Enabling Person-Centred, Integrated Care          HINZ Conference, Auckland            Thursday, 24 November 2011         ...
Enabling an Integrated Healthcare Model                                  eHealth VisionTo achieve high quality health care...
National Health IT Board                         Priority Programmes for 2011/12  eMedicines Programme                    ...
Roses and Brickbats1. South Island Concerto/Imaging solution    –    Regional implementation, Vendor engagement, Delivery2...
Roses and Brickbats1. Reliance on individuals (many on contract)2. Vendors (and others) who forget that clinician and pati...
Already in operation                                             NZ Population                                        Unde...
Priorities towards 20141. Medication Safety Programme (jointly with National Health Board   and the Health Quality and Saf...
Priorities towards 20141. Medication Safety Programme (jointly with National Health Board   and the Health Quality and Saf...
National Health IT Plan               Enabling                 Clinical           Person-Centred                  Data    ...
eHealth StrategySupporting Integrated CareNICLG and NHITBA productive partnership promoting a positive planPeter J GowAsso...
The original plan
Purpose of NICLG   To champion the development and implementation of the National    Health IT Plan.    To provide input...
NATIONAL INFORMATION CLINICAL        LEADERSHIP GROUP AGENDA        1/11/11                                               ...
NICLG Agenda-Presentations   E-Plunket, from Plunket   The Health Identity Project, from the NHITB   National Transfer ...
NICLG Agenda-Breakout session   e medications (Aaron Jackson)      Partnership with HQSC      A programme approach acro...
NICLG-learning points   Involve team in problem identification    before seeking solutions   Avoid polishing the solutio...
NHITB and NICLG-ensuring                              excellence in e health everywhere                              Where...
Champions at rugby (and Health ITimplementation-a team effort)
Supporting Integrated CareConsumer Issues1. Security and confidence arecrucial, but absolutely achievable
Consumer Issues2. Health consumers – the public –need to be led through knowledge.From unawareness, throughunderstanding a...
Consumer Issues3. Change management issues,including incentives, need to beaddressed earlyClinicians need to be supportedt...
Consumer Issues4. Work needs to start soon on thePatient PortalThe most visible sign to the publicthat change is under way.
Consumer IssuesProgress to date has beenimpressive…………..
Cliniciancats, computercats, andconsumer cats.
healthAlliance - Our Region                      Some facts about healthAlliance:                      • 500+ employees in...
What we do:       Providing some Financial Services to Taranaki DHB
hA exists to provide:• Efficient & effective delivery of transactionalactivities• Lower costs• Improved quality & sustaina...
Today• Some regional systems but still high level of duplication• 3 Teams – change process underway• 3 networks – 8 local ...
Regionally mandated 1 process, 1             system          Clinical Leadership          Freeing Clinicians for Quality...
Vendor Engagement                Vendor Capability                Software Quality & Release Lifecycles                ...
Benefits: Total DHB IS Cost
Performance to dateTo deliver outstanding shared services that enable healthcareexcellence for the Northern Region’s popul...
Regional Actions          Deliver National Health IT Plan and Health           Benefits Ltd Business Case through Norther...
Government eHealth Strategy – Supporting Integrated Care
Government eHealth Strategy – Supporting Integrated Care
Government eHealth Strategy – Supporting Integrated Care
Government eHealth Strategy – Supporting Integrated Care
Government eHealth Strategy – Supporting Integrated Care
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Government eHealth Strategy – Supporting Integrated Care

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Graeme Osborne
Director, National Health IT Board

Peter Gow
Chair, National Information Clinical Leadership Group

Ernie Newman
Chair, NHITB Consumer Panel

Barry Vryenhoek
Chief Executive, healthAlliance New Zealand Ltd
(Thursday, 9.45, Keynote)

Published in: Health & Medicine
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Government eHealth Strategy – Supporting Integrated Care

  1. 1. Enabling Person-Centred, Integrated Care HINZ Conference, Auckland Thursday, 24 November 2011 Graeme Osborne Director, National Health IT Board
  2. 2. Enabling an Integrated Healthcare Model eHealth VisionTo achieve high quality health care and improve patient safety, by 2014 New Zealanders will have a core set of personal health information available electronically to them and their treatment providers regardless of the setting as they access health services.
  3. 3. National Health IT Board Priority Programmes for 2011/12 eMedicines Programme Regional Information Platform (DHBs) 1. Community E-prescribing 1. Clinical Data Repositories/ Clinical Workstation 2. Inpatient e-prescribing 2. Patient Administration Systems 3. Medicines reconciliation, medication 3. Imaging/PACS management and administration 4. Clinical support – Labs/Pharms 4. Universal List of Medicines 5. Continuum of care: 5. NZ Medicines Formulary • eReferrals and eDischarges National Solutions Integrated Care Initiatives 1. Oncology 1. Shared Care • Long Term Conditions 2. Cardiac Health • Maternity 3. InterRAI for Aged Care • Emergency View (Canterbury) 4. Health Identity 2. Primary Care • BSMC Initiatives 5. Connected Health • Patients First Initiatives (eg. GP to GP)*Supported by ICT Infrastructure / Back Office - Finance & Supply-Chain, Data Centres.
  4. 4. Roses and Brickbats1. South Island Concerto/Imaging solution – Regional implementation, Vendor engagement, Delivery2. Shared Care – Long Term Conditions – Clinical leadership, focus on patient experience, working with clinicians on process change, real-time evaluation (NIHI)3. Northern Region - Health Alliance – The effort to make shared services work in practice, professionalism, delivering for all members of the region4. Central Region Information Systems Plan – Regional IT plan, Utilising the best within the region, Board and CEO commitment to a 4 year joint capital expenditure programmeNational Clinical Leadership Group, Health IT Cluster, National Institute for Health Innovation
  5. 5. Roses and Brickbats1. Reliance on individuals (many on contract)2. Vendors (and others) who forget that clinician and patient experience is about clinical quality and process integrity3. Our inability to learn from other industries eg. core competence4. People who use complexity as a reason to not look outside their part of the sector
  6. 6. Already in operation NZ Population Under development Planned for the future 4,412,636 as at Monday, 12 Sep 2011 at 01:28:35 pm Core Health Information - Health Identity, demographics, allergies and alerts, register of health information Long Term Conditions - Shared Care Record Comprehensive Clinical Assessment (InterRAI) Maternity - Shared Record of Care Well Child - Shared Record of Care Mental Health - Shared Record of Care Common Clinical Results (Laboratory results, Medications, Referrals, Discharges and other clinical documents) TeleHealth - In-home monitoring Four Regional IT Platforms Continuum of Care National minimum Nat. immunisation Maternity, Pharms warehouses etc. B4 Schools Clinical Information Clinical Information Cancer register register dataset datasetPatient Portal Imaging/Picture Archive Patient Administration Clinical Systems Support and billing Patient Administration Connected Health Primary/Integrated Specialist/Tertiary/ Public HealthHome Settings Family Health Centres Secondary Hospital
  7. 7. Priorities towards 20141. Medication Safety Programme (jointly with National Health Board and the Health Quality and Safety Commission): – Wide adoption of e-medications management solutions across the sector (hospital and community)2. Engaging Consumers: – Compelling consumer engagement model to attract take-up of on-line access to personal health information via health portals3. Develop IT Leaders and Teams: – Set expectations and monitor IT professional capability4. Funding of health IT innovation and national solutionsAnd, four words: Standardisation, Integration and Operating Model
  8. 8. Priorities towards 20141. Medication Safety Programme (jointly with National Health Board and the Health Quality and Safety Commission): – Wide adoption of e-medications management solutions across the sector (hospital and community)2. Engaging Consumers: – Compelling consumer engagement model to attract take-up of on-line access to personal health information via health portals3. Develop IT Leaders and Teams: – Set expectations and monitor IT professional capability4. Funding of health IT innovation and national solutionsAnd, four words: Standardisation, Integration and Operating Model
  9. 9. National Health IT Plan Enabling Clinical Person-Centred Data Integrated Care Repository ConnectedIdentity Health
  10. 10. eHealth StrategySupporting Integrated CareNICLG and NHITBA productive partnership promoting a positive planPeter J GowAssociate Professor of MedicineChair, NICLG
  11. 11. The original plan
  12. 12. Purpose of NICLG To champion the development and implementation of the National Health IT Plan. To provide input into the design of National Health IT Board sponsored programmes/projects with a view to ensuring appropriate  planning principles  design solutions  clinical representation  involvement in pilot projects, including their evaluation  advice in implementation and roll out of projects. To ensure usability and uptake of programme/projects by promoting engagement with clinicians through professional contacts and networking structures, for feedback to the NHITB and to project staff. To take a lead role in influencing health professionals and other stakeholders to develop evidence based improvements in health care processes across the continuum of the health sector. To act as an advisory group to the Health Information Standards Organisation (HISO).
  13. 13. NATIONAL INFORMATION CLINICAL LEADERSHIP GROUP AGENDA 1/11/11 Peter Gow * Ros Gellatly Jim Vause * Denise Watene Norma Campbell * David Kerr * Peter Freeman Karolyn Kerr Christine Roke Graeme Osborne Vicky Noble * Sadhana MarajObjectives for the day Di Davis Kathy Farndon Janet Gibson Amanda Ashcroft Wendy Bremner Ernie NewmanProvide an update to relevant projects across the Shaun Costello Wendy Bremnersector for clinicians to; Aaron Jackson * Culver Arran Shaun Costello David Jones1. Add input into the design of processes and IT Sandra Hicks Shelly Frostsolutions to ensure strong linkages to clinical Andrew Bowers Jim Kriechbaumprocesses and models of care. Tim Gardener Oliver Menzies2. Champion the flow of information on new Allan Panting Inga Hunter * Martin Wilson * Kim Bannisterprocesses and IT solutions to ensure clinicians Stella Ward * Richard Felthamunderstand, support, implement and ultimately Bev Nicolls Elizabeth Plantuse them. Brenda Hynes Andrew Munro Alan Merry
  14. 14. NICLG Agenda-Presentations E-Plunket, from Plunket The Health Identity Project, from the NHITB National Transfer of Care eDischarge Project, from Patients First Assessment of Risk Tool (ART), from the NHITB National Implementation of Surgical Prioritisation (responding to the report of the Office of the Auditor General), from the National Health Board Towards a national clinician-led Acute Coronary Syndrome (ACS) and secondary prevention quality improvement system, from the National Cardiac Network Report on the NHITB 2011/12 priorities and future plans, from the NHITB.
  15. 15. NICLG Agenda-Breakout session e medications (Aaron Jackson)  Partnership with HQSC  A programme approach across four DHBs  My “List of Medicines” paper tabled e referrals (David Kerr)  National alignment with regional understanding  Involve HISO to detail the definitions Shared care (Stella Ward/Matt Hector- Taylor)  Brings together multiple service streams to meet needs of people  Helps providers to communicate, and work as a team e Discharge Summary(Peter Gow/Janet Gibson)  Template headings decided (Advice to patient paramount)  Discussion on business rules around responsibility for patients after discharge  Incorporation of “request for clarification “
  16. 16. NICLG-learning points Involve team in problem identification before seeking solutions Avoid polishing the solution before engaging the sector Communication is not just about talking and listening but requires understanding and cooperation Actions speak louder than words Look on the NHIT Plan as a Quality Improvement Programme Remember the five Ts (Don Berwick)
  17. 17. NHITB and NICLG-ensuring excellence in e health everywhere Where is your health system going? Transformed organisation with high levels of quality and safety-Ambition to Improve Quality -everywhere Islands of excellence New islands within sea of ordinary appear, others go, quality and safety but no overall real change Ordinary Quality
  18. 18. Champions at rugby (and Health ITimplementation-a team effort)
  19. 19. Supporting Integrated CareConsumer Issues1. Security and confidence arecrucial, but absolutely achievable
  20. 20. Consumer Issues2. Health consumers – the public –need to be led through knowledge.From unawareness, throughunderstanding and acceptance, toactive encouragement and support
  21. 21. Consumer Issues3. Change management issues,including incentives, need to beaddressed earlyClinicians need to be supportedthrough the change.
  22. 22. Consumer Issues4. Work needs to start soon on thePatient PortalThe most visible sign to the publicthat change is under way.
  23. 23. Consumer IssuesProgress to date has beenimpressive…………..
  24. 24. Cliniciancats, computercats, andconsumer cats.
  25. 25. healthAlliance - Our Region Some facts about healthAlliance: • 500+ employees in 8 locations • Serving a population base of 36.1% of New Zealanders • Our services support 26,500 DHB staff, 15,000 computers, 10 hospital sites, 94 community sites and 266 dental sites • 81,500 assets worth over $1.1B (NBV $60 million)
  26. 26. What we do: Providing some Financial Services to Taranaki DHB
  27. 27. hA exists to provide:• Efficient & effective delivery of transactionalactivities• Lower costs• Improved quality & sustainability of service• Elimination of inefficiencies• Integrated & seamless processes• Centres of excellence, expertise & staffdevelopment• Regional alignment & standardisation of activitieswithin customer DHBsResulting in the release of funding for front-lineservices
  28. 28. Today• Some regional systems but still high level of duplication• 3 Teams – change process underway• 3 networks – 8 local Data centres• 3 Infrastructure strategies aligned to some degree• 3 IT Service Management Systems• Varied/fragmented management operating system• (KPI, Risk, Finances, Project office, etc.)• High level of duplication in core systems • Patient Admin: 4 instances; 3 systems • Clinical Workstation: 4 instances • Finance: 2 instances; 2 systems etc
  29. 29. Regionally mandated 1 process, 1 system  Clinical Leadership  Freeing Clinicians for Quality Engagement  Getting Clinicians to Agree & Align RegionallyTo deliver outstanding shared services that enable healthcareexcellence for the Northern Region’s population.
  30. 30. Vendor Engagement  Vendor Capability  Software Quality & Release Lifecycles  Procurement Processes  Procurement Lead Times  Contracting ComplexityTo deliver outstanding shared services that enable healthcareexcellence for the Northern Region’s population.
  31. 31. Benefits: Total DHB IS Cost
  32. 32. Performance to dateTo deliver outstanding shared services that enable healthcareexcellence for the Northern Region’s population.
  33. 33. Regional Actions  Deliver National Health IT Plan and Health Benefits Ltd Business Case through Northern Region IS IP  Regional Governance  Regional Capital Plans  Regional Processes  Regional Common Systems  One Network; Clinical Workstation; Patient Administration System; ERP  Regional IS Capability &  Capacity BuildingTo deliver outstanding shared services that enable healthcareexcellence for the Northern Region’s population.

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