 I have the same pleasure of working here today to open and speak at all to those of you who are not as a cat or like others who are about to listen with you, the doctors, nurses and health care managers, the needs and advances in electronic health. Every minute counts when you need the accurate information from patients going to history in the new advances. There are new advances today in electronic health which can deliver the slightly information when you need it the most. E-Health can support the clinician and deliver the services designed around the patient quickly, conveniently and very seamlessly. E-Health will speed up the referral process which will save vital time when needed to refer your patient to any specialist unit. E-Health will ultimately give you the right information at the right time. It's indeed my honour first to welcome our guest speaker, the incoming chair of the Health Information Management Systems Society, Dr Barry Shorting. Thank you so much for having me today. I greatly appreciate that this invitation is the first time I've been to this country and I always look forward to coming to this part of the world. There are many parts of the world, this is one small part that I have not been to. So it's really wonderful for me to be able to come here and get to meet all of you and actually see myself, the wonderful things that are going on in this part of the world particularly in this country. So first, thank you so much. And I appreciate you taking the time this morning to listen to me talk a little bit about the HIMS E-Health vision as well as some other concepts I have around the areas around clinical transformation, quality of care and related IT issues. Hopefully we will have a really good interaction through my presentation. What I plan to do is speak for about 25 or 30 minutes and then open it up to questions so I can answer some of the things that might be on your mind. Please feel free if you have a question about something or don't understand something that I'm talking about, just raise your hand or call out and I'm happy to address those issues with you. Take a short moment and I'm going to talk a little bit about costs of healthcare. Go quickly through that because I think many of you are familiar with it. I'll talk a little bit about the E-Health vision, collaboration and partnerships. A bit about my experiences in clinical adoption and then something that I think is very important is innovation and transformation, the key to be able to take an E-Health vision of what you want to do when using E-Health and get it actually to be used. As you might imagine, it's something us in the US are very much struggling with. Paul Romer is a famous economist from Stanford. He said a crisis is a terrible thing to waste. Well, considering the economic conditions that are going on around the world, we all have a crisis there and when you have a crisis, when you have a problem, it's the opportunity to solve the problem. When we want to be able to use electronic health records or other types of health IT to improve healthcare, to be able to increase access, to be able to reduce costs, that's a crisis. We should take those opportunity, those tools, and use them effectively. The US spends billions and billions of dollars in healthcare, more than any other country in the world, in a per capita basis or in an actual basis. And they tune up over $2 trillion solely on healthcare. It's something that the US really can't afford. And frankly, there's no country in the world that can afford to spend these huge amounts on healthcare. Because when you're spending money on healthcare, you're not spending money on some other things. Here's a graph that I'll show you a little bit about what the rest of the world is spending on healthcare. In the US is anywhere from $6,400 per capita to over $7,000 per capita. And there's no reason for us to believe that that's going to stop anytime soon. What we need to do is we need to use new information technology tools to address those issues, not only in the US, but in every single country. Medical events are occurring at such a rapid pace, not only in the technology, but also in the knowledge. If we fail to use health IT tools to address that issue, to be able to move forward in using the best possible information we have to treat patients, we'll spend a lot of time, and more importantly, a lot of money on things that are not going to make patients better and will reduce the availability of other resources to help make patients better. We have to spend our money wisely on healthcare, and that's how we're going to use health information technology. Let me talk a little bit about the ARC health vision that not only is for HEMs, but also is for me personally. Is that what I believe is the place for health IT. In the US, we formed something called the National Heat Health Collaborative, which I'll talk about in a second. It hits the Health Care Information Technology Standards Panel, CCHIT, which is the Certification Commission for Health Information Technology. Last week, we organized an office for the National Center for Health IT. What's the National Heat Health Collaborative? Well, that was called AHIP. What our Secretary of Health and Human Services did several years ago was try to bring together all stakeholders in the heat health so that they would speak to each other about the issues to accomplish the use, using health information technology effectively in the US. It was a government-informed committee, but it was made up of all types of stakeholders. The focus was on quality, safety, and cost. All of those issues are related. The development aid aims were using health IT systems, understanding the infrastructure that would be used to support those health IT systems. You need to have the broadband, you need to have the connectivity. Standards, which hits the addresses, which is if you have two systems and they don't use the same standards and they send information to each other, there is absolutely no way that they'd be able to communicate with each other. A good example of what we've been incredibly successful with around the world is standards around banking. If you send a message that's from one banking system to another, they understand each other. That's why I'm able to go to a bank here in this country and take out the local currency. I can do that anywhere in the world. Twenty years ago, I could not do that, and the reason why it was none of that interconnectivity. Even in the U.S. 25 years ago, you would go to a bank in the U.S. and unless it was your bank, you were unable to take currency out of the bank or make a deposit that no longer exists. The standards were set. All the people who were involved in those issues settled their differences, came up with standards that everybody accepted that allows us to have in the U.S. national banking, but internationally we have the international banking. The same issues occur in health care within a country. There's that need for that level of standards to allow information to be shared amongst not only within an organization, but within the systems within those organizations. There need to be protections about privacy and security. All the people, consumers, physicians, nurses, other clinicians, administrators, government all have to participate, and there has to be an education process associated with that. What does Hitsby do? Well, what Hitsby does in the U.S., it's really a very much of a model for setting standards of communication, of interoperability that then can be applied across all systems. Very, very difficult tasks. We brought together not dozens, over a hundred organizations came together within Hitsby with all different types of standards and vocabularies to try to address how can we get to be one set of standards that then can be used through all systems and all organizations. This was one of the things that makes health care so difficult compared to something like banking, is that not only we need to set standards around what data flows from one system another, but within health care because of the vocabularies that are used, we need to be able to set some standards.