ePolicy and Strategic eDevelopmentsPerson Centred and Coordinated care

Health Design Authority, Office of the Chief Information OfficerDepartment of HealthTony 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

Information

Collaboration

Principles

Standards

Experience

Process

Technology

People

HDF

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

•NEHTA and Adoption of National Packages

•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

Information

Collaboration

Principles

Standards

Experience

Process

Technology

People

HDF

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

Information

Collaboration

Principles

Standards

Experience

Process

Technology

People

HDF

Health Design Forum

Forum Process

Information

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HDF

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)

• Change and adoption

Information

Collaboration

Principles

Standards

Experience

Process

Technology

People

HDF

National eHealth Initiatives

eHealth initiatives and Involvement with NEHTA:

• Full participation and guidance in all NEHTA packages

• Key initiative: IHI Design for Australia

• 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

• 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 PilotsCurrent 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

• Interoperability Standards for Victoria (HL7/Codesets/Terminology)

• HL7 / CDA and Messaging Standards• Terminology• Principles

• NEHTA IHI Design

• Minimum Standards for Health Systems (EMR), plus..

• Health Design Forum Papers