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Ausinnovate Dr Sarah Muttitt Ministry Of Health Holdings

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  • 1. Developing a National Electronic Health Record Dr. Sarah Muttitt, CIO MOH Holdings, Singapore 24 May 2010
  • 2. Getting ready for the “silver tsunami” Pressures on healthcare system set to increase By 2030 1 in 5 Singaporeans will be over 65 By 2050 Singapore will be among the world’s demographically oldest countries with median age of 54 Disease patterns will change Demand for healthcare and care of chronic diseases will rise Healthcare costs will be bigger burden on families supporting the elderly Developing a National EHR 24 May 2010 MOH Holdings Pte Ltd Dr. Sarah Muttitt, CIO, MOHH
  • 3. Vision of an Integrated Healthcare System “ What does it mean when we say our population will be older? It means there will be more demand on healthcare because older people are sick more often. But this also means it is a different pattern of healthcare So we have to respond to this by putting in more resources into our hospital system, building new hospitals. ... get the whole system to be structured properly so that it will be adapted to cater to the ageing population. To structure it properly means we need step-down care. Picture taken from asiaone.com And one key thing we must do with this step-down care is to link up our acute hospitals […] with community hospitals, so that you can have the best of both worlds. ” -- Prime Minister Lee Hsien Loong National Day Rally 2009 Developing a National EHR 24 May 2010 MOH Holdings Pte Ltd Dr. Sarah Muttitt, CIO, MOHH
  • 4. “A Different Pattern of Healthcare” “Slow medicine” “Slow medicine” Integrated healthcare delivery system physiotherapy, rehab and physiotherapy, rehab and Appropriate care from the right site care for chronic sick care for chronic sick Better allocation of resources More cost-effective treatment and care in the healthcare continuum “Fast medicine” “Fast medicine” diagnosis and treatment of diagnosis and treatment of patients with acute needs patients with acute needs Developing a National EHR 24 May 2010 MOH Holdings Pte Ltd Dr. Sarah Muttitt, CIO, MOHH
  • 5. Healthcare landscape of the future Strategic vision of patients moving seamlessly across the healthcare system, receiving coordinated patient-centric care at the most appropriate settings. CH Screening & Polyclinics NH Enabled by the National Palliative Prevention RH Care FPs Home Care Electronic Health Record Rehab & support services (EHR) CH CH CH Polyclinics NH Polyclinics NH Polyclinics NH Screening & Palliative Screening & Palliative Prevention RH Care Prevention RH Care Screening & Prevention RH Palliative Home Home Care FPs Care FPs Care Home FPs Care Rehab & Rehab & support support Rehab & services services support CH CH services Polyclinics NH Polyclinics NH Screening & Palliative Screening & Prevention RH Palliative Prevention RH Care Care Home Home FPs Care FPs Care Rehab & Rehab & support support services services Developing a National EHR 24 May 2010 MOH Holdings Pte Ltd Dr. Sarah Muttitt, CIO, MOHH
  • 6. Vision of “One Patient, One Record” The EHR is an integrated healthcare record centered on each person. It extracts and consolidates in one record, all clinically relevant information from their encounters across the healthcare system throughout his/her life. Secure “real-time” access to patients’ EHR by authorised clinicians and healthcare providers: enable greater coordination and informed decision-making, resulting in more accurate diagnosis, better treatment and integrated patient-centric care Developing a National EHR 24 May 2010 MOH Holdings Pte Ltd Dr. Sarah Muttitt, CIO, MOHH
  • 7. The difference between EMR and EHR EMR Specific to a facility (institution, private office) Equivalent of its paper predecessor Includes everything recorded by the organization about a given patient Has “depth” but lacks “breadth” EHR Specific to an individual Captures a key subset of health information from multiple point of service systems Available electronically to authorized healthcare providers anytime, anywhere Designed to facilitate the sharing of data across the continuum of care, across healthcare delivery organizations and across geographies Developing a National EHR 24 May 2010 MOH Holdings Pte Ltd Dr. Sarah Muttitt, CIO, MOHH
  • 8. What clinicians need to see on the EHR Developing a National EHR 24 May 2010 MOH Holdings Pte Ltd Dr. Sarah Muttitt, CIO, MOHH
  • 9. Existing eHealth Systems in Singapore National EMR Exchange Hospital based Immunisation (EMRX) EMR & CPOE Registry Multiple EMR Systems Multiple Lab & Radiology Systems Critical Medical 2 public healthcare clusters Information Store (CMIS) NHG and SingHealth hospitals, polyclinics and specialist clinics Ministry of Defence (MINDEF) EMRX Extension to Community Hospitals GP Clinic Community Management Hospital based Systems EMR Minimal EMR Systems Minimal EMR Systems Private GPs (approx 300 out of more than 2,000 have a CMS) Private GPs (approx 300 out of more than 2,000 have a CMS) Community Hospitals Community Hospitals Developing a National EHR 24 May 2010 MOH Holdings Pte Ltd Dr. Sarah Muttitt, CIO, MOHH
  • 10. Interoperability - Governance Information Systems Division (ISD) Provides leadership in setting strategic direction for Singapore’s national health informatics strategy MOHH Master HIT Planning Strategic National EHR & Organization Specific Alignment Related Integrative IT Capabilities Projects HIT master planning supports the national agenda for an Electronic Health Record by 2011 by facilitating strategic alignment at various Levels of the Healthcare System Developing a National EHR 24 May 2010 MOH Holdings Pte Ltd Dr. Sarah Muttitt, CIO, MOHH
  • 11. Interoperability – Enterprise Architecture Pragmatic approach adopted to deliver an Enterprise Architecture that is Implementable Fit-for-purpose i.e. delivering value for clinicians in the near term Future-Proofed to support longer term vision for healthcare, analytics and research Developing a National EHR 24 May 2010 MOH Holdings Pte Ltd Dr. Sarah Muttitt, CIO, MOHH
  • 12. Interoperability – Standards Establishing a suite of standards that are Clinically-Driven Easy to Use Internationally Recognised to ensure clinical data included in the EHR can be: Shared and exchanged safely and reliably for the monitoring and care of patients Used meaningfully for secondary purposes including production of clinical knowledge Global Standards Engagements • HL7 (Health Level Seven) • IHTSDO (International Health Terminology Standards Development Organization) • ISO TC215 on Health Informatics • IHE (Integrating the Health Enterprise) Developing a National EHR 24 May 2010 MOH Holdings Pte Ltd Dr. Sarah Muttitt, CIO, MOHH
  • 13. Exploiting Other WOG Initiatives Next Generation Broadband “By 2010, 60 per cent of homes and offices can expect to have access to this new, ultra high-speed, all-fibre network. The network coverage is expected to reach 95 per cent by 2012. In the near future, there will be a wide range of services riding on Next Gen NBN, which will empower business users, home users, schools and learning institutions.” National Authentication Framework “NAF, a key programme under IDA’s iN2015 Masterplan aims to deploy a nationwide platform for strong authentication services for end-users accessing key online services…….. key economic sectors (e.g. financial, government and healthcare). iSPRINT “Small and Medium Enterprises (SMEs) looking to accelerate the adoption and innovative use of infocomm can now receive a wider scope of assistance under a new scheme called iSPRINT (Increase SME Productivity with Infocomm Adoption and Transformation)” eGOV Masterplan, SOEasy, GDCs, NICF, etc. etc…… Developing a National EHR 24 May 2010 MOH Holdings Pte Ltd Dr. Sarah Muttitt, CIO, MOHH
  • 14. Evaluating the Benefits of EHR Investment 10 Year Investment Strategy Identified the investment amount & costs of the EHR Determined financial and non-financial benefits Quantified the benefits of the investment Developing a National EHR 24 May 2010 MOH Holdings Pte Ltd Dr. Sarah Muttitt, CIO, MOHH
  • 15. Quantifying potential benefits 10 year investment strategy identified areas with the most positive gain Developing a National EHR 24 May 2010 MOH Holdings Pte Ltd Dr. Sarah Muttitt, CIO, MOHH
  • 16. Procurement Update General Use Cases EHR Capabilities, Prioritization Procurement Implementation Shortlist Targeted Pre Qualification Implementation EHR Proof Detailed Proof of Concept completed Completed of Concept EHR Design in October 2009 In Progress EHR Closed Tender Implementation Next Steps Developing a National EHR 24 May 2010 MOH Holdings Pte Ltd Dr. Sarah Muttitt, CIO, MOHH
  • 17. NEHR Rollout Roadmap Iterative rollout with refinement and enhancement from each deployment cycle System will mature and evolve with shifts towards shared information and care EHR Solution Design Phase 1 Phase 2 Phase 3 Phase 4 Summary Care Records Facilitation of Care Extended Clinical Clinical & Business and EHR Foundations Coordination and Team Toolset Intelligence Based Care 2+ Polyclinics Public Sector Extended to entire public sector with shorter iterations in between 2+ Restructured Hospitals View of data available in whole of Restructured Hospital systems Community 2 3/4 6+ Hospitals GPs At least 50 Clinics Approx 500 GPs Approx 1500 AIC Care Assessment Referrals Others MINDEF Developing a National EHR 24 May 2010 MOH Holdings Pte Ltd Dr. Sarah Muttitt, CIO, MOHH
  • 18. The promise of the EHR Better Clinical Care and Streamlined Workflows Patient information at the point of care Supports clinical decision making and workflows Enables providers involved in patient care journey to work as a team Seamless transition of patient into different care settings Better management of chronic illnesses Enables greater patient participation and supports self-help Better Practices and Greater Patient Safety Shared patient’s clinical records Enforces better prescribing practices with peer reviews Reduces human errors related to handwritten records Takes the guesswork out from the lack of past records Prevents duplicate and unnecessary tests; and adverse drug events Developing a National EHR 24 May 2010 MOH Holdings Pte Ltd Dr. Sarah Muttitt, CIO, MOHH
  • 19. Thank You MOH Holdings www.mohh.com.sg 24 May 2010