Transcript Presentation heading (Arial 26 pt) white

ePolicy and Strategic eDevelopments
Person Centred and Coordinated care
Health Design Authority, Office of the Chief Information Officer
Department of Health
Tony Abbenante : Manager Design Authority and Integration
ISO Continuity of Care Definition
Component of patient care quality consisting of the
degree to which the care needed by a patient is
coordinated among practitioners and across settings
and time
(ISO DIS 13940)
Continuity of Care Benefits Research
Recurring theme around information:
“Research is beginning to show that poor information transfer and discontinuity are
associated with lower quality of care on follow-up, as well as adverse clinical outcomes.
Moore et al found that errors related to discontinuity of care occurred for about 50% of
patients and that lapses in communication related to diagnostic evaluations were
associated with a significantly higher risk of readmission.” (JAMA, 2007)
Many articles sight the key difficulties around sharing information electronically:
• Lack of consistent standards for messaging and terminology for continuity
• Clear definition of information sets that are effective for continuity and the
quality of information
• Lack of application capability supporting standards and information
• Clear governance around processes, and standards
People
Information
Collaboration
Technology
HDF
Principles
Process
Experience
Standards
ePolicy and Strategic eDevelopments
Key Initiatives and Policy Direction
•
National eHealth MoU
•
The National eHealth Business Case
•
The Ministers ICT Review Panel and future ICT directions
•
The Health Design Forum
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NEHTA and Adoption of National Packages
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Key directions
MoU on developing a national eHealth
capability
• A commitment to achieving for Australia a world leading
eHealth capability underpinned by national specifications,
standards, services and infrastructure and providing for
ehealth solutions and systems that:
– enable a person’s key healthcare information to be accessed
electronically by their healthcare providers anywhere in Australia
through sharing information securely across geographic and
health sector boundaries;…
– use consistent national standards and specifications, and clinical
terminology to facilitate the inter-operability and connectivity of
health information systems.
National eHealth Business Case
• Initiative by NCIOF (National CIO’s Forum)
• Assessment of adoption of NEHTA packages
• Costing for adoption of packages by all jurisdictions
Ministers Review Panel
• Review of current common system approach - VPHS
• Review of good practice in health ICT for VPHS
– Standards, Terminology, Interoperability, Systems,
approach, policy
• Future directions for the VPHS in ICT
• Information of review will be available in the next few
weeks
Health Design Forum
Objectives and Purpose
• Sharing a common vision in the VPHS and nationally for ICT
solution trends and solutions that provide good outcomes
and benefits for patients
• Open and independent views of best practice in ICT which
support clinical best practice
• Establish a common base of knowledge around ICT
solutions in health
Health Design Forum
Objectives and Purpose
People
Information
Collaboration
Technology
HDF
Principles
Process
Experience
Standards
Health Design Forum
Outcomes
• Raise the level of knowledge across the sector in the
areas of standards and best practice, supporting the
use of IT systems in health
• To inform a set of guidelines to support ICT excellence
across the sector that has had VPHS and independent
examination
• Ensure that national directions and international trends
are considered in Victorian ICT solutions
• Share knowledge and findings within the health sector
to facilitate an understanding of ICT standards and
concepts
People
Information
Collaboration
Technology
HDF
Principles
Process
Experience
Standards
Health Design Forum
Forum Process
•HDF directs topic
•Expert group
• HDF meets to review
findings
• Topics presented to
investigates/prepares
detailed topic analysis
group for discussion
•Papers sent to HDF
• Member comments
members for review
recorded for inclusion
Investigate
Communicate
• Members approve
design
• Design documents loaded to
website for communication
across the sector
Assess
Approve
People
• Comments by members
Information
Technology
are recorded
• Design finalised and
distributed to members for
approval
Collaboration
HDF
Principles
Process
Experience
Standards
Health Design Forum
Topics for 2013
(in order of participant preference)
• EMR Adoption Models
• Exchange of health information across the care continuum
• Benefits Realisation
• Clinical Decision Support
• Adoption of PCEHRs and EHRs
• Adoption of National Identifiers (HPI-O, HPI-I, IHI)
People
Information
• Change and adoption
Collaboration
Technology
HDF
Principles
Process
Experience
Standards
National eHealth Initiatives
eHealth initiatives and Involvement with NEHTA:
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Full participation and guidance in all NEHTA packages
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Key initiative: IHI Design for Australia
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Wave 1 support project/POC (Discharge Summary to GP, Referrals)
• IHI, HPI-I/O, Discharge Summary content (Standards), Provider registration, HSD
• Minimum Standards and Maturity Level
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Rapid Integration Project/POC (Discharge Summary to PCEHR)
• IHI, HPI-I/O, Discharge Summary content (Standards), Consent Management, Patient Self
Registration, Provider Registration, NHSD
• Minimum Standards and Maturity Level
• PCEHR Viewing Capability
•
Medication Information (Scrips and Dispense records to PCEHR)
• IHI, HPI-I/O, Discharge Summary content (Standards), Consent Management, Patient Self
Registration, Provider Registration, NHSD
• Minimum Standards and Maturity Level
• PCEHR Viewing Capability
Health Design Authority – NEHTA Pilots
Current HL7 DS
Health Design Authority – NEHTA Pilots
Health Design Authority – NEHTA Pilots
Health Design Authority – NEHTA Pilots
Future Directions
• Standards and interoperability for the VPHS: to enable
CoC and associated benefits
– Terminology AMT, SNOMED, to enable CoC
– HL7, CDA (NEHTA), messaging standards
– Interoperability, and adoption of identifiers IHI’s
• EMR systems maturity models
– HIMSS, EMR maturity models
• Medications management
Interoperability and Standards
Dr. Doug Fridsma / Chief Science Officer and
Director, Office of Science & Technology
– Not all of interoperability is based on the syntax of
the data. More sophisticated ways of creating
interoperability require sharing a common meaning
for data or a common context (or workflow) in which
the data is collected or used…
– So interoperability is something that is not black or
white, but exists in the shades of gray between “not
able to exchange anything” to “comprehensive
ubiquitous data fluidity.” Also, we aren’t going to
get to there in one giant step.
Health Design Authority
Design Authority Web Page
http://www.health.vic.gov.au/designauthority
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Interoperability Standards for Victoria (HL7/Codesets/Terminology)
• HL7 / CDA and Messaging Standards
• Terminology
• Principles
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NEHTA IHI Design
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Minimum Standards for Health Systems (EMR), plus..
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Health Design Forum Papers