Kein Folientitel - Edumed

Kein Folientitel - Edumed

TTHE HE G GLOBAL LOBALV VIEW IEW . N NETWORK ETWORK Bringing Economy to Health by Creating Healthy Economies Where theres health, theres hope! The GlobalView Health Network Using commerce to serve the needs of humanity! The Electronic Public / Private Procurement System Todays problems cant be solved with yesterdays tools! H.C., C. R. 1 TTHE HE G

GLOBAL LOBALV VIEW IEW . N NETWORK ETWORKMission Statement To prevent Human Crisis in the face of worldwide Financial Crisis. Not just for a small group of people - but the whole family of mankind - and those yet to be born. To counter the enormous increase in human misery in crisis-stricken countries that threatens to spawn social and political unrest, desperation, hopelessness, decline and mass confusion. To bring about humanitarian benefit and economic improvement through creative transformation of public and private commerce with adequate attention given to meeting long-term development needs that promote health, education, nutrition and infrastructure building. To establish an international information infrastructure that links all public/private sector trading partners to enable a global e-commerce approach that generates self-sustaining funding mechanisms to support value-added state reform and modernization programs / infrastructure. To provide more resources, new strategies, better decisions throughout all sectors accelerating integration in the ongoing globalization. H.C., C. R. 2 TTHE HE G GLOBAL LOBALV

VIEW IEW GlobalView . Overview N NETWORK ETWORK A humanitarian project of planetary proportion to be deployed and operated in each nation by an alliance of multinational and local firms. A common, secure, computer-based network that can offer significant savings by organizing information infrastructure requirements in support of growth in standard-based networked applications. Designed to meet the critical business process needs of government and private sector trading partners for e-commerce and data transfer for social and fiscal programs. An Electronic Public / Private Procurement System adapted to the opportunities and risks of globalization that will replace the complex, diverse, redundant, and costly multiple communication / EDI connections that currently exist throughout the supply chain. Preserves and strengthens national and global flows of trade both in developing and industrialized nations. H.C., C. R. 3 TTHE HE G

GLOBAL LOBALV VIEW IEW GlobalViews. Global View N NETWORK ETWORK Regardless of todays financial setbacks (recession, devaluation, currency flight, slowdown in demand. GDP growth swings moving from plus to minus percent, etc.) governments must continue to provide adequate funding for meeting basic social needs and financing infrastructure building that promotes health, nutrition and education. GlobalView is devoting its energies to the creation of a new architecture for developing vast flows of capital to help governments provide uninterrupted universal access to these basic services regardless of how destabilized economies may become in developing, industrial and post-industrial nations. Everyone agrees with GlobalView that there needs to be better information generation, information gathering, and information sharing throughout all public sectors for better decision making. Timely and appropriate information can even strengthen the global flows of trade and foreign investment. H.C., C. R. 4 TTHE HE G GLOBAL LOBALV VIEW IEW

GlobalViews Blueprint . for Change N NETWORK ETWORK GlobalView has created a blueprint of dramatic reforms in the way governments conduct their business dealings to ensure that life-saving and life-enhancing programs are not reduced or eliminated. A blueprint that shows governments how they can deploy The GlobalView Network throughout their nation immediately without any financing required. GlobalView is moving toward a planetary information infrastructure for the whole global economy and all the governments and systems within it. A series of short- and intermediate-term actions that GlobalView can help execute can help governments with specific problems: H.C., C. R. Improvements in public procurement and public sector management An internationally supported public procurement adjustment program Immediate procurement supervisory and training steps for each nation Vigorous, accelerated efforts to structure domestic / global e-commerce Improved arrangements focusing on greater public / private coordination Redefining roles and responsibilities for pragmatic design, integration and implementation of GlobalViews structural reform programs 5 TTHE HE G GLOBAL LOBALV

VIEW IEW A GlobalView . Thought N NETWORK ETWORK On our planet vast gulfs exist between one mans (or womans) reality and anothers. Even so, each man is born with the yearning to make the most of his life regardless of the environment in which he lives. An individuals state of health is often a determining factor between a life of fulfillment or a life of frustration. A life of success or a life of despair. Where theres health, theres hope! With health a person can reap benefits in their life that now would seem unattainable throughout many parts of the world. With health a persons experience can be extended providing far greater resources at their command. Family relationships can show the greatest changes. There can be a metamorphosis liberating many who will rise above economic and political circumstances to develop their abilities to live happier, more fulfilling lives. H.C., C. R. 6

TTHE HE G GLOBAL LOBALV VIEW IEW The Information . Age N NETWORK ETWORK The transition from industrial to post-industrial societies requires even the most advanced nations to adapt their institutions and mentality to the Information Age. The Information Age requires pragmatic, conceptual and philosophical solutions for coping with the problems of post-industrial society. It is not confined to the material evolution of society itself, but builds on such an evolution the appropriate political and humanitarian elements that make Information Age societies more efficient and agreeable The Information Age recognizes the private sector as the engine of growth. Government interdependence, the necessity to compete, equal opportunity and mutual responsibility are all elements that have universal application. Alan Greenspan, U.S. Federal Reserve Board Chairman, says higher levels of growth in the U.S. probably can be credited to productivity increases made possible through better use of information technology. H.C., C. R.

7 TTHE HE G GLOBAL LOBALV VIEW IEW Areas That Must . Be Addressed N NETWORK ETWORK To take part in the global economy it is critical governments have in place the information and communication infrastructure that will permit their countries and people to develop successfully. Social and political development is influenced by access to affordable communications. People must have access to telephony, computers and networks. The access must be affordable, such that a much larger percentage of people from all strata within society are able to use these technologies. Information must be provided in a manner that makes it easy to use and useful in that it provides real value in their work, social and political lives. An enabling environment must be established that encourages all elements in society to engage in building an Information Society focused on meeting the needs of the people in each nation, region and worldwide. World leaders must call for development of National Information Infrastructure Plans to help guide public/private entities that are active and often must collaborate. Multilateral Banks should provide technical support to facilitate national, as well as regional and global plans. H.C., C. R. 8

TTHE HE G GLOBAL LOBALV VIEW IEW Information. is a Product N NETWORK ETWORK Information is the product of a well-defined production process. It is a product with a life cycle. Properly managed information adds value. The information-as-product approach has one clear goal: to deliver quality information to the information consumer- as a total product: Intrinsic Information Quality - Accuracy, Objectivity, Believablility, Reputation Accessibility Information Quality - Accessibility, Ease of Operatons, Security Contextual Information Quality - Relevancy, Value Added, Timeliness, Completeness, Amount of Information Representational Information Quality - Ease of Understanding, Concise and Consistent Rrepresentation, Interpretability, The information-as-product approach requires the need to understand the needs of each information consumer in their different functional departments in order to design and develop standardized and controlled procedures for collecting and updating data. H.C., C. R. 9 TTHE

HE G GLOBAL LOBALV VIEW IEW TCP/IP - GlobalViews Connectivity . Cure-all N NETWORK ETWORK With the ubiquity of the Internet, GlobalViews goal is to move each of our worlds government information systems, their public procurement entities, and all their in-country and cross-border trading partners to TCP/IP-based connections to all applications, at all levels, in all areas. Increases total-cost-of-ownership savings. Eliminates redundancies. GlobalViews commitment to TCP/IP and Internet-based communication strategies will provide faster access, allow common applications to run worldwide, and deliver information to information consumers around the globe or around the corner at the highest performance and lowest network costs. Intranet / Extranet / Internet / E-commerce all in one. GlobalViews approach will leverage the Internet over time: Finding a balance between centralized and local flexibility. Providing application development tools that can leverage core information manufacturers to better serve their consumers needs. Developing a fast way to update standards and practices H.C., C. R. 10 TTHE HE G GLOBAL LOBALV

VIEW IEW Realizing GlobalViews . Vision N NETWORK ETWORK Todays trading partner networks are complex, redundant and costly. Individual applications and business processes often use aging, proprietary protocols. Each trading partner may require other trading partners to use specific communications methods and service providers. A common network infrastructure for all public procurement frees resources and lowers costs. Current problems are organizational. GlobalViews envisions all data communications between trading partners using the TCP/IP protocol suite. This would simplify networking issues and help contain the costs associated with trading partner data communications. A single logical TCP/IP communication link that will provide users with access to all other trading partners. The logical line may consist of multiple physical links to one or many service providers to supply access diversity. As more applications are offered, trading partners will be able to eliminate many of their current multiple connections, thus gaining economies of scale. The size or speed of the connection can vary to meet each trading partners needs. H.C., C. R. 11 TTHE HE G GLOBAL

LOBALV VIEW IEW Primary Requirements and Pertinent Metrics . N NETWORK ETWORK The Public Internet is not the place for governments and their trading partners to conduct serious business among themselves. GlobalView will provide a central overseer to certify and monitor its Internet Service Providers, assist with resolution, manage security, and provide useful information to trading partners on ISP performance and services. Reliability - Trading partners must be reachable 24/365. Primary reliability requirement is high service availability. Pertinent metrics include physical route diversity; routing protocol convergence times; error and disaster recovery plans; backbone, exchange point and access circuit availability; replacement of failed customer premises equipment. Performance - Speed and responsiveness must be constant. Primary requirements include minimal network congestion and efficient and predictable routing. Pertinent metrics are latency, packet cell loss, link utilization, throughput, and efficient exchange of routing information. H.C., C. R. 12 TTHE HE G GLOBAL LOBALV

VIEW IEW Knowledge-Sharing Solutions-Oriented . N NETWORK ETWORK Approach Application Evolution Procurement process communications and collaboration Requirements planning and scheduling, collaborative design Applications Commonality Develop business cases for standardization / conduct transaction set pilots Application headers for protocols to identify destination or recipient Common look and feel for web-enabled industry applications Identification of which technologies are appropriate for a given application or business process Use of security at the application level, interoperability and scalability Barriers to Implementation Education and training Timing and coordination Audit trails and security H.C., C. R. 13 TTHE HE G GLOBAL

LOBALV VIEW IEW Electronic Commerce . Principles N NETWORK ETWORK Using as a model the recommendations of various US and European commissions on Electronic Commerce and the Global Information Infrastructure the following principles must be taken into consideration: Development of the Global Information Infrastructure should be led by the private sector. The rapid evolution expected in the next decade, in Electronic Commerce and the Internet, will only be possible in a marketdriven economy not in a regulated industry. This holds true for almost every issue including: telecommunications, payment methods, information technology, Internet accessibility, etc.) Governments should provide a suitable legal environment to buy and sell products and services through the Internet. However, they should not impose unnecessary regulations, restrictions or taxes on commercial activities that take place via electronic commerce or the Internet. Minimal Regulations and a simple legal environment will ensure competition, protect intellectual property and privacy, prevent fraud and support electronic transactions for this new medium in which there are no state, national or international borders. H.C., C. R. 14 TTHE HE G GLOBAL LOBALV VIEW IEW Some Global . Statistics N NETWORK ETWORK

Hospital Ownership - Of 173 nations reporting on hospital ownership: 68 nations100% owned by government 47 nations 75% owned by government 25 nations50% owned by government Selected Languages H.C., C. R. # Nations Total Population English (including India) 43 1,690,000,000 Spanish 20 319,000,000 French 21 198,000,000 Portuguese 6 186,000,000 Arabic 21 228,000,000

Assorted Eastern Europe 9 198,000,000 Chinese 1 1,210,000,000 German 3 97,000,000 Russian (and CIS) 10 250,000,000 Japanese 1 125,000,000 15 TTHE HE G GLOBAL LOBALV VIEW IEW Public/Private. Partnership N NETWORK ETWORK GlobalView will form a public / private partnership and planetary trading alliance to maximize its integration with information technology investments being made by individual governments and corporations. Streamlined / strengthened administrative efficiency in public institutions Enhanced government decentralization, privatization and planning Diffused best practices in health, education, training, commerce sectors Multilateral Development Banks will recommend The GlobalView

Network as a value-added multiplier to enable and assist government borrowers reach their state reform and modernization program goals. Some Public / Private Partnership Participants H.C., C. R. Sun Microsystems, EDS, AT Kearney Efficient Healthcare Consumer Response Consortium US Department of Commerce / International Trade Administration US Federal Electronic-Commerce Program (Policy Office) 16 TTHE HE G GLOBAL LOBALV VIEW IEW Not-for-Profit Non-Governmental . N NETWORK ETWORK Organization (NGO) The GlobalView Network, a not-for-profit humanitarian effort, has been researching and developing The GlobalView Health Network and Electronic Public Procurement System for most of this decade. During this time, GlobalView has identified not only numerous humanitarian service opportunities but also put together a framework to help promote and provide Health for All in the 21st Century a founding vision of the World Health Organization and a recognized goal within all

nations for all populations. The GlobalView Network is supported by the Florida Atlantic University Research Corporation and will operate in each nation and worldwide as a Non-Governmental Organization (NGO). GlobalView will coordinate its university research projects through The State University System of Florida which provides expertise in all areas of health and informatics: Medical Schools, Schools of Public Health, Nursing and Health Sciences Colleges of Engineering and Computer Sciences Centers for International Business and Trade, Environmental Studies, etc. H.C., C. R. 17 TTHE HE G GLOBAL LOBALV VIEW IEW . N NETWORK ETWORK The GlobalView Network The Electronic Public / Private Procurement System H.C., C. R. 18 TTHE HE G

GLOBAL LOBALV VIEW IEW The Electronic Procurement . System N NETWORK ETWORK Public Business to Government Government Government Private Business to Business Private PrivateSector Sector The GlobalView Network Trading Trading Trading Trading Partners Partners Partners Partners H.C., C. R. 19 TTHE

HE G GLOBAL LOBALV VIEW IEW Public Entities /Trading Partners to be . N NETWORK ETWORK Connected Energy Industry & Mining Agriculture & Education Fisheries Judical Credit & Finance Urban & Development Environment Sanitation Health & Transportation & Nutrition Communication Tourism Trade & Commerce The GlobalView Network H.C., C. R. Domestic Domestic

Domestic Domestic Trading Partners Trading Partners Trading TradingPartners Partners International International International International Trading Partners Trading Partners Trading TradingPartners Partners 20 TTHE HE G GLOBAL LOBALV VIEW IEW Present Proprietary One To One . N NETWORK ETWORK Connectivity Industry Industry & & Mining Mining Agriculture

Agriculture & & Fisheries Fisheries Judical Judical Ministerial Telecom Networks Supplier H.C., C. R. Energy Energy Education Education Credit Credit & & Finance Finance Ministerial Telecom Networks Supplier Environment Environment Urban Urban & & Development Development Sanitation

Sanitation Transportation Transportation & & Communication Communication Health Health & & Nutrition Nutrition Ministerial Telecom Networks Supplier Ministerial Telecom Networks Supplier Tourism Tourism Trade Trade & & Commerce Commerce Ministerial Telecom Networks Supplier

21 TTHE HE G GLOBAL LOBALV VIEW IEW GlobalView Open Any To Any . N NETWORK ETWORK Connectivity Industry Industry & & Mining Mining Agriculture Agriculture & & Fisheries Fisheries Judical Judical Energy Energy Education Education Credit Credit & & Finance Finance Environment Environment Urban Urban &

& Development Development Sanitation Sanitation Transportation Transportation & & Communication Communication Health Health & & Nutrition Nutrition Tourism Tourism Trade Trade & & Commerce Commerce The GlobalView Network Supplier H.C., C. R. Supplier Supplier Supplier

Supplier 22 TTHE HE G GLOBAL LOBALV VIEW IEW Worldwide Public Procurement . Initiatives N NETWORK ETWORK Our world governments spend approximately $ 5 trillion of our total $ 35 trillion Gross World Product (GWP) on Public Procurement. The GlobalView Network is working together with representatives of the following public procurement initiatives: World Trade Organization European Union SIMAP Free Trade Area of the Americas (FTAA) V. P. Gores Partnership for Reinventing Government U.S. Federal E-Commerce Program G-8 Nations Global Marketplace for Small and Medium Enterprises H.C., C. R. 23 TTHE HE G GLOBAL LOBALV VIEW IEW National Partnership for Reinventing . N

NETWORK ETWORKGovernment The National Partnership for Reinventing Government is the Clinton-Gore Administration's initiative to reform the way the federal government works. Its mission is to create a government that "works better, costs less, and gets results Americans care about. Begun in the early days of the Administration, and with Vice President Al Gore at its helm, the task force has operated the duration of the Administration through several phases of initiatives. It is the tenth federal reform effort this century and has been the longest-running federal reform effort to date. Most importantly, public trust in the federal government is finally increasing after a 30-year decline. Various polls have shown a clear and steady increase over the past four years. While it is not clear this is directly linked to reinvention, we like to think it is an important contribution. H.C., C. R. 24 TTHE HE G GLOBAL LOBALV VIEW IEW National Partnership for Reinventing . N NETWORK

ETWORKGovernment Accomplishments in Brief (As of March 1998) - measures of progress: The size of the federal civilian workforce has been cut by 348,000 -- the smallest since Kennedy held office and, as a percentage of the national workforce, the smallest since 1931. Recommended about 1,500 actions. Agencies completed about 58 percent. Of the original 1,250 recommendations, they report 66 percent completed. President Clinton signed 43 Presidential Directives and 83 laws to implement these recommendations. Over 325 Reinvention Labs have been created to pilot innovations. Recommended about $177 billion in savings over a 5-year period. Agencies locked into place about $137 billion with estimated savings or cost avoidances of about $31 billion because of these actions. Agencies eliminated about 640,000 pages of internal rules, about 16,000 pages of Federal Regulations, are rewriting 31,000 pages into Plain English. Agencies are sponsoring 850 labor-management partnerships. Employees in organizations that promote reinvention are twice as satisfied with their jobs. Over 570 federal organizations have committed to more than 4,000 customer service standards. H.C., C. R. 25 TTHE HE G GLOBAL LOBALV VIEW IEW Federal Electronic Commerce . Program Office N NETWORK ETWORK The Federal Electronic Commerce Program Office provides central leadership and management for the use of EC in the U.S. Federal Government. The Office of Electronic Commerce consists of 3 teams: The EC Coordination Team works with Federal agencies, OMB, and others

to coordinate, monitor, and report on government-wide implementation of EC. The EC Policy Team works with Federal agencies, OMB, the Electronic Process Initiatives Committee, and others to develop a policy framework to support key government-wide EC applications. The Card Technology Team works with Federal agencies and industry to coordinate, monitor, and report on the government-wide implementation of card technologies. Electronic Commerce - the Future of Government Business With the spread of computer and Internet use throughout American society, consumers can buy nearly everything on-line: from electricity to books; airline tickets to movie tickets; futures contracts to insurance policies; automobiles to flowers. H.C., C. R. 26 TTHE HE G GLOBAL LOBALV VIEW IEW Federal Electronic Commerce . Program Office N NETWORK ETWORK Electronic Commerce is becoming the preferred way of doing business with government, as well. Over the next several years, Federal agencies will buy and pay for most products and services electronically. Universities and research centers will seek grants and deliver reports online. Citizens will use smart cards to receive a range of benefits. Vendors will have real time access to government business opportunities

and government buyers will find what they need on electronic catalogs. Electronic Commerce is actually the use of many core technology tools - the Web, electronic data interchange, electronic mail, electronic funds transfer, electronic benefits transfer, electronic catalogs, credit cards, smart cards, and other techniques - to deliver citizen services and conduct government business. The Federal Electronic Commerce Office is Co-chaired by officials from the General Services Administration and the Department of Defense. H.C., C. R. 27 TTHE HE G GLOBAL LOBALV VIEW IEW Understanding the . Transformation N NETWORK ETWORK to Electronic Government Networks, not hierarchies will define government in the 21st century. - VP Al Gore (Picture of a fully electronic 21st Century government). Service delivery is shifted to serve the citizen. Instant access: anytime, anywhere, in any format, in any medium. Access is available at home, at the library, at a corner telephone/information booth. National Infrastructure: but local robust government networks interoperate, delivering online services across all hardware platforms, database structures, application programs. One access to Federal/state/local govts. Citizens have control to find what they need - interactive contact and realtime data and information.

The face of government becomes open and consistent to its commercial partners. Standard, predictable electronic procurement processes employed across all government organizations. Each citizen can access only to public information and whatever information is needed to conduct business with government. Only the affected individual has the power to use and release information. H.C., C. R. 28 TTHE HE G GLOBAL LOBALV VIEW IEW Understanding the . Transformation N NETWORK ETWORK to Electronic Government Government and private business will merge services where it benefits the citizen. Transactions can be completed at one sitting. Buying a car includes payment of sales tax, purchase and creation of the license plate, and signing up for the proper level of insurance; Planning a trip with a travel agent updates or creates a passport as well as an itinerary of lodging, transportation, and amusements. Single procurement opportunity access- CBDNET and move toward CBDPlus Supporting interoperable web catalogs and other single face efforts. CommerceNet Catalog Interoperability Pilot. CommerceNet, a premier industry association for promoting and building electronic global commerce solutions on the Internet. Federal Government is working with

CommerceNet on electronic catalog interoperability - a commercial solution. ARNet. Officially sanctioned source for government procurement information and electronic acquisition tools. Ties Federal procurement electronic efforts to a virtual single point. H.C., C. R. 29 TTHE HE G GLOBAL LOBALV VIEW IEW Understanding the . Transformation N NETWORK ETWORK to Electronic Government EBT - Electronic Benefits Transfer. Automation of the massive $500 billion a year transfer of monetary benefits from the Federalto-state-to-local government for distribution and direct Federal government-to-citizen distribution of entitlement funds. There are currently 143 systems and methods to transfer funds from the Federal treasury to the citizen recipient. It is shared system delivery, based on a commercially developed infrastructure. Efforts towards integrated search facilities The government is supporting new ways to organize and search for information using the customer-centered view. A number of university efforts supported with government grant funds, to develop new ways to search for information. There is a lot of research and development in this area. e.g. MIT Media Labs GOVBOT. A powerful tool enables fast, accurate, and timely searches of US government web pages, documents, statistics, agencies, departments and resources. This method of access to government information can only grow more sophisticated and powerful.

H.C., C. R. 30 TTHE HE G GLOBAL LOBALV VIEW IEW Understanding the . Transformation N NETWORK ETWORK to Electronic Government Broad approaches to solving security problems. Security on the Internet, on your home computer, in the company's accounting system have all taken on new challenges with the astronomical growth of users and information prepared, transmitted and used in an electronic form. The Identity issue -"On the Internet, no one knows you are a dog." (Privacy Concerns) ACES: transaction-based, supports citizen-government on-line transactions, strong ID without compromising privacy. Smart Cards-allow strong ID for a variety of applications and mobility To Sum Up- The Government's Goal H.C., C. R. Common Approach is Value Added by Government Seamless, single face approach

Working with industry on solutions Secure access with privacy 31 TTHE HE G GLOBAL LOBALV VIEW IEW Globalization of Public . Procurement N NETWORK ETWORK The majority of current public procurement is based on traditional administrative practices and means of communication mainly a paper-based system of notification, dissemination and tendering. The GlobalView Network will revolutionize the awarding of contracts. An electronic marketplace in which suppliers list products and prices in electronic catalogues; contracting entities compare prices and conditions; order electronically best value items that meet their needs. Electronic procurement will be more transparent, more open to dialogue with suppliers, and more efficient than paper-based systems. Worldwide use of GlobalViews Network will greatly diminish the dangers that incompatible national electronic public procurement systems could create. Major new problems of technical incompatibility among systems could make it more difficult to communicate and

consequently we may not be able to reap the expected benefits of electronic public procurement. H.C., C. R. 32 TTHE HE G GLOBAL LOBALV VIEW IEW Strategies and . Tactics N NETWORK ETWORK The GlobalView Networks strategy is to move industries toward a data-centered trading environment by redesigning each industrys supply chain so that all participants can simultaneously share information electronically instead of generating information each time a product passes from trading partner to trading partner. Trading partners in each nation will be linked immediately to The Network to facilitate efficient order management that will improve information exchanges and interdependencies existing among partners H.C., C. R.

Online product directories and interactive catalogs Automatic bidding opportunities / Pre-negotiated supplier discounts An electronic library of RFP's, RFQ's, and ITB's Electronic customer identification / Electronic product identification Electronic order management and processing Electronic shipping / Electronic receiving Electronic billing / Electronic funds transfer / EDI transaction sets. 33 TTHE HE G GLOBAL LOBALV VIEW IEW Catalysts for . Support N NETWORK ETWORK Technical Reasons: Single, secure, reliable, managed network Open system and standards (interoperability) Less complex than todays variety ot methods Simpler deployment of new technologies Lower barriers to electronic exchange of information Business Reasons:

New and existing government / business to business functions More efficient business cycles Significant transformation of competition in all industries Common global network solution to reduce current costs Faster information exchange Business continuity and disaster recovery H.C., C. R. 34 TTHE HE G GLOBAL LOBALV VIEW IEW Public Procurement . Training N NETWORK ETWORK Changing traditional procurement practices will succeed when there is a change in management ethos away from closed relationships with limited suppliers to a transparent and truly commercial environment open to other bidders and value for money is the primary motivation. Training on procurement rules and best practice may well be the best and least costly way to achieve such a change. The GlobalView Network will provide systematic and rigorous training for officials in order to give them the tools that effective procurement demands. The Network will spread a global program of training worldwide. Steps must be taken now to stimulate the training of procurement officers in the new and evolving skills they need to better perform their new role.

The Network will provide tools and methods needed to improve Small and Medium Enterprise (SME) access to public and private procurement markets and to fulfill their training needs in relation to information technology and related challenges such as security and confidentiality. H.C., C. R. 35 TTHE HE G GLOBAL LOBALV VIEW IEW Multilateral Banks (Project . Procurement) N NETWORK ETWORK After a loan is approved, funds are available to implement the project and purchase the items, works and expertise needed. Implementation of the project is the responsibility of the borrower, as is procurement of goods and services. The Multilateral Development Banks are not a party to any contract, but they do require that procurement follow agreed procedures as reflected in the legal documents. These include, among others: H.C., C. R.

The criteria for packaging the contracts The various methods of procurement that may be used The thresholds within which those methods apply Rules for prior and subsequent review of specifications Bid documents Evaluations 36 TTHE HE G GLOBAL LOBALV VIEW IEW Multilateral Banks (Project . Procurement) N NETWORK ETWORK They carefully supervise implementation and the procurement process to ensure that procedures are followed and the process is fair and impartial. While specific procurement rules and procedures may differ depending on the type of project, the Banks have three basic concerns that govern their procurement policies: To ensure that the loan is used to buy only those goods and services needed to carry out the project, and that they are procured in the most efficient and economical manner possible. To give all qualified bidders from the Banks member countries an equal opportunity to compete for Bank-financed contracts. To encourage development of local contractors and manufacturers in borrowing countries. H.C., C. R. 37

TTHE HE G GLOBAL LOBALV VIEW IEW Multilateral Banks (Project . Procurement) N NETWORK ETWORK The Banks experience has shown that these objectives can best be achieved through an international competitive bidding process (ICB) with a margin of preference given to domestic goods and, under certain conditions, to domestic contracting services in developing countries. They have some special features and requirements that prospective bidders should note, including the following: Public Advertising All goods or works to be procured through ICB must be advertised internationally and in at least one major local newspaper. For large, specialized contracts, invitations should also be advertised in technical magazines, newspapers, trade publications of wide international circulation. Currency of Bid Bidders are entitled to bid in their own currency or other currencies in which they would incur expenditures, or in an international currency specified by the borrower in the bidding documents. Payments Successful bidders are entitled to receive payments in the currencies of their bid, thereby minimizing the bidders exposure to exchange rate fluctuations. Bidders in Bank-financed contracts are not required to accept any portion of their payments in countertrade. H.C., C. R. 38 TTHE HE G GLOBAL LOBALV VIEW IEW Transforming European Public Procurement

. N NETWORK ETWORK (SIMAP) Quoting Mario Monti (member of the European Commission Directorate General XV): Developing and applying an effective public procurement policy is an essential element in delivering the best possible services at the lowest cost to the public. It is also of prime importance to helping EU suppliers to compete in an increasingly competitive world procurement market. However, the benefits for procurement authorities, utilities, taxpayers, customers and suppliers will be more effectively secured if we can extend and improve our systems for collecting and disseminating information about contracting opportunities to potential suppliers across the Union. We must also continue to build confidence and commitment among suppliers and contracting entities. To do this we need to provide both purchasers and suppliers with relevant, accessible and comprehensive information in the right form and at the right time. H.C., C. R.

39 TTHE HE G GLOBAL LOBALV VIEW IEW Transforming European Public Procurement . N NETWORK ETWORK (SIMAP) Todays Information Technology advances provide the tools to not only create significant improvements in the supply of relevant information, but also revolutionize the whole way of doing business between procurement entities (government authorities and utilities) and suppliers. SIMAP (systeme dInformation pour les Marches Publics) represents a major step in this direction. Although it is starting with two relatively modest pilot projects, the Commission expects it to be extended ultimately to all suppliers and procurement entities in the EU and beyond. Public procurement markets represent a significant proportion of the European Unions economy (an estimated 10 12% of the EUs GDP), so that opening up these markets to competition is of crucial importance to the success of the Single Market as a whole. H.C., C. R. 40

TTHE HE G GLOBAL LOBALV VIEW IEW Transforming European Public Procurement . N NETWORK ETWORK (SIMAP) SIMAP is the European Unions initiative to promote, coordinate and manage that process of change in the world of public procurement. Take advantage of the opportunities that IT offers to create a Europewide electronic environment for the whole procurement process Encourage the rapid introduction of these technologies so that from the internal planning stage, through electronic tendering to invoicing and payment will in the future be a seamless, paperless chain. Provide coordination both within the EU and internationally to ensure that additional information will increasingly be made available electronically. Facilitate the transition to a streamlined, less cumbersome and more focused procurement process in such a way that all players, whether purchasers or suppliers, will benefit from the use of new electronic tools with European public procurement. Simple and speedy access to information giving suppliers the necessary added knowledge and expertise required to compete at the EU level. Allow participating procurement entities to disseminate more and better information to potential suppliers throughout the Union. H.C., C. R. 41 TTHE HE G GLOBAL LOBALV VIEW IEW Transforming European Public Procurement

. N NETWORK ETWORK (SIMAP) At their February 1995 Summit on the Information Society the leaders of the G7 nations decided that electronic tendering should be developed as a priority application for the new information superhighways. In a few years the whole procurement process could take place electronically, from internal planning through electronic tendering to invoicing and payment, offering enormous savings in time and efficiency. It is not only in the context of relations between purchasers and suppliers that change is occurring. Inside purchasing organizations, procurement practices are undergoing far-reaching re-engineering, with a view toward greater streamlining, reduction in manual procedures, significant cost savings and enhanced user friendliness at all levels of the organization. More generally, access to external databases and advisory services is enhanced by electronic tools. H.C., C. R. 42 TTHE HE G GLOBAL LOBALV VIEW IEW Transforming European Public Procurement . N NETWORK

ETWORK (SIMAP) New electronic tools provide opportunities to purchasing bodies to cooperate via the exchange of information, ideas, and experience. Information on topics of previous work for other procuring entities will be easily accessible help decision-makers decide on contract awards. European Commission has launched an initiative to use new electronic tools in order to make public procurement more efficient. This initiative is known as SIMAP. Two pilot projects have already been launched to demonstrate and develop tools for use in public procurement. These projects involve 75 procurement entities (from all 15 Member States) which issue a large number of procurement notices. The use of a Common Procurement Vocabulary developed by the Commission, which attributes a nine digit code to some 6,000 commonly used terms, allows tender opportunities to be translated into the EUs eleven official languages for publication in the Official Journal of the EU and in its online equivalent TED (Tenders Electronic Daily) in accordance with the Unions procurement legislation. H.C., C. R. 43 TTHE HE G GLOBAL LOBALV VIEW IEW Transforming European Public Procurement . N NETWORK ETWORK (SIMAP)

Suppliers need tools to provide easier online access to tender opportunities and contracts awarded, plus other information already available in the Member States which can help them respond more competitively to public procurement opportunities. This includes information on tenders with a value lower that of the thresholds specified in EU legislation. Further work is underway on enhancing access to information areas such as: Environmental issues Information on local conditions Business practices Price levels Help for business to find local partners when bidding for contracts in other Member States Help in the translation of call for tender, standards and electronic product catalogues H.C., C. R. 44 TTHE HE G GLOBAL LOBALV VIEW IEW The Free Trade Area of . the Americas (FTAA) N NETWORK ETWORK

The effort to unite the economies of the Western Hemisphere into a single free trade arrangement was initiated at the 1994 Miami Summit of the Americas and renewed at the 1998 Santiago Summit of the Americas. The Heads of State of the 34 democracies in the region agreed to construct a "Free Trade Area of the Americas" or FTAA and to complete negotiations for the agreement by 2005. The effort to build the FTAA is a dynamic process that involves three key components: The Trade Ministers of the Western Hemisphere, who have developed the overall work plan for the FTAA; The 12 FTAA Working Groups established by the Trade Ministers that are gathering and compiling information on the current status of trading relations in the Hemisphere; The Vice-Ministers of Trade of the Western Hemisphere, who coordinate the efforts of the working groups and make policy recommendations to the Trade Ministers. H.C., C. R. 45 TTHE HE G GLOBAL LOBALV VIEW IEW FTAA Working Group on Government . N NETWORK ETWORKProcurement Terms of reference: Collect, systematize and create an inventory of the legislation, regulations, and procedures in the countries of the Hemisphere regarding government procurement, starting at the central government level, including, among other, state-owned enterprises. On the basis of that inventory, undertake a study of barriers to access to procurement by the public sector.

Create an inventory and analysis of regulations on government procurement included in integration schemes and other existing agreements to which countries in the Hemisphere are signatories. Compile available data on purchases of goods and services by central governments, including, state-owned enterprises, in the Hemisphere. Identify areas of commonality and divergence among government procurement systems in countries of the Hemisphere. Recommend methods to promote transparency in government procurement. Make specific recommendations on how to proceed in the construction of the FTAA in this area. Recommend methods to promote understanding of the WTO Government Procurement Agreement. H.C., C. R. 46 TTHE HE G GLOBAL LOBALV VIEW IEW Overview of WTO Agreement on . N NETWORK ETWORK Government Procurement Procurement of products and services by government agencies for their own purposes represents an important share of total government expenditure and thus has a significant role in domestic economies. While ensuring best value for money will be secured through an open and non-discriminatory procurement regime, governments sometimes seek to achieve certain other domestic policy goals through their purchasing decisions, such as promotion of local industrial sectors. Measures to this effect may be either explicitly prescribed in national legislation, for example prohibitions against the purchase of foreign goods or services or from foreign suppliers, preference margins, setasides and offsets, or measures or practices which have the effect of denying foreign products, services and suppliers the opportunity to compete in domestic government procurement markets, including

selective tendering, non-open technical specification requirements and, lack of transparency in tendering procedures including contract awards. Such discriminatory government procurement procedures and practices can lead to distortions in international trade. H.C., C. R. 47 TTHE HE G GLOBAL LOBALV VIEW IEW Overview of WTO Agreement on . N NETWORK ETWORK Government Procurement Government procurement has been effectively omitted from the scope of the multilateral trade rules under the WTO, in the areas of both goods and services. In the General Agreement on Tariffs and Trade, originally negotiated in 1947, government procurement was explicitly excluded from the key national treatment obligation. More recently, government procurement has been carved out of main commitments of the General Agreement on Trade in Services. Since it is estimated that government procurement typically represents 10-15% of GDP, this represents a considerable gap in the multilateral trading system. The trade-restrictive effects of discriminatory procurement policies and of the desirability of fulfilling these gaps in the trading system resulted in a first effort to bring government procurement under internationally agreed trade rules in the Tokyo Round of Trade Negotiations. As a result, the first Agreement on Government Procurement was signed in 1979 and entered into force in 1981. It was amended in 1987, with this amended version entering into force in 1988. H.C., C. R.

48 TTHE HE G GLOBAL LOBALV VIEW IEW Overview of WTO Agreement on . N NETWORK ETWORK Government Procurement The GPA establishes an agreed framework of rights and obligations among its Parties with respect to their national laws, regulations, procedures and practices in the area of government procurement. The cornerstone of the rules in the Agreement is non-discrimination. Government Parties to the Agreement are required to give the products, services and suppliers of any other Party to the Agreement treatment "no less favorable" than that they give to their domestic products, services and suppliers and not to discriminate among goods, services and suppliers of other Parties. Each Party is required to ensure that its entities do not treat one locallyestablished supplier less favorably than another locally-established supplier on the basis of degree of foreign affiliation or ownership nor discriminate on the basis of country of production of the good or service being supplied. In order to ensure that the basic principle of non-discrimination is followed and that access to procurement is available to foreign products, services and suppliers, the Agreement lays heavy emphasis on procedures for providing transparency of laws, regulations, procedures and practices regarding government procurement. H.C., C. R. 49 TTHE

HE G GLOBAL LOBALV VIEW IEW G7 Initiative "A Global Marketplace for . N NETWORK ETWORK Small and Medium Enterprises (SMEs) Early in 1995 the G-7 nations launched a group of eleven initiatives that collectively aim to demonstrate the potential of the information society and stimulate its deployment. One of these initiatives, "A Global Marketplace for SMEs", has the overall objective of facilitating increased competitiveness and participation in global trade for SMEs by exploiting the opportunities offered by the development of the global information society. Electronic commerce enables companies to be more efficient and flexible in their internal operations, to work more closely with their suppliers, and to be more responsive to the needs and expectations of their customers. It allows companies to select the best suppliers regardless of their geographical location and to sell to a global market. One special case of Electronic Commerce is electronic trading, in which a supplier provides goods or services to a customer in return for payment. The initiative is open to participation by non-G-7 countries and international organizations.

H.C., C. R. 50 TTHE HE G GLOBAL LOBALV VIEW IEW G7 Initiative "A Global Marketplace for . N NETWORK ETWORK Small and Medium Enterprises (SMEs) The initiative has three themes: Theme 1 - global information network for SMEs -This will contribute to the development of an open non- discriminatory environment enabling SMEs to access information they need and disseminate information on their products, technologies, etc., using international information networks. Theme 2 - SME requirements - legal, institutional and technical This aims to ensure that the systemic issues associated with an open global marketplace for SMEs are addressed, and will provide a framework based on the systematic issues that will ensure that the project as a whole responds to the explicit needs of SMEs. Theme 3 - international test-beds for Electronic Commerce -This theme will: (i) promote awareness of the issues that must be addressed to realize a "global marketplace for SMEs" through global Electronic Commerce; (ii) encourage the development of test-beds, pilot projects, cooperative ventures that evaluate or demonstrate approaches to addressing the issues; (iii) publicize successful demonstrations of global Electronic Commerce involving SMEs. H.C., C. R. 51

TTHE HE G GLOBAL LOBALV VIEW IEW . N NETWORK ETWORK The GlobalView Network The GlobalView Network will implement and operate its Electronic Procurement System to create the funding mechanism to deploy and operate The GlobalView Health Network and other proposed public sector networks in each nation and worldwide. H.C., C. R. 52 TTHE HE G GLOBAL LOBALV VIEW IEW . N NETWORK ETWORK Industry Industry & & Mining

Mining Agriculture Agriculture & & Fisheries Fisheries Judical Judical Energy Energy Education Education Credit Credit & & Finance Finance Urban Urban & & Development Development Environment Environment Health Health & & Nutrition Nutrition Sanitation Sanitation Transportation Transportation & &

Communication Communication Tourism Tourism Trade Trade & & Commerce Commerce The GlobalView Network 13 Channels of Content in each Sector H.C., C. R. 53 TTHE HE G GLOBAL LOBALV VIEW IEW Approach to Worlds Governments and . N NETWORK ETWORK Ministries Make presentations to Minister of Health, all other government Ministers, other appropriate public procurement entities. H.C., C. R.

Explain how The GlobalView Network can be deployed throughout all health facilities and public procurement entities as a national public service utility with no government or private sector capital expenditure required. Explain how GlobalViews Electronic Procurement System will generate a transaction-based-fee revenue stream to offset deployment / operating costs. Analyze past, present and future government budgets to determine total amount of annual health and other public sector procurement expenditures. Estimate all private sector procurement Network can facilitate. Determine total annual amount of transaction-based-fees generated by public and private procurement. Present proposal outlining extent of Network deployment based upon multi-year Procurement System fee revenue stream. Explain how the total of these fees can be pre-identified and will represent only a small percentage of overall savings generated by using the Network. 54 TTHE HE G GLOBAL LOBALV VIEW IEW . N NETWORK ETWORK The

GlobalView Network The GlobalView Health Network H.C., C. R. 55 TTHE HE G GLOBAL LOBALV VIEW IEW The GlobalView .Health Network N NETWORK ETWORK The GlobalView Health Network will be deployed and operated as a public service in each nation available for use by all public and private sector health stakeholders and all health procurement entities. The Network will assure the patient needs by: Linking each nation's health assets/facilities (all of which feed data into the national and global health system) in order to improve communication and interoperability of assets; Providing manageable and maintainable structured access to these assets enabling end-users to access information and tools when and where needed; Integrating evolving tools and methods to assist health sector personnel make informed decisions that impact areas of strategic planning, health administration and clinical care. The fast lane to world health on the global information superhighway H.C., C. R. 56

TTHE HE G GLOBAL LOBALV VIEW IEW Nationwide Intranet . N NETWORK ETWORK Linking All Health Facilities/Assets Hospital Clinic Medical School Home Health Pharmacy Alternate Site Laboratory Insurer Imaging Govt. The GlobalView Network 13 Channels of Content of The GlobalView Health Network H.C., C. R. 57 TTHE

HE G GLOBAL LOBALV VIEW IEW 13 Channels. of Content N NETWORK ETWORK Channel 1: Data for Decision-Making (Strategic Planning for Public Policy) Channel 2: Multimedia Reference Library (Selected WWW sites, CD-ROMS, etc.) Channel 3: Telemedicine (Consultation/Teleradiology/Distance Learning) Channel 4: Computer-based Interactive Medical Education/Staff Training Courses Channel 5: Electronic Public Procurement System/Logistics/EHCR TM Channel 6: Medical Search Service (International and Country-Specific) Channel 7: National Data Banks (Management/Outcomes/Comparative) Channel 8: Priority Care Program (Prioritization/Protocols/Universal Access) Channel 9: Clinical Applications/Clinical Expert Medical Decision Systems/Others Channel 10: Administrative Applications/Materials Management/Business Support Channel 11: Health Service Programs (Monitoring and Migrating of Pilot Projects) Channel 12: Disease Management Programs/Managed Care Programs Channel 13: Multilateral Hotline (Linking All Health Facilities on the Planet) H.C., C. R. 58 TTHE HE G GLOBAL LOBALV VIEW IEW EHCR - Efficient Healthcare Consumer . N NETWORK ETWORK Response

Efficient Healthcare Consumer Response (EHCR) is a consortium of North American suppliers, distributors and providers formed to reduce healthcare supply chain costs by $11 billion annually EHCR is an example of the industrys commitment to cut waste and improve the quality of patient care EHCRs objective is to encourage decision makers all along the healthcare supply chain to join the consortium and agree to implement improvement programs to move the industry toward the goal of eliminating $11 billion in avoidable process costs EHCRs target audience is decision makers in healthcare suppliers, providers, manufacturers and distributors of all sizes senior management as well as heads of logistics, materials management, supply chain and related services. Senior executives / management of 20+ prominent healthcare organizations are members of EHCRs Executive /Strategic Operating Committees H.C., C. R. 59 TTHE HE G GLOBAL LOBALV VIEW IEW Channel 5 - EHCR Strategies and IT N NETWORK ETWORKSolution .Sets TM Public Public//Private PrivatePurchasing PurchasingEntities Entities Efficient Product Movement

Inventory Management Control Systems Continuous Replenishment Processes Product Packaging and Handling Efficient Order Management Contract / Pricing Administration Purchase Order to Payment Sales Activated Settlement Efficient Information Sharing H.C., C. R. Electronic Product Information Point-of-Use Data Capture Electronic Customer Information Distributors Distributors Distributosr Distributosr Manufacturers Manufacturers Manufacturesr Manufacturesr 60 TTHE

HE G GLOBAL LOBALV VIEW IEW Present Proprietary One To One . N NETWORK ETWORK Connectivity Nursing Nursing Home Home Home Home Health Health Clinic Clinic Physician Physician Office Office Ministerial Telecom Networks Supplier H.C., C. R. School School Nurse Nurse Ministerial Telecom Networks

Supplier Hospital Hospital Pharmacy Pharmacy Medical Medical School School Alternate Alternate Site Site Imagin Imagin g g Laboratory Laboratory Private Private Insurer Insurer Government Government Ministry Ministry of of Health Health Social Security Social Security Ministerial

Telecom Networks Supplier Ministerial Telecom Networks Supplier Ministerial Telecom Networks Supplier 61 TTHE HE G GLOBAL LOBALV VIEW IEW GlobalView Open Any To Any . N NETWORK ETWORK Connectivity Nursing Nursing Home Home Home Home Health Health Clinic Clinic

Physician Physician Office Office School School Nurse Nurse Hospita Hospita ll Pharmac Pharmac y y Government Government Ministry Ministry of of Health Health Social Social Security Security Medical Medical School School Alternate Alternate Site Site Laborator Laborator y y Imaging

Imaging Private Private Insurer Insurer The GlobalView Network Supplier H.C., C. R. Supplier Supplier Supplier Supplier 62 TTHE HE G GLOBAL LOBALV VIEW IEW Integrated Partnership Serving Patient N NETWORK ETWORK Needs. Patient Re-Insurer Insurer Govt. Payer

Research & Development Provider The GlobalView Network Retailer Distributor Manufacturer Converter H.C., C. R. 63 TTHE HE G GLOBAL LOBALV VIEW IEW The GlobalView .Health Network N NETWORK ETWORK The GlobalView Health Network can assist (in an unprecedented way) the decision-making processes pivotal to all policy, administration and clinical aspects of the daily and long-term operation of national health systems and the more efficient, effective management and operation of our world's $3 trillion health establishment. The GlobalView Health Network will provide 24/365 access to 13

digitized channels (categories) of tools, methods, software applications, knowledgebases, training programs, and communications capabilities that treat information as a strategic priority necessary to ensure that essential public health functions are maintained worldwide. Such functions build on existing primary health care services: Guiding sustainable health systems; Ensuring active surveillance; Making care available across the life span; Preventing and controlling disease, and protecting health; Fostering the use of, and innovation in, science and technology; Building and maintaining human resources for health; Securing adequate financing for sustainable health systems H.C., C. R. 64 TTHE HE G GLOBAL LOBALV VIEW IEW The GlobalView .Health Network N NETWORK ETWORK The GlobalView Health Network will develop and continually evolve an adaptable global healthcare system architecture at multiple levels of resolutions to assist stakeholders at all levels of the health system manage and operate health assets more efficiently and productively. The GlobalView Health Network will be custom-designed (language and content) to support the validated and approved strategic, clinical, management, educational and other enduser needs of each nations health system.

Enable faster, more precise decision making; more accurate diagnosis; faster treatment delivery; training of health professionals and personnel to facilitate, access, and interpret data from multiple sources (health sector information systems, software packages, value-added services and data bases). Also, to collect, process, analyze, and utilize data efficiently. H.C., C. R. 65 TTHE HE G GLOBAL LOBALV VIEW IEW The GlobalView .Health Network N NETWORK ETWORK Enable health sector decision makers to adjust more quickly to changing health demands and conditions, and to capitalize on change by controlling health costs and increasing operational efficiencies. Enable each nations Ministry of Health and other health stakeholders to collect, analyze, share and act upon real time health, medical, and resource data making it possible for health information to be recorded, collected, analyzed and acted upon with immediacy and foresight. Data based decision making contributes to the enactment of

policies and programs that allocate health resources to priority problems as supported by epidemiological and demographic data (at national and local levels particularly in the present environment of decentralization). H.C., C. R. 66 TTHE HE G GLOBAL LOBALV VIEW IEW Universal Product Numbers . (UPN/EAN) N NETWORK ETWORK The Network supports the adoption of the use of universal product numbers, industry-wide numbering systems for supplies that can solve the product identification quagmire found along the supply chain. UPN/EAN provides a common language that simplifies all distribution processes from ordering to receipt of products. The product number can be used by all trading partners throughout the supply chain: Ensure more accurate and reliable product and pricing information for managing just-in-time and continuous replenishment agreements. Eliminate product identification errors in purchase orders, shipments, invoices and price/sales catalogs Facilitate accurate tracking, scheduling and cost accounting of products and billing Enable full use of bar code technology in materials management Provide basis for electronic compilation and analysis of product utilization information Enhance accuracy and efficiency of EDI between all trading partners

H.C., C. R. 67 TTHE HE G GLOBAL LOBALV VIEW IEW Linking UPN/EANs . to CPT and ICD N NETWORK ETWORK Linking UPNs to CPT and/or ICD will provide a better understanding of supplies used for medical procedures as well as for diagnosis and results in analyzing underutilization overutilization most efficient use cost effective use fraud Linking UPNs to CPTs/ICDs documents the complete supply chain from the maufacturer to the patient respectively to the health care plan. Providers and Insurer will gain a better understanding of supplies

used on the procedure and diagnosis level to develop new policies and best practice guidelines for most efficient use and best quality of care. H.C., C. R. 68 TTHE HE G GLOBAL LOBALV VIEW IEW Coding: UPN/EAN, . CPT, ICD N NETWORK ETWORK UPN: The Universal Product Number uniquely identifies healthcare products. It is derived either from HIBCC-LIC or UCC/EAN barcode labeling data sructures. The UPN is to be universally used as a key identifier on each inventory unit of all products and also used as the key identifier to communicate product information between all trading partners in the supply chain. CPT: Physicians' Current Procedural Terminology is used by physicians and other health care professionals to code their services for administrative transactions. ICD-9-CM: The International Classification of Diseases, Ninth Revision, Clinical Modification, classifies both diagnoses (Volumes 1 and 2) and procedures (Volume 3). All hospitals and ambulatory

care settings use it to capture diagnoses for administrative transactions. The procedure system is used for all in-patient procedure coding for administrative transactions. H.C., C. R. 69 TTHE HE G GLOBAL LOBALV VIEW IEW Linking UPN/EAN. to CPTand ICD N NETWORK ETWORK Diagnosis (ICD) H.C., C. R. Procedures (CPT) Supplies (UPN) 70 TTHE HE G GLOBAL LOBALV VIEW IEW GlobalViews Living . Laboratory N NETWORK ETWORK GlobalView plans to establish a Living Laboratory at the Multimedia

Laboratory of the Florida Atlantic University College of Engineering. To develop a useful GlobalView Health Network on a wide scale there are challenges at all levels of systemness from the basic hardware platforms, communications, operating systems, applications, databases, networks, user interfaces and to the level of the health assets themselves. In order to drive the development of GlobalViews Health Network we need to be able to add health assets in a meaningful way and provide the framework for these assets to become interoperable and synergistic. This requires an adaptive application architecture that allows for growth and evolution of the system dynamically over time. In order to develop and deploy on a large scale such an interoperable Network we must fully understand the requirements that such a system and its assets impose. The Living Laboratory will identify and clarify the technical, business, implementation, deployment and operations requirements. H.C., C. R. 71 TTHE HE G GLOBAL LOBALV VIEW IEW GlobalViews Living . Laboratory N

NETWORK ETWORK The Living Laboratory will: integrate assets from various asset classes and be able to retrieve information from remote sites to help determine communications requirements and requirements at the asset site to make the asset available develop a common interface which will allow a user to easily traverse the asset classes and provide a user interface framework within each class drive the more detailed user interface requirements as more assets within each class are added. Technical goals include testing the integration of technologies for: H.C., C. R. reliable storage/retrieval of medical information for varied applications real-time, data-driven medical decisions real-time global transport of medical records with accuracy/speed/security computer-based medical training, diagnostic, and reference tools electronic procurement and just-in-time delivery (logistics) systems telemedicine, telehealth and teleradiology applications. 72 TTHE HE G GLOBAL LOBALV VIEW IEW

Capabilities Integration & Assessment . N NETWORK ETWORK Program To identify the products, technologies & services offered by vendor companies to determine how these fit into The GlobalView Health Network's 13 Channels of Content. Product, technologies & service architectural implications Obtain base information on each vendor's products, technologies & services Review base information for architectural issues Layout base workflow as a result of the vendor's offering Integrate vendor's workflow into overall GVHN architecture Build base simulator and run initial tests using vendor's offering and workflow Refine workflow and simulation assumptions based on vendor's offering -working with vendor company. H.C., C. R. 73 TTHE HE G GLOBAL LOBALV VIEW IEW Capabilities Integration & Assessment . N NETWORK ETWORK Program Cost & revenue implications for both GVHN and Vendor Obtain base product, technology and/or service costs from vendor Integrate costs into architectural / workflow simulation model From end-customer needs analysis obtain forecasted load/usage

levels relevant to vendor's offerings. Integrate load/usage data into architectural / workflow simulation model From simulation obtain ranges for costs and revenue and feed them to business plans and supply-chain analysis. H.C., C. R. 74 TTHE HE G GLOBAL LOBALV VIEW IEW Capabilities Integration & Assessment . N NETWORK ETWORK Program Identification of base work required to integrate with GVHN program for both GVHN and Vendor From the architectural / workflow model identify GVHN changes required to integrate the vendor's offering For the top three changes outline detailed work/tasks required along with skills required and effort. From the architectural / workflow model identify vendor changes required to integrate the vendor's offering For the top three vendor changes outline detailed work/tasks required along with skills required and effort - interact with vendor to assess. From the architectural / workflow model identify impact on core consortium partners which require changes to integrate the new vendor offering. For the top impacted vendor changes - outline detailed work/tasks required along with skills required and effort - interact with vendor to assess. H.C., C. R. 75

TTHE HE G GLOBAL LOBALV VIEW IEW Capabilities Integration & Assessment . N NETWORK ETWORK Program Integration of the needs assessment into the cost and workflow analysis Obtain needs {functionality and costs} from needs assessment effort-needs are grouped on a subsystem basis {e.g. Procurement} Map needs and sub-solution provider offerings if available Modify architectural / workflow model based on the needs and costs assessments Where sub-solution vendor not identified - detail the sub-solution requirements prior to obtaining a vendor - details in terms of minimum work to integrate a sub-solution provider. H.C., C. R. 76 TTHE HE G GLOBAL LOBALV VIEW IEW The G-7 Global Healthcare Applications . N NETWORK ETWORK Project: Sub-project 1, "Towards a Global Public Health Network" Investigates linking existing and emerging public health data telematics networks to ensure systems are inter-operable across

the world, user-friendly, fast, and cost-effective. Sub-project 2, "Improving Prevention, Early Detection, and Treatment of Cancer" aims at establishing multimedia databases which will enable health professionals across the world to seek decisional support for patient management and referral. Sub-project 3, "Improving the Prevention, Diagnosis and Treatment of Major Cardiovascular Diseases" aims at establishing centers of excellence providing tele-consultation services and access to multimedia databases providing peripheral centers and health professionals access to information and expertise. H.C., C. R. 77 TTHE HE G GLOBAL LOBALV VIEW IEW The G-7 Global Healthcare Applications . N NETWORK ETWORK Project: Sub-project 4, "A 24-hour Multilingual Telemedicine Surveillance and Emergency System Around the World" providing the basis for a 24-hour multilingual emergency teleconsultation service to benefit travelers, workers in isolated places and those living in regions with less developed healthcare service. Sub-project 5, "Enabling mechanisms for global health networks" aims to identify the most efficient tools and

communication infrastructure for accessing and navigating health networks focusing on online translation and the harmonization of security standards for patient related data exchange. Sub-Project 7, Evidence and effectiveness where evidencelinked information is delivered to the point-of-care, while at the same time enabling the retrieval of patient-related information from the point-of-care which contributes to updating the published information. H.C., C. R. 78 TTHE HE G GLOBAL LOBALV VIEW IEW Europe's Health . Future N NETWORK ETWORK There are wide variations between European healthcare systems but there are many shared perspectives and themes in their reform programs - because they are responding to common pressures and the possibilities offered by modern information systems. The starting point for most healthcare reforms has been the concern to control escalating costs, but other objectives, such as to ensure equitable access and to improve quality of care have been major determinants of European health reforms.

While central measures to control cost have had an important impact, the main aim of health reforms has been to change the way decisions are made about the direction and management of health services. The aim is to create a self-regulating system, which reflects an appropriate balance between the desired level and quality of service and the resources which are affordable. H.C., C. R. 79 TTHE HE G GLOBAL LOBALV VIEW IEW Europe's Health . Future N NETWORK ETWORK The impact of European healthcare reforms can be seen at these levels in decision making: Health objectives, policy and responsibilities are more clearly defined Management of health service provision integrates the management of medical practice and of resources, in response to patient needs The management of patient treatment and care is based upon evidence of best medical practice regardless of setting At each level reformed decision processes are dependent upon information. Better information systems and better use of information are the keystone for European healthcare reforms. Healthcare reforms are primarily dependent upon developments

in information management and technology. European healthcare information prior to reform was typically based upon central returns recording activity categorized by ICD code, plus financial and personnel information. H.C., C. R. 80 TTHE HE G GLOBAL LOBALV VIEW IEW Europe's Health . Future N NETWORK ETWORK Within healthcare providers a range of separate systems would support each department, with separate systems also supporting general practice offices and community based services. Reforms to healthcare have required a common method for identifying patients with similar health needs and requirements. Most nations have opted for a Diagnosis Related Group (DRG) based system. This provides a basis for managing services with hospitals and contracts between purchasers and providers. It is questionable whether DRGs will provide a good basis for outcomes measurement.

The development of inter-operable information systems will permit a seamless management of patient treatment and care primarily across community boundaries. Within healthcare providers this can be achieved by an integrated system, such as The GlobalView Health Network. H.C., C. R. 81 TTHE HE G GLOBAL LOBALV VIEW IEW Europe's Health . Future N NETWORK ETWORK However, the need for interoperability requires a framework of standards and policies. Many European countries are establishing national health information management strategies. These strategies must provide integration of medical and administrative data, while establishing safeguards for privacy of confidential patient information. It is also important to improve the data quality and to establish clear pathways for information flows within the healthcare system. There are many advantages to establishing a European-wide / worldwide

approach to information management. The basis is the creation of The GlobalView Health Network. It would provide a larger market for information system suppliers to meet European and world-wide healthcare needs and would enable exchange of medical knowledge and patient-based information. The European Commission is addressing this need through its DirectorateGeneral (DG XIII) for telematics under the Advanced Informatics in Medicine (AIM) program. H.C., C. R. 82 TTHE HE G GLOBAL LOBALV VIEW IEW Pan American Health Organization . N NETWORK ETWORK Recommended Application/Content List Surveillance and epidemiological information - information on the patterns and trends of diseases and related healthcare measures. Management information - for day-to-day management needs and for planning, programming, budgeting, operations, monitoring, evaluation. Clinical data / information - to support diagnosis/ treatment.

Literature search / retrieval - documentation, reports, publications. Knowledge - information readily usable to support a technical task or health-related decision, such as solution of a public health matter or the diagnosis of a medical problem, conduction of a laboratory test and related proposed treatment, timely / appropriate prescribing of drugs. Telemedicine - the ability to bring remote consultation by specialists and to assist in linking teachers and students in continuing medical education and employee training. H.C., C. R. 83 TTHE HE G GLOBAL LOBALV VIEW IEW 1998 Summit of the Americas Health . N NETWORK ETWORK Initiative The proposed 1998 Summit of the Americas Initiative "Health Technology Linking the Americas", a single proposal with 3 well linked components will foster the wide application of these health technologies to improve health conditions and contribute to human development, helping to define the inequities more clearly as well as providing the possibilities of reducing them. The governments will: 1. Endorse a Regional Initiative for Vaccines that will address

research, development, production and utilization of vaccines, and support the harmonization efforts in the area of pharmaceutical products, with special emphasis on essential drugs. This initiative builds on the success of national immunization programs and regional efforts that resulted in the polio eradication and a new initiative to eliminate measles and neonatal tetanus, maintenance of high immunization coverage, and would help move the countries into the technological developments that will bring new and improved vaccines into their immunization programs. H.C., C. R. 84 TTHE HE G GLOBAL LOBALV VIEW IEW 1998 Summit of the Americas Health . N NETWORK ETWORK Initiative This initiative will foster the technology exchange within the Region and with industrialized countries. Special attention will be given to the development of the following vaccines: triple viral vaccine (measles, mumps, rubeola), and polysaccharide vaccines against typhoid (S. Typhi), meningitis hemophilus M. Meningitides), and pneumonia (S. Pneumonia), by means of promoting multinational projects for research and technological development. Together with the above, and taking into consideration the ongoing processes of economic integration, will be the support to countries in their efforts to harmonize regulatory requirements and procedures for the approval, registration and marketing of pharmaceutical products, with special emphasis on essential drugs. Regulatory harmonization will improve the availability of quality drugs and

prevent the marketing of ineffective or dangerous products. Finally, this initiative will stimulate collaboration among the countries providing a concrete area of common interest to the private sector, international agencies and the multilateral lending institutions. H.C., C. R. 85 TTHE HE G GLOBAL LOBALV VIEW IEW 1998 Summit of the Americas Health . N NETWORK ETWORK Initiative 2. Strengthen and improving the existing regional networks of health information technologies and surveillance systems, such that all stakeholders have access to data to help them make correct decisions. Countries must address existing and emerging issues through increased use of health communication technology and surveillance. It is necessary to take advantage of this opportunity in order to improve the collection, analysis and dissemination the data that countries can produce about their own health situation. Countries will support all the efforts towards developing more effective health information, epidemiological surveillance, networks of laboratory, and vital statistics systems which, among other objectives, are essential in reducing maternal mortality in adolescence and throughout the reproductive years.

There is no doubt that the rapid development of information technology will revolutionize our approach to health. H.C., C. R. 86 TTHE HE G GLOBAL LOBALV VIEW IEW 1998 Summit of the Americas Health . N NETWORK ETWORK Initiative Partnership in the area of telecommunications will generate networks which will allow for the exchange of information among countries and the use of telemedicine for increasing access to some services. In addition, it will contribute to building institutional capacity for undertaking health care technology assessment. This constitutes the basis for the rational adoption of and investment in, new health care technologies. It is an area of increasing importance in the field of health systems development, and an instrumental piece for advancing the agendas of health sector reforms processes in the countries of the Region.

It is aimed at assessing the safety, efficacy and cost of procedures and interventions, and bears direct implications for improving quality of care, for resource allocation practices, and for the definition of investment priorities in the health sector H.C., C. R. 87 TTHE HE G GLOBAL LOBALV VIEW IEW 1998 Summit of the Americas Health . N NETWORK ETWORK Initiative 3. Develop and utilization of effective low-cost technologies to provide Basic Sanitation Services, ensuring safe water supply, sanitation and solid waste management. Governments can ensure the safety of the water sources in the conventional distribution systems. In some countries the systems that are proposed are no doubt efficient, but are costly. Development and utilization of proven effective low-cost technologies in this field: Will expand the provision of basic sanitation services Will diminish the health risks associated to this problem Would have a positive impact in the poor population segments of the countries, especially in the rural areas.

H.C., C. R. It would reinforce as well the goals of the 1990 World Summit for Children by fostering declines in infant and child mortality. 88 TTHE HE G GLOBAL LOBALV VIEW IEW 1998 Summit of the Americas Health . N NETWORK ETWORK Initiative There are also newer developments in the field of solid waste disposal, sanitary disposal of garbage, and promising ideas for returning waste to agricultural areas, thereby in the medium term, enhancing food production. Several of these technologies already exist, requiring further dissemination and application. This effort would be complemented with an intense program of technical cooperation for the application of these technologies. This approach will allow to support the items of the Plan of Action for the Sustainable Development of the Americas that accompanied the Declaration of Santa Cruz de la Sierra, in terms of identifying and adapting these technologies to the concrete realities of our countries.

H.C., C. R. 89 TTHE HE G GWorld LOBAL LOBAL V V IEW IEW Health Organization: Health for All in the 21st . Century Vision and N NETWORK ETWORK Policy The GlobalView Health Network will facilitate deployment of projects that support the values and help to achieve the goals of the World Health Organizations Health for All in the 21st Century vision. The official Health for All policy was written into WHO's 1946 constitution, initiated as a goal for all societies in 1977 and renewed in 1995. WHO health partners (Multilateral Banks, United Nations, World Trade Organization, NGOs, Academia, Researchers, and the Private Sector) emphasize "Health for All remains the central vision for health in the 21st century". Embracing Health for All policy values will influence the type of choices made by governments and national and local health

stakeholders when Selecting among their policy options The way these choices are made The interests they serve H.C., C. R. 90 TTHE HE G GLOBAL LOBALV VIEW IEW World Health Organization: . N NETWORK ETWORK Health for All Goals and Values The goals of Health for All are to achieve: An increase in healthy life expectancy for all people Universal access to quality health care Health equity between and within countries These goals will be realized through the implementation of three interrelated policy directions: Embracing the values of Health for All Making health central to development Developing sustainable health systems Health for All is based on the following values: Universal right to health / equity-oriented policies and strategies

The application of ethics to health policy, research and service provision The incorporation of a gender perspective into health policies and strategies H.C., C. R. 91 TTHE HE G GLOBAL LOBALV VIEW IEW World Health Organization . N NETWORK ETWORK Essential Public Health Functions Health for All presents the values and principles to guide action and policy for health at global, regional, national and local levels. The GlobalView Health Network will provide 24/365 access to health informatics tools, methods, approaches and training programs that ensure World Health Organization Health for All essential public health functions are maintained in each nation and worldwide. Such functions build on existing primary health care services H.C., C. R.

Guiding sustainable health systems Ensuring active surveillance Making care available across the life span Preventing and controlling disease, and protecting health Fostering the use of, and innovation in, science and technology Building and maintaining human resources for health Securing adequate financing for sustainable health systems 92 TTHE HE G GLOBAL LOBALV VIEW IEW 1. Guiding Sustainable . Health Systems N NETWORK ETWORK According to Health for All, if public health policy makers and practitioners are to be able to make informed decisions for public health; they need to use epidemiological, economic, management, demographic, and other types of information. This information is most timely and appropriate when derived from health- and management-information systems, public health surveillance systems, special registries, surveys, and studies. In support of WHO's Health for All, The GlobalView Health Network would provide access to tools, methods and training programs to improve skills for informed decision making using epidemiological, demographic, economic, and management information for: Obtaining and allocating resources Developing strategies to regulate and support private sector contributions to national health goals

Resource planning models Population projections H.C., C. R. 93 TTHE HE G GLOBAL LOBALV VIEW IEW 1. Guiding Sustainable . Health Systems N NETWORK ETWORK H.C., C. R. Geographic information systems Budget tracking systems National integrated health facilities data banks Identifying information needs and knowing how to obtain, validate, and analyze data from different sources Building decision making capacity to use information for: identifying and setting priorities; formulating health policies; identifying costeffective health interventions; planning, implementing, monitoring, and

evaluating public health programs. Strengthening information systems and enhancing use of tools to facilitate: availability of needed data; access to multi-source data; management of data; quality of timeliness of data; and interpretation and presentation of data Enhancing skills of technical advisors in: collecting valid data; improving the quality of data; conducting appropriate analysis; and communicating with decision makers about technical information Identifying and communicating with senior decision makers about program achievements and resource needs clearly and compellingly 94 TTHE HE G GLOBAL LOBALV VIEW IEW 2. Ensuring Active . Surveillance N NETWORK ETWORK According to Health for All, a hallmark of a sustainable health system is its emphasis on active surveillance and monitoring. Global, regional, national and local surveillance, monitoring and early warning systems will alert the public to impending threats to health, thus allowing appropriate action to be taken. Enhanced linkages between local settings, national organizations and WHO will be made possible by improved information and communications technologies. Complementary mechanisms that monitor States' implementation of agreed obligations will be part of global surveillance. National and local information systems for health such as The GlobalView Health Network are a prerequisite for the development of effective, efficient, equitable and quality health systems. National and local monitoring, surveillance and evaluation need to provide

timely information to decision-makers and the public that will facilitate evaluation and management of health systems and facilitate the best use of resources. H.C., C. R. 95 TTHE HE G GLOBAL LOBALV VIEW IEW 2. Ensuring Active . Surveillance N NETWORK ETWORK An integrated system of active surveillance and monitoring for health will focus, at least, on the following areas: Infectious diseases Health status and trends, including birth and death rates Implementation of international norms, standards and regulations Progress in reducing health inequities Performance of the essential public health functions The impact of various lifestyles on health status Transnational health problems and sectoral impacts on health H.C., C. R. 96 TTHE HE G GLOBAL LOBALV VIEW IEW

3. Making Care Available Across the Life N NETWORK ETWORK Span. According to Health for All, a life span approach to health care acknowledges the complex and interrelated effects of many factors on the health of individuals and their children. Life span care emphasizes interventions with a preventive potential that extends from birth to death. The life span approach is based on evidence of intergenerational effects, and on linking early factors - present from before conception to childhood - with health in adolescence and later life. There are many examples of conditions and behavior whose early prevention is important for later health. A life span approach to health promotion, prevention and care has the potential to limit disability and enhance the quality of life in later years. Health care settings in the twenty-first century will differ from today. A greater focus on incorporating scientific evidence into clinical practice, combined with an emphasis on quality of care, should reduce variations in diagnoses and outcomes. A wider range of care and specific services in community settings should be available directly or indirectly, such as through the use of communications technology. H.C., C. R. 97 TTHE HE G GLOBAL LOBALV VIEW IEW 3. Making Care Available Across the Life N NETWORK ETWORK Span. The GlobalView Health Network would provide capacities for the conversion of raw, disparate streams of patient data into uniform,

actionable, comparative clinical information - one of the best ways for the world's medical community to track the effectiveness of different therapies. Also, the objectivity and inherent fairness of informatics systems provide what all health professionals crave: feedback. Health care providers at all levels of the system can now look at various processes, costs and quality components of the care they deliver and the sum of these components can now be calculated to determine which clinical approaches are clearly better, more costeffective and less risky. Cutting edge databases can report how effectively patients have responded to various procedures. Monitoring and measuring medical practices and the ability to form a consensus about what tests and procedures will be allowed will translate into better health for everyone across their life span - and into Health for All. H.C., C. R. 98 TTHE HE G GLOBAL LOBALV VIEW IEW 3. Making Care Available Across the Life N NETWORK ETWORK Span. In support of WHO's Health for All, The GlobalView Health Network would provide assistance that would: Establish two-way communication among all facilities and professionals to enable collection of relevant patient data to create life-span computerized patient records and to provide 24/365 access to these records on a secure

basis to all appropriate health personnel. Institutionalize the capacity to reengineer by developing concrete processes, tools and methods for detecting external changes; determining what those changes mean; modifying or transforming the health system accordingly. Enable communication among NGOs to discuss global expansion of successful community-based, problem-focused approaches to health services based upon community-wide assessment of health care needs and collaborative implementation of solutions Facilitate expansion of community-based, primary health care services for specific population segments receiving inadequate health services (infants and children; adolescents; the elderly; rural families; urban poor). Develop extensive networks, and coalitions with health care and social agencies to develop cooperative efforts to meet the medical needs of the underserved. H.C., C. R. 99 TTHE HE G GLOBAL LOBALV VIEW IEW 4. Preventing and Controlling Disease . N NETWORK ETWORKProtecting Health According to Health for All, disease prevention for populations is crucial to human development. Disease prevention and disease management across the life span benefits individuals and communities. Community-based disease prevention and health protection services benefit all, with implementation demanding minimum individual participation. Maintenance and extension of such services, where needed, should be a priority of local government.

The auditing of preventive actions and disease management programs can be vastly improved through the usage of The GlobalView Health Network. The opportunity exists to yield improved health and a reduction of costs through these actions. The bottom line of prevention is to reduce the incidence of disease (infectious or chronic). The Network would monitor and audit the determination of incidence locally and nationally. Disease management programs offer great potential to reduce costs while improving outcomes and are great opportunities for improvement and savings. H.C., C. R. 10 0 TTHE HE G GLOBAL LOBALV VIEW IEW 4. Preventing and Controlling Disease . N NETWORK ETWORKProtecting Health In support of WHO's Health for All, The GlobalView Health Network would provide assistance that would: Encourage governments to set priorities for establishing communitybased disease prevention and health protection services emphasizing delivery, maintenance and extension of such services, where needed. Encourage delivery of primary care health services as an important instrument for achieving stronger emphasis on (a) health promotion and disease prevention, and (b) care of the chronically ill, especially among the elderly with multiple problems. Primary care allows for disease prevention, health promotion, and early detection of disease. Provide access to tools and methods to enable worldwide efforts for surveillance and control for diseases of global importance through collaboration with WHO and its international partners. Provide access to tools and methods enabling decisions regarding global

eradication to be based upon global consensus so that any action is taken only after consideration of the likely direct and indirect benefits. H.C., C. R. 10 1 TTHE HE G GLOBAL LOBALV VIEW IEW 4. Preventing and Controlling Disease . N NETWORK ETWORKProtecting Health Determine simplest and quickest means of linking all points of care for: collection of relevant data, making relevant data available to medical decision makers and measuring outcomes in support of prevention and disease management programs. Facilitate provision of 24/365 two-way communication among all facilities and professionals for planning, implementing, monitoring, managing and evaluating public and private sector health care, prevention and diseasecontrol interventions and programs. Collaborate with public health services, pharmaceutical, health insurance and managed care industries worldwide to institute prevention and disease management programs throughout all health facilities in each nation. Provide access to and distribution of community-based disease prevention and disease management programs as well as health protection services. Provide access to tools, methods and training programs that prioritize assisting the poorest countries and communities deal with the burden of childhood infectious diseases, maternal mortality and undernutrition. H.C., C. R. 10 2

TTHE HE G GLOBAL LOBALV VIEW IEW 4. Preventing and Controlling Disease . N NETWORK ETWORKProtecting Health Provide access to tools, methods and training programs as well as the two-way communication needed for developing and expanding community-based health care programs emphasizing child survival and other infant, child and adolescent health services including: Providing assistance to numerous public and private voluntary organizations to strengthen children's health care interventions including training health workers and physicians and developing local and regional capacities to deliver primary care services. Helping develop information systems that increase management, evaluation and planning abilities of local health agencies for children's health care. Conducting demographic and health surveys which provide data on the status of children's health interventions. Disseminating information on health care financing and sustainability. Finding better, more economical methods of diagnosis, treatment, prevention and control of diseases that affect women and children. H.C., C. R. 10 3 TTHE HE G GLOBAL LOBALV VIEW IEW 4. Preventing and Controlling Disease

. N NETWORK ETWORKProtecting Health Providing field and applied research support to improve maternal and neonatal care, behavior and pregnancy outcomes. Working with underserved communities to improve health service delivery and community and home health practices (nutrition, education, preventive programs, early diagnosis, etc.). Mobilizing health teams to provide care / train community health workers. Developing an information exchange among country leaders and health providers on all aspects of children's health care. Providing non-degree and degree training for health workers and professionals through short-term training courses. Providing technical assistance for appropriate feeding services to improve the nutritional status of women, infants and children including nutrition education programs. Training service delivery personnel and providing technical assistance on the prevention of selected diseases and deficiencies. H.C., C. R. 10 4 TTHE HE G GLOBAL LOBALV VIEW IEW 5. Fostering the Use Of, and Innovation . N NETWORK ETWORK In Science and Technology According to Health for All, closer partnerships between science and technology, between users and innovators, and between the private and public sectors will increase the chances that innovations in science

will contribute to improved health worldwide through the development of technology and the implementation of research. The scope of technologies for health extends from those that provide a direct benefit to health such as genetic modification, biologicals, pharmaceuticals and medical devices to those that are supportive of health system functions, such as telecommunications, information technologies, devices for environmental protection, and food technologies. Communications and electronic information technologies, for instance, offer opportunities for the most remote researchers to participate fully and contribute to scientific progress. The GlobalView Health Network would provide the 24/365 two-way communication needed for voice, data, video and the ability to share images of all kinds. H.C., C. R. 10 5 TTHE HE G GLOBAL LOBALV VIEW IEW 5. Fostering the Use Of, and Innovation . N NETWORK ETWORK In Science and Technology The Network's data collection and analysis capabilities will assist governments to collaborate with various individuals, agencies, NGOs,

and institutions in identifying specific health needs and finding quality, cost-effective solutions for each of them (pilot programs). This will foster community-based, primary health care services for selected age groups which are subject to frequent problems, and for specific segments of the population that receive inadequate health services. This would assist governments to focus on creative health projects that involve a wide representation of community interests. The value of collecting information and analyzing data from a set of given projects lies in putting it to use by disseminating it to local officials, institutional leaders and other policy makers. Policy makers may then make better, more knowledgeable decisions about health care for people if they have information from several successful, proven projects. Information, for example, on the costs and benefits of preventive community health care for the elderly, as opposed to the costs and drawbacks of treating such individuals after they become ill. H.C., C. R. 10 6 TTHE HE G GLOBAL LOBALV VIEW IEW 5. Fostering the Use Of, and Innovation . N NETWORK ETWORK In Science and Technology In support of WHO's Health for All, The GlobalView Health Network would provide assistance that would: Provide tools and methods that allow poorer countries to take maximal advantage of developments in technology and benefit from the

experiences of other countries. Support country-specific research priorities and action, through which countries will work towards improved national and global health. Promote primary care research, clinical trials and access to publication of results. Promote original research that encompasses evaluations of model and demonstration projects to improve rural health, statistical comparisons of rural-urban differences, and mathematical models examining the service utilization patterns of rural residents. Provide access to databases, knowledgebases, and global reference sources, identify tools to transfer knowledge, technical support, exchange of experiences, and foster use of appropriate technology and knowledge assets. Improve treatment outcomes based on best available scientific evidence. H.C., C. R. 10 7 TTHE HE G GLOBAL LOBALV VIEW IEW 6. Building and Maintaining . N NETWORK ETWORK Human Resources for Health According to Health for All, a well-trained and motivated workforce is essential for health systems to function well. The health workforce of the twenty-first century must be capable of providing quality health services based on Health for All values. A culture of health that respects and supports the right to health, ethics, equity, and gender sensitivity, and analysis in protecting and promoting public health is fundamental. GlobalViews well-designed computer-based courseware provides

enhanced ease of access to instructional courses and sequences. With interactive multimedia consistent, high-quality training presentations could be given at a time that is convenient for each workers schedule. For staff with wide ranging computer skills and training needs the courses allow users or their supervisors to customize training or pick and choose as needed. High demands and narrow budgets are a genuine challenge for computer-based training. As the systems mature and health providers cope with the changes in their training and educational needs, interactive multimedia will become the trainer-ofchoice in health care. H.C., C. R. 10 8 TTHE HE G GLOBAL LOBALV VIEW IEW 6. Building and Maintaining . N NETWORK ETWORK Human Resources for Health In support of WHO's Health for All, The GlobalView Health Network would provide assistance that would: Expand human resources planning's current emphasis on medical and nursing personnel to be complemented by a cadre of people capable of working in a multidisciplinary and collaborative fashion. Extend the boundaries of existing developmental, environmental, social, public health and medical disciplines to include members of the community who will increasingly provide care for people at home and in the community. Constantly upgrade health worker's skills to utilize new technologies. Give greater attention to training in communications and health promotion skills to serve the public need for better information about health. Use telecommunications linkages to offer new opportunities for distance learning and diagnostic support in many settings and allow accelerated

development of human resources in poor countries and communities. Address broader human resource issues, such as transnational movement of health professionals, availability of training, need for international harmonization of education and service standards through broad global and national policies. H.C., C. R. 10 9 TTHE HE G GLOBAL LOBALV VIEW IEW 7. Securing Adequate Financing . N NETWORK ETWORK for Sustainable Health Systems According to Health for All, government action and regulation are needed: To secure an adequate level of financing (through public or private sources) To promote cost containment and fiscal discipline To provide essential drug and technology lists To ensure that national resources are utilized equitably to meet health needs. Close collaboration between health, finance and planning departments in government is required to achieve these objectives. When the government is the main funder of health systems, it follows that equity of access, efficiency, and cost containment is more likely.

The GlobalView Health Network would make it possible for health information to be recorded, collected, analyzed and acted upon with immediacy and foresight. H.C., C. R. 11 0 TTHE HE G GLOBAL LOBALV VIEW IEW 7. Securing Adequate Financing . N NETWORK ETWORK for Sustainable Health Systems Data-based decision-making contributes to the enactment of policies and programs that allocate health resources to priority problems as supported by epidemiological and demographic data. In today's health care environment, epidemiological data collection is principal to creating priorities for the delivery of care and management of finances. Additionally, epidemiological data helps health care providers make educated decisions relevant to budgetary planning and longterm forecasting. Future trends suggest that this form of data collection will drive much of healthcare decision making and will determine how funds are allocated.

Being able to monitor and respond to changing health conditions, whenever and wherever they happen, are keys to health success. H.C., C. R. 11 1 TTHE HE G GLOBAL LOBALV VIEW IEW 7. Securing Adequate Financing . N NETWORK ETWORK for Sustainable Health Systems In support of WHO's Health for All, The GlobalView Health Network would provide assistance that would: Encourage improvement of analytic capabilities to ensure the equitable and efficient use of financial resources. Ensure costs of providing access to essential health system functions, as well as the burden of rationing, will be distributed fairly across the population. Help secure adequate levels of financing for sustainable health systems from community sources and international donors (poorest countries) ensuring that a large share of financing derives from a prepaid source of revenue to improve the chances of achieving equitable and efficient health services; and from cost containment measures. Create pre-identifiable funding streams (from procurement savings and other sources) to sustain on-going costs to deploy and maintain The Health for All Network in each nation and worldwide in order to help bring Health for All in the 21st Century to not just a small group of

people, but the whole family of mankind - and those yet to be born. H.C., C. R. 11 2 TTHE HE G GLOBAL LOBALV VIEW IEW Primary Health. Care System N NETWORK ETWORK The World Health Organization's Health for All Program emphasizes Primary Health Care (and Prevention) as the centerpiece of health system reform worldwide because PHC programs are more cost-effective than curative programs. WHO believes PHC should constitute the core of an affordable basic health package accessible to all citizens. PHC prevents disease, promotes stimulates community participation. Even in developed nations, such as the United States, after decades of relative neglect in a health care system that placed most of its emphasis on specialization, high technology, and acute care medicine, the value of PHC is again being recognized as vital to the reform sweeping the U.S. health care industry.

H.C., C. R. healthy lifestyles and 11 3 TTHE HE G GLOBAL LOBALV VIEW IEW Primary Health. Care System N NETWORK ETWORK The GlobalView Health Networks definition of primary care is presented in terms of the function of primary care, not solely in terms of who provides it. The critical elements include: Integrated and accessible health care services Services provided by primary care clinicians generally considered to be physicians, nurse practitioners, and physician assistants but involving a broader array of individuals in a primary care team Accountability of clinicians and systems for quality of care, patient satisfaction, efficient use of resources, and ethical behavior The majority of personal health care needs, which include physical, mental, emotional, and social concerns A sustained partnership between patients and clinicians Primary care in the context of family and community H.C., C. R. 11

4 TTHE HE G GLOBAL LOBALV VIEW IEW Primary Health. Care System N NETWORK ETWORK The GlobalView Health Networks road map for reaching its goals are reflected in five assumptions: Primary care is the logical foundation of an effective health care system because primary care can address the large majority of the health problems present in a population. Primary care is essential to achieving the objectives that together constitute value in health care / quality of care (including achievement of desired health outcomes), patient satisfaction, and efficient resource use. Personal interactions that include trust and partnership between patients and clinicians are central to primary care. Primary care is an important instrument for achieving stronger emphasis on (a) health promotion and disease prevention and (b) care of the chronically ill, especially among the elderly with multiple problems. The trend toward integrated health care systems in a managed care environment will provide opportunities/challenges for primary care. H.C., C. R. 11 5 TTHE HE G GLOBAL LOBALV VIEW IEW Primary Health .Care System N

NETWORK ETWORK To bring this PHC vision closer to reality, The GlobalView Health Network intends to address the opportunities for and challenges of reorienting primary health care in our world: Give a clear definition of the function of primary care that can guide public and private actions to improve health care. Encourage certain organizational arrangements for health care, built on a foundation of strong primary care that will facilitate the coordination of the full array of services essential for maintaining and improving patient health status. Argue for development and dissemination of improved information systems and quality assurance programs for primary care. Suggest financing mechanisms that encourage good primary care rather than episodic interventions late in the disease process. Enhance the knowledge base for primary care based on clinical and health services research. H.C., C. R. 11 6 TTHE HE G GLOBAL LOBALV VIEW IEW Primary Health. Care System N NETWORK ETWORK Encourage support for training of a primary care workforce sufficient in numbers to meet the needs for primary care; equipped with the skills and competencies that match the function as The GlobalView Health Network has defined it; and prepared to work in the context of a team that includes primary care physicians, nurse practitioners, physician assistants, community health workers, and other health professionals. Advocate development and sustained support of means to make

primary care available to all people, regardless of economic status, geographic location, or language and cultural differences. Speak to the development of primary care as a continually improving system in an era of rapid change through program evaluations and dissemination of innovations. The World Health Organization's Health for All Program emphasizes Primary Health Care (and Prevention) as the centerpiece of health system reform worldwide because PHC programs are more costeffective than curative programs. H.C., C. R. 11 7 TTHE HE G GLOBAL LOBALV VIEW IEW Primary Health Care . Steering Group N NETWORK ETWORK The GlobalView Health Network envisions a Best Practice Primary Health Care System that can be customized for integration into any of our world's national health systems electronically supported by The GlobalView Health Network. Coordinated implementation by many participants over time is unlikely to take place unless an entity exists whose purposes are to build appropriate coalitions, stimulate action, and monitor and facilitate implementation. The GlobalView Health Network suggests the formation of a Primary Health Care Steering Group to coordinate efforts to promote and enhance primary care, conduct research and development projects, provide technical assistance, disseminate information on primary care infrastructure, innovative models of primary care, and methods to monitor primary care performance. Important parts of the Health for All agenda require government action, but for many elements the key

decision makers are to be found in in health care plans, in educational institutions, in professions, and in private foundations and NGOs. Many of these are committed to a renewed emphasis on primary care. H.C., C. R. 11 8 TTHE HE G GLOBAL LOBALV VIEW IEW Primary Health Care . Steering Group N NETWORK ETWORK This is a time when creative effort and collaboration can influence the forces driving health care change in the directions defined by Health for All. The climate for moving ahead on a global Health for All agenda emphasizing primary care is quite favorable. In support of WHO's Health for All, The GlobalView Health Network and the Primary Health Care Steering Group will work with governments to initiate national policies that support these recommendations, especially those that: Address the long-term needs for a health workforce Develop institutional and individual leadership Strengthen managerial capacity Improve the management, infrastructure and institutional environment with a special emphasis on primary healthcare: H.C., C. R. 11

9 TTHE HE G GLOBAL LOBALV VIEW IEW Values Guiding Network . Establishment N NETWORK ETWORK Patient Care: Enhance timely access to medical care and other health services. Maximize resource allocation to direct patient-care services. Facilitate health promotion, disease prevention, and early diagnosis. Enhance appropriate patient referral and service utilization. Keep patient-care decision making as close as possible to the patient. Promote horizontal, patient-focused processes. Minimize disruption of the present system during implementation.

Provide compassionate, comprehensive, well coordinated healthcare with equal access to equal services regardless of racial, ethnic, economic or geographical considerations - especially for women, children and the elderly. H.C., C. R. 12 0 TTHE HE G GLOBAL LOBALV VIEW IEW Values Guiding Network . Establishment N NETWORK ETWORK Quality: Facilitate the development of integrated systems of care. Ensure systemwide consistency in quality and coverage. Minimize fragmentation of functions. Enhance capacity for continuance improvement.

Facilitate systemwide data acquisition and performance measurement. Flexibility: Facilitate sharing and collaborative agreements. Accommodate national and local healthcare reform initiatives. Facilitate local flexibility and decision making. H.C., C. R. 12 1 TTHE HE G GLOBAL LOBALV VIEW IEW Values Guiding Network . Establishment N NETWORK ETWORK Efficiency: A combined clinical and management information system that is firmly based on gathering information during the course of clinical care and deriving management data as a by-product of these interactions. Gives each health facility immediate access to consolidated data at the regional / national levels and foster sharing of data between facilities.

Maximize timeliness of information flow to appropriate decision makers and internal and external stakeholders to maximize responsiveness to individual patient needs and outside stakeholders. Provide clear lines of authority and responsibility, enhance managerial accountability, minimize redundancies, maximize administrative efficiencies. Ensure each organizational layer / higher level oversight provides added value. H.C., C. R. 12 2 TTHE HE G GLOBAL LOBALV VIEW IEW Benefits to Ministry . of Health N NETWORK ETWORK Quality Improvement - conducting an ongoing review of how to improve the quality of care and of administrative services. Utilization Management - monitoring and reporting on all aspects of health care service use across all provider groups. Patient Services - providing problem-solving assistance and guidance

on how to use the health system. Citizen Satisfaction - providing (patient/provider) satisfaction surveys Medical services - overseeing clinical services such as those offered at health plan facilities. Outcome measurement - ongoing evaluation of outcome data. Provider relations developing / maintaining productive relationships. Regulatory compliance - making sure that all health plans maintain licensure, certification and accreditation. Administration - overseeing all health plan operations Claims processing - receiving claims information H.C., C. R. 12 3 TTHE HE G GLOBAL LOBALV VIEW IEW Benefits to Health . Providers N NETWORK ETWORK Better care of the patient by using the Network due to: Diagnostic aids, clinical pathway protocols / science-based guidelines Initial patient assessment / severity satisfaction Disease management programs / real-time use of outcomes Provider education, profiling and feedback

Real-time second opinion: Computer-based sophisticated medical algorithms Access to telemedicine Continuous updated education for best available medical service. Easier electronic administration of health operations including more efficient electronic medical records instead of using paper records. More efficient claims processing, transmission of claims information, faster reimbursement of claims due to real-time exchange of information. H.C., C. R. 12 4 TTHE HE G GLOBAL LOBALV VIEW IEW Benefits to Third . Party Payers N NETWORK ETWORK

H.C., C. R. Controlling costs and managing risks Authorizing appropriate treatment Providing individual attention to members Adding value through an ongoing dialogue Communicating with potential subscribers Facilitating enrollment processes Benefits management Premium billing and accounts receivable Provider contract and pricing management Capitation Claims management (medical / hospital / drug / dental / other provider) Claims payable Customer / provider service Correspondence generation 12 5 TTHE HE G GLOBAL LOBALV VIEW IEW Benefits to Third . Party Payers N NETWORK ETWORK

Medical management Data warehouse H.C., C. R. Certification / authorization Case management / disease management Concurrent review Discharge planning Provider credentialing Quality improvement Appeals Utilization database / membership database Utilization reports Outcome indicators Practice providers 12 6 TTHE HE G GLOBAL LOBALV VIEW IEW

More GlobalView Health . Network Benefits N NETWORK ETWORK The Network will provide those who finance health care (The Ministry of Health, multilateral organizations and third party payer organizations) with more information about the cost, effectiveness and quality of the services they are buying. The Network will provide more information with which to manage costs and improve healthcare. Eliminate medical tests and operations that are unnecessary - decreasing duplicative and erroneous tests. Persuade doctors to prescribe only the most cost-effective drugs and surgical procedures. Provide a computerized mechanism through which doctors will have to demonstrate that their work is effective. Encourage hospitals/clinics to treat more people as out-patients or at home to curb health care costs; shorten hospital stays; reduce visits per illness. Evaluate new alternatives available in the area of commercial or proprietary criteria guidelines. Increase productivity of healthcare providers by shifting time from paperwork to patient care. H.C., C. R. 12 7 TTHE HE G GLOBAL LOBALV VIEW IEW More GlobalView Health . Network Benefits

N NETWORK ETWORK Become doctors helpmates to manage data, combine information services, eliminate unnecessary patient record duplication and advise on trade-offs using something more than enlightened guesswork (instinctive decision making involves greater risk than does decision making based on qualitative information). Improve financial / management information handling; generating and updating the value-for-money appraisals that the Ministry of Health and insurers require. Automate all hospital operational and clinical departments (Pharmacy, Imaging, Laboratory, Surgery, Nurse Services. Scheduling, Business Office, Materials Management, etc.). Allow concurrent review of performed care. Provide the electronic storage of all medical records with systems that facilitate access, retrieval and information sharing. Provide more careful assessment of the benefits of medical treatment (including many new technologies which although they are expensive will yield off-setting savings by reducing need for hospitals, doctors and nurses). Education and preventive care (with major implications for cost reduction). H.C., C. R. 12 8 TTHE HE G GLOBAL LOBALV VIEW IEW More GlobalView Health . Network Benefits N NETWORK ETWORK Create country-specific expert-intelligence software programs to aid in

medical decision making. These systems examine patient data, such as symptomology, medical background, diet, drug history and laboratory test results and then apply this data against a knowledge base, measuring it against the rules of judgment and providing physicians with clinical indicators to assist in diagnosis as well as user-established protocols. This information helps improve the speed and effectiveness of patient care. The established data bases within each nation can lead to creation of customized expert systems to serve the entire population. Provide chronic disease management (e.g. diabetes, asthma) - a holistic, integrated, systematic approach to managing when, where, how and by whom key disease states can be best and most efficiently prevented, diagnosed, treated and maintained for the benefit of all concerned. Dramatic improvements in productivity / job satisfaction. Allow physicians and their staff to manage the patient care / practice enhancement aspects of their practices more effectively (physician / hospital networking). Provide clinical oversight to identify when to modify, develop and approve clinical compliance with the government or an accreditation committee. H.C., C. R. 12 9

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