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PHI2008 Keynote Speech Lenert

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Les Lenert, NCPHI, CDC kenote speech slides for PHI2008, Seattle, WA, USA

Les Lenert, NCPHI, CDC kenote speech slides for PHI2008, Seattle, WA, USA

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  • Transcript

    • 1. Rockefeller Foundation Bellagio Workshop Week One: Enterprise Public Health Informatics (and Pathway to Interoperability)
    • 2. What was this all about?
      • Place
      • People
      • Mission
      • Ideas and ideals
      • Expected obstacles
      • Unexpected innovations drive novel solutions
      • The way(s) forward
    • 3. Bellagio: On hill above a lake and a picture-perfect hill-country town
    • 4.  
    • 5.  
    • 6. National Health System in Context Internal Audit Hospital & Lab Services Management Services Medical Services Nursing Services Human Resources for Health Financial Resources Disease Control & Prevention Drug & Medical Supplies Support Services Planning & Information Primary Health Care Governorate South Governorate West Governorate North Governorate East District N1 District N2 District N3 District N4 District E1 District E2 District E3 District E4 District W1 District W2 District W3 District W4 District S1 District S2 District S3 District S4 Justice Tourism and Culture Transportation Marine Resources Social Welfare Labor Energy and Power Trade & Industry Internal Affairs Local Government Lands Public Works-Housing Public Affairs Agriculture Health Natural Resources Information & Media Foreign Affairs Finance A National Goverment
    • 7. People that would benefit from technology often have a difficult time imaging how a technology might change what they do, Scott Adams captured it brilliantly… June 5, 2009
    • 8. Enterprise Architecture (The Open Group Architecture Framework)
      • Industry Consortium
      • Membership Lead
      • Outputs Approved by Members
      • Uses Industry Standards
      • Contributes to Standards
      • Architect Certification Program
      • 8 Versions in 12 Years
      Background www.opengroup.org
    • 9.  
    • 10. The National Health System as an Enterprise Internal Audit Hospital & Lab Services Management Services Medical Services Nursing Services Human Resources for Health Financial Resources Disease Control & Prevention Drug & Medical Supplies Support Services Planning & Information Primary Health Care Governorate South Governorate West Governorate North Governorate East District N1 District N2 District N3 District N4 District E1 District E2 District E3 District E4 District W1 District W2 District W3 District W4 District S1 District S2 District S3 District S4 A National Health System
    • 11. Are These initial Building Blocks Directionally Correct for an Appropriate Architecture?
      • Health Services
      • Laboratory
      • Pharmacy
      • Human Resources
      • Environmental Monitoring
      • Decision Support
      • Health Finance
      06/05/09
    • 12. What Common Architecture Building Blocks are Needed First? 06/05/09 Common HIS Architecture 6 5 4 3 1 2 12 11 10 9 7 8 National HIS Architecture 1 11 7 2 National HIS Solutions B B A A HIS Solutions A A A A A A B B B B B B
    • 13. Goal
      • Common set of interchangeable products
      • Modular approach to development
      • Open source approach
        • Different groups spearhead modules of greatest interest to them
    • 14. Conceptual Model of an Architecture Data Sources Integrated Health Information System Policies, Resources and Processes Routine and Non-Routine Data Collection Activities Extract and Integrate Data
    • 15. NCPHI: Health Protection Framework
      • Supply chain management
      • Outbreak Management System
      • Countermeasure Tracking
      • HAN
      • Biosense Integrator
      • PHIN Messaging
      • PHIN Vocabulary
      • Nationally Notifiable Disease Surveillance System (NEDSS)
      • Biosense
      • Biointelligence Center
      • Epi-X
      • Simulation
      Data Inform- ation Knowledge Decisions Plans Actions HEALTH THREAT
    • 16. Health Protection Framework Foundation EDUCATION POLICY EVALUATION RESEARCH APPLICATIONS & SERVICES STANDARDS Actions Plans Decisions Knowledge Information Data HEALTH THREAT
    • 17. Changing the Rules: IBM NHIN Prototype Architecture
    • 18. Clinical Document Architecture
    • 19. EA in Service Oriented Architecture Model
      • Systems
        • Agile development
        • Combine functions if needed across categories to tailor to workflow within county
      • Services support systems
        • Vocabulary modeling
        • Document, patient and encounter identifiers
        • Storage and retrieval
        • User authentication
        • Population summarization
        • Data exchange
    • 20. An SOA Enterprise Architecture Patient ID Document ID Encounter ID User authentication and security Vocabulary modeling and cross mapping Storage and retrieval Population summarization Data entry Decision Support Work flow management Collaboration tools Health services Laboratory Pharmacy Finance Planning Environmental Monitoring
    • 21. Real World Intrudes…
      • Segment architecture complexity
      • Workforce and informatics capacity
      • Program specific information needs and funding
    • 22. Complexities of Segment Architectures
      • Segments discussed
        • Laboratory
        • Pharmacy
        • Disaster response
        • Acute and chronic care
        • Vital statistics
        • Others
    • 23. Lab System Complexity
    • 24. Pharmaceutical Management
    • 25. Pharmaceutical Care is Disease Specific
    • 26. Emergency Response and Emerging Methods
    • 27. Workforce and Capacity Issues
      • What workforce
        • How can we (national governments) pay these guys enough to keep them?
      • What capacity?
        • Sierra Leone
    • 28. Silo Oriented Funding Issues
    • 29. Unexpected Innovations
      • Mobile phone and text messaging for EMR access in Kenya
      • San Paulo comprehensive public health system
        • EMR. Lab, Billing, and population health management using an SOA framework
    • 30. Moving Onward and Upward
      • Country specific enterprise architecture
      • Organized opportunism (SOA model)
      • Collaboration to demonstrate benefits of integration
    • 31. Commitment to address the Issue
      • WHO Country EA efforts
      • NCPHI WHO Collaborating Center and International Health Informatics Office
      • Rockefeller ?
      • Gates ?
      • Government led efforts disease specific programs (USA and others) ?
    • 32. The National Health System Internal Audit Hospital & Lab Services Management Services Medical Services Nursing Services Human Resources for Health Financial Resources Disease Control & Prevention Drug & Medical Supplies Support Services Planning & Information Primary Health Care Governorate South Governorate West Governorate North Governorate East District N1 District N2 District N3 District N4 District E1 District E2 District E3 District E4 District W1 District W2 District W3 District W4 District S1 District S2 District S3 District S4 A National Health System
    • 33. Design and Build Open Source Components Based on EA Map 06/05/09 Common HIS Architecture 6 5 4 3 1 2 12 11 10 9 7 8 National HIS Architecture 1 11 7 2 National HIS Solutions B B A A HIS Solutions A A A A A A B B B B B B
    • 34. Design and Build the Components Needed to for Country Applications and Systems Patient ID Document ID Encounter ID User authentication and security Vocabulary modeling and cross mapping Storage and retrieval Population summarization Data entry Decision Support Work flow management Collaboration tools Health services Laboratory Pharmacy Finance Planning Environmental Monitoring
    • 35. Tailor Comprehensive Systems to Program Needs Core Comprehensive System (San Paulo) V1 tailored for HIV V2 tailored for immunizations V3 Tailored for malaria Synergies And health benefits Synergies And health benefits Incremental expansion to a national system
    • 36. Concluding Remarks From An Architect
      • Daniel Burnham
      • “ Make no little plans; they have no magic to stir men's blood and probably will themselves not be realized. Make big plans; aim high in hope and work, remembering that a noble, logical diagram once recorded will not die.”
      (1846-1912)
    • 37. Thanks to And to PHI ….
    • 38.  

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