1 times higher than the global mean. 4 Recent Fund staff research confirms Italy's continued success in maintaining the high quality of its export mix.
ISTAT, IMF staff calculations 11 rapidly seeking out new destinations, building a global reputation, outsourcing low valueadded activities,
DOTS, IMF staff calculations 12 Where ait, ßjt, and kt are exporter, importer, and product fixed effects that can vary across time.
For more detail, a comprehensive treatment of Italy's main economy-wide bottlenecks is provided in the most recent Article IV Staff Reports for Italy;
IMF Staff calculations using BACI database, developed by Gaulier & Zingano (2010) 19 Appendix. Shift-Share Analysis and Competitiveness (from ECB, 2012) The method envisages a decomposition of export growth based on a weighted variance analysis (ANOVA) of bilateral export data, disaggregated by product.
and M. Pianta, 2010, Innovation and Employment: a Reinvestigation Using Revised Pavitt Classes, Research Policy, Elsevier, Vol. 39 (6), pp. 799 809.
Secondly, the number of healthcare workers is expected to diminish relative to the total population (without changes to the healthcare system,
25%of the working population would be needed to provide today's level of care by 2040 in a typical western country).
Finally, Section 5 concludes the paper providing directions for future work. 2 ICT innovation in Healthcare The advance of ICT technologies is leading to the design of novel electronic healthcare services that improve people's health
A comprehensive list of existing methods is presented in 7. An example of indirect method is proposed in 8. This work aims to identify hypertensive patients who do not adhere to prescribed medication using an ontology based approach.
For instance, a patient might set strict access rules regarding his health condition and his disease and leave unrestricted access to some information
This work has been done in the context of the THECS project which is supported by the Dutch national program COMMIT. 6 References 1. Guarda, P.,
Further, it ascertains the growth rates of innovative SMES vis-à-vis non-innovative SMES in terms of sales turnover, employment, and investment.
and started work in Helsinki, Finland in 1985. The Institute undertakes applied research and policy analysis on structural changes affecting the developing and transitional economies,
Work is carried out by staff researchers and visiting scholars in Helsinki and through networks of collaborating scholars and institutions around the world. www. wider. unu. edu publications@wider. unu. edu UNU World Institute for Development Economics
along with investment growth and employment growth on gross value-added growth by means of multiple regression analysis. The paper brings out substantial evidence to argue that innovations
employment generation, export promotion, etc. Of these, the ability of SMES to innovate assumes significance
it should have in-house technological competence in the form of technically qualified and motivated entrepreneurs or managers with innovative ideas and technically skilled employees.
does that directly contribute to the growth of firm size in the form of growth of sales turnover, investment, and employment?
Internal factors could be self-motivation, technical education background, work experience, and innovative ideas of entrepreneurs.
investment and employment resulting in the growth of firm size. It is with the above theoretical framework that we have set the objectives of the study. 3 Objectives, scope,
and employment of innovative SMES vis-à-vis non-innovative SMES 6 To probe the relationship between innovation
and data on economic variables such as employment, investment, sales turnover, etc. The validity and reliability of the questionnaire was ensured and based on the knowledge and experience of the authors,
discussions held with industry experts and representatives of SME associations. Further based on a pilot study covering about 10 enterprises each in the three sectors, we did an item analysis for the questions excluding those
What is more significant is that it was to gain self employment by implementing their innovative ideas and/or to exploit market opportunities that majority of these entrepreneurs have setup their firms.
By and large, it is clear that both internal factors such as self-motivation, technical education background, work experience,
and increase capacity utilization or energy utilization or manpower utilization or improve inventory management or enter the international market.
In this context, a comparative growth analysis in terms of sales, investment and employment for innovative and non-innovative SMES is appropriate. 5 Innovative and non-innovative SMES:
and employment The growth performance of SMES has been analysed in terms of sales turnover, investment, and employment. The growth performance has been analysed for all the SMES of each sector for innovative and non-innovative SMES separately and within the innovative group of SMES, for innovative SMES
We have gathered data on sales at current prices as well as on employment and the current value of investment (in plant and machinery) from the SMES of auto
While the calculation of the growth of employment is fairly simple, it is necessary to make the five years'data on sales comparable by converting the values of current prices into values at constant prices.
and employment for innovative and non-innovative SMES. It is clear that innovative SMES have registered a higher rate of growth compared to non-innovative SMES in terms of sales, investment,
and employment in all the three sectors. However the growth rates of the three variables differ within as well as between sectors.
In the auto component sector, both innovative and non-innovative SMES registered a higher growth of investment followed by sales and then employment.
In fact, employment of non-innovative SMES declined absolutely. In the electronics and machine tool sectors, sales growth was higher than that of investment
and investment growth was higher than that of employment for both innovative and noninnovative SMES.
In the electronics sector, non-innovative SMES registered negative growth in terms of investment and employment. Overall, the growth analyses for the three sectors clearly indicate that innovative SMES are better off relative to noninnovative SMES.
and labour would depend more on how far they have been able to satisfy their customers'needs and requirements rather than on the nature of innovations in terms of new products/processes or improved products/processes.
along with rate of growth of capital as well as that of labour, has a significant influence on the rate of growth of sales turnover of innovative SMES.
Similarly, Kg and Lg are CARG of capital and labour, respectively, during 2001/2 2005/6 and ISP is average percentage of innovated products in total sales of individual SMES during 2001/2 to 2005/6.
Since we did not find any statistically significant interaction effects of industries/sectors with the explanatory variables of labour and capital,
equally important is the increase in capital as well as labour. Thus if an innovative SME could expand the scale of production in terms of capital
and labour and achieve an increase in innovation sales, it will be able to experience a significant improvement in the growth of GVA.
Innovative SMES registered higher growth relative to non-innovative SMES in terms of not only sales turnover but also employment and investment in all the three sectors.
along with investment growth and employment growth, had a positive influence on GVA growth, in all the three sectors.
'Staff Working Paper 441. WASHINGTON DC: World bank. Cosh, A, . and A. Hughes (eds)( 1996).‘‘The Changing State of British Enterprise:
2. 3 2. 6 Manpower utilization 7 7 4 15 14 11 12 12 11 2. 1 1. 8 2
15.53-1. 81 22.17 8. 75 Employment 14.43-14.63 7. 06-20.34 6. 87 3. 27 Note:*
)**IP&P (25)**Sales 15.91 32.24 14.48 23.09 22.44 17.71 Investment 28.60 19.98 16.07 9. 49 20.17 24.39 Employment 13.95 16.79
Innovation and growth of SMES Internal Factor (Firm Level competence)- Self-motivation-Technical education & entrepreneurship-Work experience-Innovative ideas External Factors (Market Pressure
, Employment and Investment Drivers Dimensions Achievements Outcomes
OECD Health Policy Studies Improving Health Sector Efficiency The Role of Infor mation and Communication Tech nologies OECD Health Policy Studies Improving Health
and work to coordinate domestic and international policies. The OECD member countries are: Australia, Austria, Belgium, Canada, the Czech republic, Denmark, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Japan, Korea, Luxembourg, Mexico, The netherlands, New zealand
, Norway, Poland, Portugal, the Slovak Republic, Spain, Sweden, Switzerland, Turkey, the United kingdom and the United states. The Commission of the European communities takes part in the work of the OECD. OECD Publishing disseminates widely the results of the Organisation's statistics gathering
. This work is published on the responsibility of the Secretary-general of the OECD The opinions expressed
The Expert Group provided technical input and feedback on the work at three meetings convened during the course of the project.
An additional expert meeting was organised by the BIAC at OECD Headquarters in 2007 under the OECD Labour Management Programme.
The authors would like to express particular thanks to country experts who aided in the implementation of case studies,
Bill Pattinson (Australia) assisted the Secretariat as an outside expert consultant on background work for the chapter on monitoring
9 Executive summary...11 Introduction...25 Chapter 1. Generating Value from Health ICTS Introduction...32 1. 1. Health information technology can drive improvements in quality and efficiency in health care...
it is clear from the case studies in this report that these tools are perceived as substantially increasing the safety of medical care by generating a culture of safety, improving clinical staff actions and workflows,
and initiatives to increase provider awareness, including through the promotion of adverse event reporting. Chronic disease is the biggest obstacle to the sustainability of many public health-care systems.
Experience in other sectors shows that these functional improvements can have a positive effect on staff productivity.
Data from 22 sites in British columbia show that report 14 EXECUTIVE SUMMARY IMPROVING HEALTH SECTOR EFFICIENCY:
experts in Massachusetts (United states) reported huge administrative cost savings as a result of introducing electronic claim processing through the New england Healthcare Electronic Data Interchange Network (NEHEN),
benchmarking and 16 EXECUTIVE SUMMARY IMPROVING HEALTH SECTOR EFFICIENCY: THE ROLE OF INFORMATION AND COMMUNICATION TECHNOLOGIES OECD 2010 identification of quality improvement opportunities.
particularly in countries where physicians are remunerated on the basis of fee-for-service. 18 EXECUTIVE SUMMARY IMPROVING HEALTH SECTOR EFFICIENCY:
policy approaches that link financial incentives (e g. bonus payments) to the adoption and use of ICTS for specific tasks
THE ROLE OF INFORMATION AND COMMUNICATION TECHNOLOGIES OECD 2010 Enabling robust and reliable privacy and security frameworks Health information can be extremely sensitive and professional ethics in health care demands a strict adherence
The effective and consistent collection of 24 EXECUTIVE SUMMARY IMPROVING HEALTH SECTOR EFFICIENCY: THE ROLE OF INFORMATION AND COMMUNICATION TECHNOLOGIES OECD 2010 data from the patient's primary care record can facilitate greater efficiency
Adoption has remained remarkably uneven despite more than a decade of promotion and significant public investment. There are large variations particularly in the adoption
and patient management solutions developed by the Great Southern Managed Health Network in Western australia (Box 1. 1). It is clear from interviews that they can substantially improve the safety of medical care by improving clinical staff actions/workflows and bringing evidence-based,
Decision support tools, such as flow sheets, were developed to guide daily work, and substantial efforts were made to foster self management.
The most frequently cited effect of ICTS on efficiency is reduced related to utilisation of health care services On efficiency,
Experience in other sectors shows that this can have a positive effect on staff productivity.
ICTS can reduce some of the work involved in collecting patient information and getting it to where it is needed.
since labour typically represents the lion's share of dispensing costs in community pharmacies. This could improve customer satisfaction,
while also allowing staff to provide new services that could help diversify the pharmacy's revenue base. 1. 3. Reports on cost-savings tend to be anecdotal in nature In the countries covered by the case studies,
experts in Massachusetts reported staggering administrative cost savings as a result of introducing electronic claims processing through the New england Healthcare Electronic Data Interchange Network (NEHEN),
Claims that cost USD 5. 00 to submit in labour costs per CHAPTER 1. GENERATING VALUE FROM HEALTH ICTS 41 IMPROVING HEALTH SECTOR EFFICIENCY:
However, across most OECD countries, measuring the quality of the health care is a labour-intensive
and performance experts to develop standardised and nationally-recognised metrics that can be used to monitor impacts on quality and cost of care.
while consumers and payers (e g. health plan and employer) are the ones most likely to reap the significant savings.
Offer nonfinancial incentives to physicians, like awards, promotions, etc. Set in place a system of quality control to monitor
or diverted from other work. Even with such an investment, differences in the underlying architecture of EHR systems,
OECD (2007), Improved Health System Performance through Better Care Coordination, OECD Health Working papers No. 30, Directorate for Employment, Labour and Social affairs, OECD Publishing, www
and GPS stood to achieve additional income amounting to 30%of their salary. This required a 20%increase in the NHS GP budget.
The bonus payments authorised by ARRA offer significant inducement for providers to adopt and use EHRS
Beaulieu, N d. and D. R. Horrigan (2005), Putting Smart money to Work for Quality Improvement, Health Services Research, Vol. 40, pp. 1318-1334.
The Health IT Policy Committee in the United states (Certification and Adoption Work Group meeting of 14 july 2009) 5 recently noted the issues listed below pertaining to certification of EHRS that are equally reflective of commonly-held certification concerns in other countries:
billing, scheduling, EMR, workflow, ergonomics, and clinical decision support. In Alberta, the products that were tested
the risk increases that stigmatising disclosures could affect areas such as employment status, access to health insurance and other forms of insurance,
As such, patient recruitment became a preeminent concern for the HIE enterprise, if it was to be viable.
Intention to adopt addresses the propensity of users to adopt these applications in their clinical work,
and reduce redundancies in the establishment of a national/local e-health strategy. They are used commonly by countries
Indicators for International Comparisons of Health ICT Adoption and Use, Document DELSA/HEA (2008) 15/REV1, Directorate for Employment, Labour and Social affairs, OECD Publishing, Paris
pragmatic progress and promising potential, Powerpoint presentation to OECD Expert Meeting on ICT in the Health Sector, Paris. Riksrevisjonen (Office of the Auditor General of Norway)( 2008), Riksrevisjonens
and impacts of electronic messaging have been noted by GPS, allied professionals, staff in hospitals and the Western australia Country Health Services.
which includes preventive and health promotion activity, as well as education and capacity building. Outreach models are characterised by the periodic supply of a range of health services from one location
It was acknowledged that the UWA Centre for Software Practice had been a critical, if not major factor in the successful implementation of the project, both for the enthusiastic dedication of its staff, the not for profit nature of the partnership and the extensive expertise in software
engaging physicians in the work of jointly pursuing primary care renewal and better care for patients in the North.
Governance Successful implementation was based on the development of largely positive working relationships and partnerships between NHA staff and physicians.
Physician leadership The project originated with a medical professional organisation interested in promoting the quality and safety of medical care.
and experts in quality and safety to help set the agenda and facilitate the process.
and sharing with the stroke unit experts at Son Dureta. Integrated picture archiving and communications system (PACS) for the management of radiological images from community hospitals.
developing, and operating the underlying infrastructure that has enabled the programme to work. Central to the programme, Ib-Salut's Hospital Son Dureta in Palma, ANNEX A. COUNTRY CASE STUDIES 143 IMPROVING HEALTH SECTOR EFFICIENCY:
The work of locum GPS is demanding because of patients with a wide range of problems and needs and of the urgency of many problems.
and approved by professional associations; 2) implement a patient management system within two years from the purchase of a computer;
THE ROLE OF INFORMATION AND COMMUNICATION TECHNOLOGIES OECD 2010 independent expert organisation providing guidance on infrastructure and standards related to the national EHR effort.
THE ROLE OF INFORMATION AND COMMUNICATION TECHNOLOGIES OECD 2010 Annex B. Project background and methodology This report builds on activities carried out under two distinct but overlapping work streams.
Activity on work stream 1 has focused on collecting information on how OECD countries are monitoring health ICTS,
On work stream 2, the project has proceeded in several phases. First, a scoping paper was commissioned to review the strength of the available evidence on the impacts of ICTS on productivity and efficiency in the health sector.
and consider how the work could best be carried out. Given the dearth of data, the workshop concluded that implementation of case studies would be the most promising approach.
A group of OECD experts in health information technology was established to help guide the work, the development of a framework for the selection and analysis of case studies and interpretation of results.
The number of interviews conducted was determined together with experts of the host country and by an assessment of the characteristics of the proposed case studies, including the variables under investigation,
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