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State of the Nation: Health Sector Leaders Panel
 

State of the Nation: Health Sector Leaders Panel

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Johan Vendrig ...

Johan Vendrig
GM Information Services – healthAlliance

Andrew Terris
Programme Director, Patients First

Darrin Hackett
GM HIQ, Acting CIO Waikato DHB

Martin Wilson
GP, Sexual Health Physician, Clinical Leader
Pegasus, executive NICLG

Tony Cooke
Manager Health Systems Investment and
Planning, Information Group, NHB

(Thursday, 4.15, Panel)

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  • A Single view of multiple sources of information about a patient Consistent with the National Health IT plan of providing electronic information about a patient at any poin6 of care
  • This is not a detailed presentation on how to use eSCRV, there will be function training sessions closer to rollout of eSCRV
  • Inbox Anything marked 'confidential' is not to be extracted Extract the last 5 years of inbox Delete any inbox records older than 5 years from today Only header information is to be sent – no documents are to be extract Last Contact Date Extract the last consult date within the last 12 months (date only, not the record) Delete Consult dates from the PC-CDR that are older than 12 months from the current date Anything marked 'confidential' is not to be extracted Classifications All Diagnosis are to be extracted , on the premiss they can be displayed in order of Red, Blue then Black Anything marked 'confidential' is not to be extracted Medications All Blue list medications are to be extracted; also extract other prescribed medications in the previous 6 months from current date. Delete medications (except long term) from the PC-CDR that are older than 6 months than the current date Anything marked 'confidential' is not to be extracted Allergies and alerts Screening Data Anything marked 'confidential' is not to be extracted Extract Only: BP (Blood Pressure) WT (Weight) Delete Screening data from the PC-CDR that is older than 36 months from the current date
  • Pegasus The data is held at Pegasus A firewall and other systems prevent access to the data. All access is monitored. To view the data Log into concerto if ESCRV is selected data is asked for from Pegasus Pegasus records who role when and what looked at
  • The Whole practice the GP’s in this practice will not have access to e-SCRV, as they need to be contributing data to enable the proximity audit Global opt off ring the Privacy Office at the hospital and opt off MedTech Opf off The whole patient clinical sections Any data with ‘confidential’ ticked is not extracted Pegasus The data is held at Pegasus A firewall and other systems prevent access to the data. All access is monitored.
  • Patient Consent Have to ask the patient permission to access their data If Unable to ask patient permission, enter the reason permission could not be asked Where the viewer does not have permission and reason is give, a human is to review all reasons and ensure the reason matches patient condition (eg unconscious). Where the reason does not match patient condition, the breach will be referred to the CDHB Privacy Office for action. Proximity Audit an automatic process to match a consultation/encounter to viewing the patient data within a 24 hour period of viewing the data. I f there is no consultation and the data is viewed, this is referred to the CDHB Privacy Office for review and possible action against the individual Privacy Auditing at Pegasus Exception reports generated to show, for Eg Proximity Audit Who has looked at what patient When many people look at one patient When one person looks at many patients the reasons for access when patient does not say yes etc
  • Some matters have been resolved – the vision, the direction, the expectations of the plan Ownership of the plan lies with the regional and national governance groups – clinical leadership necessary; executive ownership and funding Progress is measured through Readiness Assessment Chart (pizza chart, or pink and white terraces), Regional and National Landscapes, Quarterly Milestones, Pipeline diagram Sometimes necessary to resource level across regions, allow some regions to take lead on nationally significant rollout programmes eg hospital e-Pharmacy Maternity – all DHBs have a similar problem; new quality initiative launched by Minister; importance of measuring and monitoring performance of the sector consistenty; importance of a good information system to support clinicians deliver care ED – agreed set of specifications and processes Enter into a partnership arrangement with key vendors to continue to develop solution organically Health Identity – building a foundation platform and set of core processes to support sector; high availability, improved data quality
  • Some matters have been resolved – the vision, the direction, the expectations of the plan Ownership of the plan lies with the regional and national governance groups – clinical leadership necessary; executive ownership and funding Progress is measured through Readiness Assessment Chart (pizza chart, or pink and white terraces), Regional and National Landscapes, Quarterly Milestones, Pipeline diagram Sometimes necessary to resource level across regions, allow some regions to take lead on nationally significant rollout programmes eg hospital e-Pharmacy Maternity – all DHBs have a similar problem; new quality initiative launched by Minister; importance of measuring and monitoring performance of the sector consistenty; importance of a good information system to support clinicians deliver care ED – agreed set of specifications and processes Enter into a partnership arrangement with key vendors to continue to develop solution organically Health Identity – building a foundation platform and set of core processes to support sector; high availability, improved data quality

State of the Nation: Health Sector Leaders Panel State of the Nation: Health Sector Leaders Panel Presentation Transcript

  • State of the Nation Health Sector Leaders Panel
    • Johan Vendrig:
    • GM Information Services – healthAlliance
    • Andrew Terris:
    • Programme Director, Patients First
    • Darrin Hackett:
    • GM HIQ, Acting CIO Waikato DHB
    • Martin Wilson:
    • GP, Sexual Health Physician, Clinical Leader
    • Pegasus, executive NICLG
    • Tony Cooke:
    • Manager Health Systems Investment and
    • Planning, Information Group, NHB
  • State of the Nation Health Sector Leaders Panel
    • Northern DHBs’ Shared Services
    • E nable healthcare excellence for the Northern Region’s population
    • Johan Vendrig,
    • GM Information Services - healthAlliance
  • hA IS Strategic Context
    • Information at point of care that affects change in what we do
    • From Exchange of Information to Shared Information
    • New (IS) Service Models to deal with complexity & affordability
    • A balanced investment portfolio
    Decision Support Workflow Outcomes Records Results & Costs Quality & Profitability Research & Analysis Resources
    • Regional eRecord (of the future)
      • DHB Mental Health & Addiction Services, Community Pharmacy Dispensing, eReferrals, Shared Care
    • Specialty Systems Alignment
      • e.g. RIS/PACS, Endoscopy, Concerto
    • Business Systems Alignment
      • Finance & Procurement IS NDHB, Rostering WDHB
    • Primary Care (PHOs & PHO/DHB Alliances)
      • Access to Diagnostics, Promotion of GP PMS Software as a Service, Patients First Initiatives
    • Regional Shared Services
      • Establishment of new healthAlliance, Integration of 3 IS teams
    Achievements 2010/2011
  • healthAlliance IS Shared Service
    • 10 years - Waitemata and Counties
    • 7 years – Regional Strategy Metro Auckland
    • 18 months – Regional Strategy Northern Region
    • 8 months – New hA including 4 Northern DHBs
    • 2 months - New hA IS structure (250 staff)
    • To date: 8 shared systems + alignment of suppliers & applications in key areas
    • Still high level of duplication elsewhere
      • 100’s Clinical and Business applications
      • 3 networks – 8 local Data centres
      • 3 IT Service Management Systems
      • Fragmented Management Operating Systems
  • healthAlliance IS Business Plan 11/12
  • Shared Service Challenges
    • Reliance on DHBs commitment to “one system one process”
    • Regional alignment of Information Management
    • Regional Governance – Prioritisation & Capital
    • Potential negative economies of scale
      • Increased complexity & interaction across 4 DHBs
    • Getting used to new scale of investments
      • How to stay nimble
    • Distraction of restructure & staff turnover
    • Integration of teams & culture (incl. geography)
    • Balance local, regional and national activity
    • Care Connect – Regional eRecord (of the future)
      • GP PMS integration, Shared Care 2&3, eReferrals 2&3, expand HES, Regional Concerto, Patient Portal
    • Primary Care
      • Clinical Pathways, Acute Demand Management
    • Patient Administration Systems
      • Northland/Auckland migrations
    • Population Health Systems
      • Standardisation of Pop health tools, regional repository
    • Business Systems
      • Finance/Procurement, Rostering, ECMS, BI & Costing
    • Shared Services
      • Performance Improvement & Alignment of IM
    Focus Areas 2012/2014
  • Long Term Critical Success Factors
    • Information Management and System Services that are independent from organisational boundaries and health service models.
    • A core solution that enables consistent patient centred approach to clinical decision making regardless of how the clinical team is employed/paid and which facility is used.
  • State of the Nation Health Sector Leaders Panel
    • Patients First
    • The Quality and Information Programme for Primary Care in New Zealand
  • State of the Nation Where have we come from?
    • GP2GP
    • Clinical Pathway tool evaluation
    • PMS Requirements
    • Health Quality Measures Library
    • SMM Primary Care
    • PMS Toolkit development
    • eDischarge
    • Sector engagement and teamwork
    • Community ePrescription Service
    • PMS Certification/validation
    In the last 18 months, Patients First has delivered or is well down the path of delivery on:
  • State of the Nation Clinical Leadership
    • RNZCGP, GPNZ, NHITB
    • Broader governance: HQSC, MoH Primary Care, Pharmaceutical Society, Nursing representation
    • Expert clinical panels (PMS, Pathways, Health Quality Measures)
    • Linkages with PCIMG, NICLG and other national forums
  • Focus Areas Focus Areas 2011-2014 Narrative Sector engagement and representation (leadership) Contribute to sector activity in primary care quality and better integration of information to support care delivery. Act as a conduit for joining the dots across current sector initiatives and future direction. PMS systems - requirements and certification Introduce a sustainable model that provides a framework, governance and incentives for driving better quality PMS product and integration of information to support quality practice, delivery and population health planning. Primary Care Integration Includes project delivery of (eContinuum Projects) GP2GP, eDischarge, Community ePrescribing and input to sector standards Primary Care National System and environment maintenance Manage the maintenance tail created by eContinuum projects (e.g. GP2GP, Community ePrescribing, eDischarge). Facilitate the primary care component of the Sector test environment and contract management of relevant vendor maintenance Health Sector Measurements Delivery and support of the Health Quality Measures Library including the infrastructure, education and support to integrate identified measures into the library and support the adoption and use of the library.
  • State of the Nation The Future…next 12 – 24 months
    • Integration –
      • leverage the “Babel Fish” for enabling application integration
      • PMS certification
      • eContinuum delivery (ePrescription Service, core and common concepts)
    • Measures that matter –
      • rolling out and extending the Health Quality Measures NZ infrastructure
  • Midland – Clinical Leadership 10 year view
    • CMIO role approved
    • Regional Clinical Leadership
      • The primary objective of the Midland Regional IS Plan (MRISP) is providing the tools that clinicians need in order to provide optimal care.
      • Proactively provide clinical advice and facilitate clinical leadership and involvement to drive and champion the definition, ongoing refinement and implementation of the MRISP and Midland region IS initiatives.
      • Ensure strong linkages to clinical processes and models of care in the implementation of clinical information solutions through the MRISP.
      • a stronger role for clinical leadership in the governance group of the overall programme, which would be supported by the IS professionals.
  • Midland – Achievements to Date
    • Midland One Health “Enabling IT Infrastructure Services”
      • Midland Connected Health procurement of network and equipment completed.
        • First SDP and circuits to be live in December; RFP for Service Management in November
      • Midland Regional Platform aligned with national infrastructure, RFI in December.
    • Regional ePharmacy
      • Regional Solution Definition document close to complete
      • Business Case in draft, targeting approval in early 2012
    • Regional PACS
      • Expansion to Tairawhiti close to complete (now supports 3 DHBs)
    • eMedicines National pilot
      • Stand alone Medicines Reconciliation in pilot
      • Currently testing integration between dispensing, ePrescribing and Clinical Workstation.
  • Midland – Focus for 2012
    • Clinical Information Systems
      • Clinical Workstation and CDR across the region
    • Prioritisation process being established
      • Prioritisation to be done by a regional cross-disciplinary Clinical and Executive group
    • IS Investment Portfolio established
      • A 4 year investment view based on DHB capital plans and the MRISP
    • Current IS Investment Portfolio snapshot: FY11/12
      • 67 initiatives proposed across Midland; 45 are in progress or already committed
      • 56 are local; 11 are regional
  • State of the Nation A South Island Clinicians view
    • A clinicians view of the changes and achievements that have occurred over the last 12 months, and what is planned and expected for the next 12 months. What does it mean for clinicians and patients?
    • Connected systems: ERMS, Health pathways, e-SCRV, Project chain.
    • In 10 minutes!! I have so much to show you and I intend present it real-time so hold on for the ride!!
    • National developments with NZULM and NHI engine are critical but I will leave them to others
  • Respect and privacy
    • Part of this presentation is live by remote access to Wainoni Medical Centre in Christchurch and involves use of real patients who have generously given their permission for the use of their records. They understand there will be a few non clinical people present.
    • Those of you in the room who are clinical will have a total understanding of the nature of this privacy
    • Non clinical attendees are reminded of the fact that information on the screen must never be discussed ever outside this room under any circumstances.
    • Definitely no photographs or video
  • A new future in connected health
    • Jumping the gap
  • ERMS ( Electronic referral management system) live demonstration. Dr Martin Wilson
  • E lectronic R eferral M anagement S ystem usage
  • Live presentation of ERMS Dr Martin Wilson
  • ERMS structure
  • ERMS View
  • Community Radiology Expert Review
  • e-S hared C are R ecord V iew Pegasus CDHB and Dr Martin Wilson
  • eSCRV Project Structure ?? Recent Maternity advisory group
  • eSCRV
    • Purpose of Use from eSCRV Privacy Framework:
    • “ There is a comprehensive recovery plan for the Canterbury region and due to the disrupted health system the creation of a eSCRV is an essential strategy of the overall recovery effort. The purpose of the eSCRV is the provision of relevant patient information to health professionals at the point of care so that informed decisions can be made to support the delivery of safe, high quality healthcare in an efficient way , with the patient being the primary beneficiary. The respectful use of people’s health information will be the underpinning principle.”
  • eSCRV
    • From National Health IT plan:
    • “ To 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 .”
  • In Christchurch 2014 was our 2011 eSCRV Demonstration
    • Live demonstration of:
      • Single Sign On to eSCRV in Concerto
      • Concerto
  • eSCRV is Data Viewed in Concerto
  • Proposed Medications View
  • Data Contribution Proposal
    • The following data is proposed to be contributed:
      • Patient demographics
      • Patient inbox header information
      • Last contact date
      • Diagnosis (classifications)
      • Prescribed medications
      • Allergies and alerts
      • Screening data (blood pressure and weight)
    • Disclaimer will show on access to the eSCRV data:
      • “ While all care has been taken in the preparation of the medical record, no warranty is given as to the accuracy, completeness or reliability of the data submitted.”
  • Privacy – Overview
  • Privacy – Access Matrix
  • Privacy – Patient Confidentiality
    • The whole practice can choose not to participate.
    • Patients can globally opt off the whole system.
    • In MedTech Opt off:
      • The whole patient.
      • Clinical section of data, such as all medications.
      • Anything marked ‘confidential’ is not extracted.
    • Patient consent at point of access to eSCRV.
  • Privacy – Patient Confidentiality…
    • At Pegasus
      • a firewall and other systems prevent access to the data.
      • All access to data is actively monitored and reported on.
    • Proximity Audit at CHDB
    • Privacy Auditing at Pegasus
      • Exception reports generated automatically for Privacy Officer to review and investigate.
  • eSCRV – Information & Involvement
    • If you would like:
      • Further Information
    • Please contact either:
      • Clinical Lead Dr Martin Wilson [email_address]
      • Project manager Jackie Keys at Pegasus [email_address]
      • Cartoons [email_address]
  • State of the Nation IT Health Board - National View
    • National Health IT Plan
      • Moving from planning to execution
      • Measuring progress
      • Co-ordinating across regions
  •  
  • State of the Nation IT Health Board - National View
    • National Health IT Plan
      • Moving from planning to execution
      • Measuring progress
      • Co-ordinating across regions
    • National Initiatives
      • Maternity
      • Emergency Department
      • Health Identity
  • State of the Nation IT Health Board - Regional View
    • Regionalisation challenges
      • Governance – sharing but separate
      • Cost allocation/asset management
      • Building capability
    • Regionalisation benefits
      • Move faster, more flexibility
      • Co-opetition
      • Need to use standards