ICT Innovation Vouchers Scheme for Regions The ICT innovation voucher aims to support micro-enterprises and SMES to use digital technologies to innovate
The aim is to encourage the use of new ICT-based business models. Each scheme is tailored
Micro-enterprises and SMES benefitting from a voucher can exchange the latter against ICT services, including services from private companies,
universities, research centres and other accredited ICT knowledge and service providers. The voucher provides the company with easy access to specialist services,
such as creating a business website and using it profitably, learning to use e-commerce tools to buy or sell,
Some of the Innovation vouchers'programme managers took the opportunity to share their experience as implementing bodies during the workshop(/digital-agenda/news/ict-innovation-vouchers-workshop-exchanging-bestpractices) organised in the context of the Open Days 2014
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.
and Enterprise Ireland, BT and Microsoft for the provision of physical and electronic facilities to support the activities of the group.
Health Service Transformation cannot be achieved without ICT The HSE Transformation Programme calls out six transformation priorities that refer to easily accessible integrated health services,
Indeed, senior clinicians have stated that investing to improve our ICT capability is now more important than additional investment in clinical facilities.
the sheer scale of the opportunity becomes clear. As examples, we could achieve: -€195m annual saving by treating chronic illness in the home €79m annual saving through the use of electronic patient records to improve hospital processes
savings, improved patient safety and improved access to care are made possible through ICT investment in areas
we need to substantially increase our investment in, and our effective use of ICT. The HSE needs to focus on a structured,
Innovative approaches to project financing may also be possible in some areas to reduce the upfront investment cost to the HSE.
Investing for a potential 400%return As an indication of the scale of the investment,
The additional investment will enable the implementation of a wide range of patient care and administrative applications delivered via a robust and secure infrastructure.
Industry experience indicates that the breakeven time for the individual investments in such a programme will vary from less than 1 year to 5 years.
In the longer term, a European commission study2 indicates a typical lifetime Return on Investment of 400%for advanced Healthcare ICT systems.
To ensure that we maximise the return from the high levels of investment involved, clear focus will be required on the definition and quantification of objectives, programme management and benefits realisation.
The positive participation of all stakeholders is essential and the introduction of financial incentives may be required to ensure such participation.
As part of the move towards a smart economy, the government directs Enterprise Ireland to establish a healthcare technology cluster.
we will also begin to position Ireland as a world class supplier of healthcare services and healthcare ICT systems for the global market.
In this way we will establish valuable assets for the new smart economy. ICT's Role in Healthcare Transformation Report of the Health ICT Industry Group Page 6 2. Ireland's Healthcare Challenge 2. 1 Where we stand today Despite much progress over recent decades,
and our cancer services are reaching world class standards with increasing survival rates. The substantial progress achieved has recently been indicated in the Euro Health Consumer Index 2009,
where Ireland has made a significant improvement to 13th place out of 33 European health services reviewed.
In the UK and Europe, there is considerable effort to manage the growth of private healthcare services.
and opportunities for economies of scale have been missed. The change of focus from Acute to Primary care has been slow,
The economic downturn has exacerbated the existing financial crisis across the HSE. We have evolved as one of the most expensive health service in the OECD,
Opportunities for shared services have not been exploited, with excessive levels of staffing across multiple procurement offices, labs and other facilities.
For example we have failed to implement systems such as Computerised Practitioner Order Entry (CPOE), also known as Order Communications
investment in Healthcare ICT is more important than additional clinical facilities. ICT's Role in Healthcare Transformation Report of the Health ICT Industry Group Page 8 2. 2 The role of ICT in the HSE Transformation Clearly the underinvestment in ICT has caused not all the
However, as with complex service enterprises such as airlines, insurance and banking, the transformation needed cannot take place without significant investment in ICT and the co-requisite business process re-engineering.
which will meet the requirements of all the stakeholders-patients, professionals and taxpayers. The urgent need to address the ICT deficit
These challenges include funding the investment effective process re-engineering, systems implementation, and the HSE's capacity to absorb
and strategy for healthcare, including elements such as public health education and improvement, engaging all stakeholders in the planning and delivery of healthcare services,
and services that they have confidence in and staff are proud to provide. The expectation that citizens have of healthcare services continues to rise,
and steps need to be taken to understand and respond to these demands. Advances in medical science, especially in the areas of diagnostics, therapeutic medicines and surgical procedures, are suggesting a future where many medical conditions will be predicted,
discovered and treated at an early stage and with minimum risk and impact on the patient.
the adoption of mobile and digital services in other areas of life will cause many to question why they have to travel to obtain medical care,
and exceed these demands, delivering a better patient experience, fewer unplanned demands on clinical resources,
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
and communications technology (ICT for Health or‘ehealth')to help deliver the following results: 3. 1 Better patient care (Safe, Effective) 3‘Safe'means avoiding injuries to patients from the care that is intended to help them (preventable medical errors In many instances medication errors
-Right Patient, Right Medication, Right Dose, Right Route, Right Time‘Effective'is about providing services based on scientific knowledge, also known as evidence-based medicine.
which use graphics to aid communications. Geographical challenges can be overcome by emerging ehealth innovations such as telemedicine for remote consultations, teleradiology for remote expert readings, home patient monitoring of chronic diseases,
efficiently and effectively meeting the increasing demands of stakeholders in the healthcare environment, patients, professionals and funders.
allowing stakeholders in the patient's health to access this information remotely. Access to this information allows for continuity of care between different care delivery organisations or other organisations, such as social services,
making the registry a complete chronic care record. 4. 3 Computerised Practitioner Order Entry (CPOE) Computerised practitioner/(or physician) order entry (CPOE), also known as Order Communications,
but in highly integrated environment can often be found embedded in systems such as Patient Portals, Self service Applications and Personal Health Records.
and best practices for the better management of certain conditions. 4. 8 Telemedicine Telemedicine consists of a series of technologies that enable care services to be provided remotely.
and health authorities have achieved large benefits from the investment and utilisation of ICT. They have driven improvement in patient care and satisfaction;
improved utilisation of resources (staff and equipment) and leveraged additional benefit from existing ICT investments.
By integrating electronic health records and other decision support tools within the clinical care environment,
while streamlining crucial processes within the hospital including electronic management of medication administration, provision of access to evidence-based clinical data for clinicians and identification of opportunities for clinical, operational, financial and regulatory
Transition from a reactive to a pro-active system better communications. Sharing of bed management information for all locations, reducing the need for walkabouts.
Denmark wanted to increase communication between its various public and private healthcare providers, including GPS, pharmacies, hospitals and clinics.
Enterprise-wide collaboration software. Overview: The Secretaria Municipal de Saúde de Belo Horizonte (SMSA-BH), reorganised its citywide health services and defined nine health districts that each serve a certain geographic, population
and administrative space. In total, SMSA-BH operates 137 healthcare centres, six emergency centres and more than 40 associated hospitals.
Doctors use the software's instant messaging capability to consult with each other for quick questions or opinions in a secure real-time environment.
and the second are the indirect benefits to The irish economy through the positioning of healthcare ICT as key component of the development of the‘smart'economy. 6. 1 Direct Benefits‘The Patient
) in hospitals Ambulatory Care Level Enable the delivery of healthcare services in the patient's home through home health monitoring Availability of entire healthcare record at any ambulatory care facility the patient attends,
resulting in potential opportunity savings of almost €300 million. In the Czech republic alone there are over 2. 1 million acute admissions every year
resulting in opportunity savings of over €131 million. ICT's Role in Healthcare Transformation Report of the Health ICT Industry Group Page 24 6. 1. 3 Care Pathway/Patient Flow Reducing Diabetic
resulting in opportunity savings of over €460 million. 6. 1. 5 Primary/Secondary Care Integration Increase in Number of General practitioner (GP) Appointments through Electronic Medical record Almost 65 million
This in turn could result in potential opportunity savings equivalent to nearly €3. 7 billion. In The netherlands alone, 560,000 bed-days could be made available through the same technology,
equalling potential opportunity savings of up to €600 million. Increasing Availability of Secondary Care Appointments through Electronic Appointment Booking The number of wasted appointments or Did Not Attends (DNA) in secondary care in England could be reduced through the use of Electronic Appointment Booking systems by 600,000,
implying a potential opportunity saving over €130 million. Reduction in Waiting Times through Electronic Appointment Booking Patients in France could see a doctor 5. 3 days sooner through the use of Electronic Appointment Booking.
and Chronic Disease Management Systems Patients in France could see a reduction in readmission to hospital for CHF of over 39,000 reaching opportunity savings of over €110 million through EMR with CDMS. 6. 1
conditions through access to knowledge based best practices via an EMR with Chronic Disease Management capabilities and communication with their physicians through a Patient Portal.
with government encouragement, the HSE increases its investment in Healthcare ICT, and systems progressively go into operation,
Co-requisite with the investment in new ICT systems will be the task of process transformation within the HSE.
and will create an environment where willingness to adapt will bring demonstrable benefit to those involved.
monitor and forecast future healthcare demand. Increased perception of value delivered from the healthcare service: By driving the more effective delivery of high calibre services from the overall investment in our health service,
the ICT-enabled improvements will enhance the reputation of the service in the eyes of both staff and the public.
and may also provide a better environment to help tackle community programmes relating to lifestyle and behavioural illness. 6. 2. 2 Indirect Benefit to the Economy In addition to the benefits
indirect benefits can be generated for the economy as a whole. Healthcare is increasingly becoming an internationally traded service
or consumers of medical services, depending on their capabilities and capacities. Clearly one of the factors that will influence Ireland's reputation in those markets is our competitive position in all aspects of modern medicine,
and business-friendly environment, Ireland has a tremendous opportunity to exploit multiple opportunities in these international markets.
helping us become a world-class supplier of healthcare services to the rapidly growing international market.
Stimulate direct job creation and business opportunities: Provide a stimulus to the 70,000 person, €20bn ICT industry by protecting
Attract large Healthcare ICT investments to Ireland: Position Ireland with clear demonstrable capability in a strong and vibrant healthcare ICT cluster,
helping attract further inward investment and support the development of the smart economy. Achieve a leadership position in Healthcare ICT:
and also laying the foundations for a new growth engine within the smart economy. In order to prepare for this journey we make the following nine recommendations:
As part of the move towards a smart economy, the government directs Enterprise Ireland to establish a healthcare technology cluster.
we will also begin to position Ireland as a world class supplier of healthcare services and healthcare ICT systems for the global market.
In this way we will establish valuable assets for the new smart economy. ICT's Role in Healthcare Transformation Report of the Health ICT Industry Group Page 30 Bibliography ehealth for a Healthier Europe!
States and the European commission on boosting ehealth investment, Alexander Dobrev, empirica, Germany, Tom jones, Tanjent, UK, Veli N. Stroetmann, Karl A. Stroetmann, Jörg Artmann, Anne Kersting
Congressional Budget Office IT for Healthcare, Market Trends, Nov 2008, Enterprise Ireland Euro Health Consumer Index 2009 Report
, 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
which continues to evolve in line with a rapidly changing global economy. This paper will offer a comprehensive assessment of Italy's external competitiveness,
outlining how they might perhaps be augmented in the context of an increasingly integrated global economy. The following sections will then focus on the evolution of Italy's export share;
focusing in particular on the role of innovation in shaping the economy's continued trading success. The concluding section will outline some implications for the Italian authorities'structural reform agenda.
Over the past two decades, discussion of the Italian economy has centered increasingly on the key themes of weak growth and competitiveness.
which has produced a stagnant economy and a labor market in which average earnings are largely decoupled from productivity and demand conditions.
With Italian trading partners introducing productivity-enhancing reforms, and with the historical escape route of competitive devaluation unavailable, this has resulted supposedly in a sizable competitiveness gap,
which has weighed down on investment, confidence and growth (Manasse, 2013). Against this backdrop, however, Italian exports have held up relatively well (in value terms).
Most recently, the buoyancy of exports in the face of depressed global demand has underscored the continued adaptability and resilience of Italian trading firms.
For Italian firms facing increased cost-based competition from emerging-market exporters, the former has perhaps become more and more important.
and adapt to a changing global environment. Although the economy as a whole may have faced difficulty integrating and exploiting new technologies to boost performance reflecting perhaps a broad range of structural and administrative impediments it may be that Italian exporters have had better success. To this end,
the chapter will separate Italy's exporting industries by their sources of innovation: extending the Pavitt (1984) Industrial Taxonomy,
The Conference Board, Total Economy Database 6 0%20%40%60%80%100%1995 2007 2011 Export Shares, by Industry Group Science
) Using a total-economy ULC-based measure, Italy's competitiveness appears to have deteriorated by up to 5 percent
rising wages may reflect the creation of higher-level jobs in an increasingly innovative and technologically competitive economy.
but rather in the supply of finalassembly services, which form only a small portion of the iphone's final price.
and improving on the (labor-focused) ULC indicator in the previous section, the VA-REER thus captures the overall cost competitiveness of the full range of a country's factors of production.
to include an additional term that reflects the role of outsourcing in offsetting the impact of domestic factor-price inflation (Bayoumi, Saito, & Turunen, 2013.
therefore more on the actual price competitiveness of a country's gross exports, rather than its factors of production.
owing in part to role of low-cost imports from low inflation countries. Interestingly, Germany presents the opposite picture.
owing to the fact that Germany imports a large and increasing proportion of its inputs from countries with relatively high inflation.
NON-PRICE COMPETITIVENESS A. Quality Indicators The relative strength of Italian exporters may also reflect their ongoing efforts to fend off competition by upgrading the quality of their products.
In a stable world economy, changes in competitiveness might indeed be captured by changes in relative prices.
In an evolving global economy, however, a country's competitiveness may also reflect the ability of its exporting firms to adapt successfully to a changing external environment;
upgrading the quality and composition of their export mix, 4wto/UNCTAD relative unit-value data is available at:
but for the precrisis period (1995 2007), the figure below suggests that Italy has managed generally to orient its exports to markets with a rapidly expanding demand for imports,
and administrative impediments that have helped stifle growth in the broader Italian economy; and which are now weighing even on this once-dynamic sector.
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;
. and P. Howitt, 2009, The Economics of Growth,(MIT Press). Bank of Italy, 2009, Reports on Trends in the Italian Productive System, Occasional Paper No. 45 (Bank of Italy:
French Exports in the Turmoil, Journal of International Economics, Elsevier, Vol. 87 (1), pp. 134 46.
Working Paper 2009 2,(Department of the treasury, Italian Ministry of the Economy and of Finance. Crafts, N,
and I. Bunda, 2008, The Changing Role of the Exchange rate in a Globalised Economy, Occasional Paper Series, No 94,(European central bank).
Manasse, P.,2013, The Roots of the Italian Stagnation, CEPR Policy Insight No. 66,(Centre for Economic policy Research.
Innovation in information and communication technology has a great potential to create large impact on modern healthcare.
To ensure the adoption of new healthcare services, the new innovative technologies need to be complemented with new methods that can help patients to establish trust in healthcare service providers in terms of privacy, reliability,
This paper sketches various lines of research for the development of trusted healthcare services namely, patient compliance, reliability of information in healthcare,
and user-friendly access control. 1 Introduction The high bandwidth connectivity provided by the Internet enables new services to support citizens in their daily lives.
An important category of these services is healthcare services. The first examples of these services already exist today,
and soon new services will emerge offering increased sophistication and improved but cheaper healthcare. An exponential growth of these services is expected, due to two tenden-cies.
First, demand for care and cure will increase over the next decades caused by the ageing population (within 40 years,
one in every four people will be over 60). 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).
New ICT supported healthcare services can overcome this problem by allowing people not to rely only on traditional care.
However, to ensure the adoption of new healthcare services, the new innovative technologies need to be complemented with new methods that can address related ethical and societal issues.
Current home healthcare services are rudimentary in nature. Often they rely on call centers or nurses visiting the patient
Trust is a requirement for the widespread adop-tion of healthcare services by clients (patients
In this paper, we present the research lines for trust management in home healthcare services. Home healthcare services aim to support people who are chronically ill
or who are rehabilitating. These services gather patient's sensitive information that is then interpreted by medical professionals to manage their diseases.
The adoption of such services, however, hardly relies on the patients'trust in a healthcare service provider in terms of privacy of the data chain
and physicians'trust in the reliability of information and data contributed by patients. In particular a number of questions should be addressed:
How can patients use home healthcare services while ensuring their privacy and controlling the use of information in a simple intuitive way?
Section 3 discusses the problem of trust towards healthcare services. Section 4 discusses trust management for home healthcare services.
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
and well-being but also extend beyond the individual towards sustainability of our society. Consequently, many countries created policies to foster innovation and spread the successful adoption of these technologies in their healthcare sector.
and provide faster and cheaper healthcare services. On the other hand, they are exposed to different security and safety threats as the patient is far from healthcare providers,
and search electronic health data, thereby endangering people's privacy. 3 Trusted Healthcare Services Electronic healthcare services offer important economic and social benefits for our society.
Patients rely on these services for their safety and care and for improving their quality of life. For physicians, electronic health and wellness services offer support for providing more effective and continuous Care for insurers and governments,
these services bring a reduction of costs, and for commercial service providers, this is a new business opportunity.
However, electronic healthcare services cannot be exploited until the trust question has been addressed in a fundamentally correct way.
Indeed trust is a prerequisite for the acceptance of these services by end users. Trust establishment is crucial for physicians
and service providers as they will use healthcare services to implement and extent (medical) treatments.
In particular, healthcare providers need to trust the patient data they obtain remotely from the measurement devices deployed in patient's home.
It is crucial for them to know that a vital sign of a registered user is measured (not of his friends/children),
trust is also of special relevance because healthcare services deal with very personal and private information.
Home healthcare services monitor patients and gather data that is interpreted by medical professionals. Health and well-ness services support people in need in many ways on the basis of personal and health related information.
People in health communities share health and well-being information which then becomes potentially available to the whole community and beyond.
stating that their electronic health records cannot be shared electronically. 2 To facilitate the acceptance of electronic healthcare services,
Standard Internet security techniques provide authentication and encryption of the communication with a service provider. However
The THECS project addresses the very important trust questions (transparency, privacy and security) for healthcare services.
The project addresses trust as one of the key issues for new electronic healthcare services.
This notion is new for electronic healthcare services (and for Internet services in general), and it is fundamental for their success. The objective of THECS is to create new techniques for measuring
and to benefit from these new services. The concrete goal of the THECS project is to create and define:
Ethical, legal, sociological and psychological requirements for trust in healthcare services. The spectrum of healthcare services is very wide,
ranging from formal medical services to pure commercial services that support every day activities. Often these services share information.
It is this integration of services from different domains and information sharing that is of particular interest.
A technical protocol to reliably assess the quality of medical data (e g.,, blood pressure) measured by patients at home, e g.,
, identification of the patient, compliance with measurement protocol, certification of the measurement device. A cryptographic technology that enables health service providers to process encrypted medical information
In the remainder of this paper, we will focus on trust management for home healthcare services. 4 Trust Management for Home Healthcare Services Home healthcare services have been proposed to decrease the cost of healthcare while making it more comfortable for the patient.
These services aim to support people who are chronically ill (e g. post-stroke, diabetes, Chronic obstructive pulmonary disease (COPD)) or who are rehabilitating.
The adoption of such services, however, hardly relies on the trust that both patients and medical professionals have provided in the healthcare services.
In particular, a number of questions should be addressed: How can compliance with a treatment be measured reliably?
How can patients use home healthcare services while ensuring their privacy and controlling the use of information in a simple intuitive way?
In the remainder of the section, we discuss various research lines to address these challenges. 4. 1 Patient Compliance In home healthcare services,
we need comprehensive solutions for measuring patient compliance for home healthcare services. The development of such solutions requires investigating
where patients rate the services of doctors and healthcare providers via a web portal or a health oriented network 20,
Additional problems appeared with the growing use of web portals rating healthcare services. Patients often subscribe to expert websites and search information regarding their illness on the Internet.
on addressing the problem of trust in home healthcare services. Moreover, to reassure patient safety,
and tools that visualize indicators for data reliability in a way that is understandable by end-users. 4. 3 User friendly advanced access control Healthcare services deal with very personal and sensitive information.
while posing strict constraints on the access to sensitive information, the system has to cope with the dynamic environment of healthcare
For instance, various enterprises designed platforms which allow users to set their privacy and access control policies.
The design of a user-friendly access control model demands to conceptually divide the access control model in two layers:
A fundamental need is to design novel electronic healthcare services that improve people's health
the adoption of electronic healthcare services relies also on ethical and societal aspects such as the trust that end-users (e g.,
, patients and physicians) has towards such services. In this paper we discussed the challenges for developing trusted home healthcare services.
The THECS project addresses the issue of trust in healthcare services. In particular, the project aims to define the technology necessary to deploy trusted healthcare services.
We presented various lines of research which will be investigated also within the project to address such challenges, namely patient compliance, reliability of information in healthcare,
and user-friendly access control. Acknowledgements. This work has been done in the context of the THECS project
Proceedings of the 2nd International Symposium on Applied sciences in Biomedical and Communication Technologies. 2009) 1 6 14.
IFIP Advances in Information and Communication Technology 330. Springer (2010) 277 288 35. Pearson, S.,Shen, Y.,Mowbray, M.:
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