Connected Health Progress Report


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Ross McKenna
Information Directorate
Ministry of Health
(P20, 17/10/08, Sector Systems stream, 10.30am)

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  • Connected Health Progress Report

    1. 1. Ross McKenna Information Directorate Ministry of Health, New Zealand OCTOBER 2008 Connected Health Progress Report HINZ Annual Conference October 2008
    2. 2. Agenda <ul><li>Connected Health in context </li></ul><ul><ul><li>Sharing and accessing information, connectivity and interoperability </li></ul></ul><ul><li>Programme Update </li></ul><ul><ul><li>Research findings </li></ul></ul><ul><ul><li>Networking standards </li></ul></ul><ul><ul><li>Provision of core components </li></ul></ul><ul><ul><li>Broadband for health </li></ul></ul>
    3. 3. Healthcare is changing… “ It’s amazing actually, that the general public have this concept that we are all interlinked electronically, and they’ll say ‘My GP is down in Napier, but you’d be able to just get the notes, won’t you?’ and they think it’s all linked. But no, it’s not that easy.” (Quoted from a urban GP) Provider centric Illness Site of Care Episodic Care Supply management Solitary decision making Efficiency Decentralised, generalised care Patient & Whanau centric Wellness Continuum of Care Disease Management Demand management Collaborative , evidence based decisions Effectiveness Coordinated , specialised care
    4. 4. 15,000 locations and every year… <ul><li>173 million visits to primary care, 46.4 million dispensed prescriptions, 23.2 million laboratory tests, 681,102 hospital discharges… </li></ul>340,000 Cytology requests 180,000 Patient Records 390,000 Vaccination reminders 270,000 New Patient registrations 4,100,000 Patient reports 20,000,000 Prescriptions 1,300,000 Referrals 760,000 Reminders 331,000 Cytology results 435,000 Discharge advices 534,000 Discharge letters 185,000 Mammography results 710,000 After hours reports 2,163,000 Outpatient letters 6,409,000 Radiology results 317,000 Info requests 400,000 Screening results Electronic 5% Phone 8% Paper 87% General Practice* *Wales 2004 OUT How can we make the clinical information generated in the health system about a patient available to any authorised caregiver regardless of where or which organisation he/she is working for? IN
    5. 5. Application/Service/Network INTEROPERABILITY Ability to share data securely Ability to access data securely <ul><ul><li>Telecommunications Infrastructure Architecture standards </li></ul></ul><ul><ul><li>Data terminology and Coding standards </li></ul></ul><ul><ul><li>Interoperability standards </li></ul></ul><ul><ul><li>Medical record storage and retrieval standards </li></ul></ul><ul><ul><li>Privacy and Security standards </li></ul></ul>Supporting Health System information flows Health information available where and when it is needed People, Processes and Technology
    6. 6. Connected Health Progress Update <ul><li>New Zealand Health Provider research </li></ul><ul><li>Broadband </li></ul><ul><li>Network and Interoperability Standards </li></ul><ul><li>Provision of core components to support communication </li></ul>
    7. 7. Ministry-Commissioned Qualitative Research <ul><li>Second phase of a 3 phase provider research exercise: </li></ul><ul><li>Stage 1 - Provider definition and Segmentation </li></ul><ul><li>Stage 2 - Qualitative – indicative sample, exploratory open questions, identifies areas to target for further research </li></ul><ul><li>Stage 3 - Quantitative – specific questions to understand detailed gaps and requirements </li></ul><ul><li>Objectives </li></ul><ul><ul><li>Inform the Connected Health Programme </li></ul></ul><ul><ul><li>Identify the key demand “gaps” in ICT in the delivery of healthcare in New Zealand </li></ul></ul><ul><ul><li>Understand the drivers and barriers to introduction of ICT innovations and changes </li></ul></ul><ul><ul><li>Support sector initiatives </li></ul></ul>
    8. 8. Representational Coverage of the Health and Disability Sector - - GPs Rural (19%) GPs Urban (20%) Plunket (1%) Children’s Health Camps (1%) Private Emergency Hospitals and Ambulances (5%) Other Government Agencies’ Health Services (5%) Student and Youth Clinics (4%) Private Hospitals and Long Term Residential Care (5%) Central Health Agencies (5%) Not-for-profit Community Providers (7%) Pathology, Radiology and Laboratories (5%) Pharmacies (4%) Independent Practitioners (5%) Private Medical Specialists / Dentists (7%) Management Organisations (7%)
    9. 9. UMR asked New Zealand health providers who they wanted to communicate electronically with but couldn’t…
    10. 10. Long-term Residential Care GPs Private Specialists/ Hospitals DHBs Ministry Of Health ACC WINZ Independent Practitioners A & E Ambulance GPs Private Specialists/ Hospitals DHBs Ministry Of Health Pathology/ Radiology Labs A & E Ambulance Central Agencies Pharmacies Independent Practitioners Long-term Residential Care Student/ Youth Clinics Not-for-profit Organisations MSOs/PHOs Not-for-profit Organisations DHBs Other Health Agencies Private Specialists/ Hospitals DHBs CYF Ministry Of Health Private Specialists/ Hospitals Independent Practitioners Pathology/ Radiology Labs A & E Ambulance GPs Private Specialists/ Hospitals Long-term Residential Care ACC 111 / Other Emergency Services Central Agencies GPs DHBs Patients Not-for-profit Organisations GPs Private Specialists/ Hospitals DHBs CYF MSOs/PHOs Pathology/ Radiology Labs GPs Other Health Agencies Private Specialists/ Hospitals DHBs Patients Pharmacies GPs Private Specialists/ Hospitals Private Specialists/ Hospitals GPs Other Health Agencies DHBs Other Health Agencies Independent Practitioners Pharmacies Not-for-profit Organisations Pathology/ Radiology Labs A & E Ambulance Long-term Residential Care Independent Practitioners GPs Other Health Agencies Private Specialists/ Hospitals Long-term Residential Care Ministry Of Health ACC Work and Income Student/ Youth Clinics GPs Patients Other Youth Health Services Family Planning Training Providers District Nurses Pharmac
    11. 11. Incompatible ICT systems Remote access Access to secure intranet for communication Internal organisations ICT systems are not integrated Patient management issues Accessing current systems applications A lack of electronic patient info transfer leads to other inefficiencies Needing improved access to clinical technology Privacy and security concerns Costs of technology Willingness to embrace more interconnectedness Suggestions for a central repository of information UMR Research: What New Zealand health care providers said… Lack of standardisation in receiving and sending patient information Use of technology differs widely in the sector Quality of info is impacted by electronic gathering of info Need for health standards for clinical codes
    12. 12. Health care providers… <ul><li>Want to be able to: </li></ul><ul><li>Share patient-record information </li></ul><ul><li>Improve clinical processes and workflow efficiency </li></ul><ul><li>Reduce medical errors and improve patient safety </li></ul><ul><li>Improve quality of care </li></ul><ul><li>Reduce dual record keeping – paper and electronic </li></ul><ul><li>Supported by: </li></ul><ul><li>ICT Strategies and Leadership </li></ul><ul><li>Interoperability and better integration between primary and secondary </li></ul><ul><li>Consistency, accreditation and implementation </li></ul><ul><li>Training and support when implementing new products </li></ul>
    13. 13. Enabling connectivity Willingness to embrace more interconnectedness Needing improved access to clinical technology Sharing information electronically Platform for collaborative& coordinated care Accessing more information electronically Lack of standardisation in receiving and sending patient information Incompatible ICT systems A lack of electronic patient info transfer leads to other inefficiencies Accessing current systems/ applications Increased availability of High Speed Broadband Networking & Interoperability Standards Directory Services DNS, RADIUS,CA Dot health domain Connected Health Programme
    14. 14. Broadband for Health <ul><li>Broadband Investment Fund - $325 Million </li></ul><ul><ul><li>Criteria includes “community benefits” focus on supporting Health and Education outcomes </li></ul></ul><ul><li>Joint Procurement Group established in SSC </li></ul><ul><ul><li>$35 Million funding for stimulating uptake </li></ul></ul><ul><ul><li>Combine Health and Education Demand </li></ul></ul><ul><ul><li>$5M for 3 – 4 pilots to ‘test’ approach and processes </li></ul></ul><ul><li>Connected Health “demonstrator” pilots – up to 10 </li></ul><ul><ul><li>Objectives – learning and provide a reference point </li></ul></ul><ul><ul><li>Provide funds to leverage existing or planned clinical projects – focus on information access and sharing </li></ul></ul><ul><ul><li>Employ Reference Architecture and standards </li></ul></ul><ul><ul><li>Link to JPG if possible </li></ul></ul>
    15. 15. Networking standards <ul><li>Reference Infrastructure Architecture </li></ul><ul><ul><li>Disaggregated 3 tier model </li></ul></ul><ul><ul><li>Key principles supporting Government approaches to Networking </li></ul></ul><ul><ul><li>Reference for designers and purchasers </li></ul></ul><ul><li>Network interface standards </li></ul><ul><ul><li>Provide open access to multiple networks </li></ul></ul><ul><ul><li>Includes internet and private network standards </li></ul></ul><ul><li>NZ Health IT Cluster </li></ul><ul><ul><li>Facilitating Vendor Forum </li></ul></ul><ul><ul><li>Refer to website – Connected Health pages </li></ul></ul>
    16. 16. Providing “core” components for provider organisations nationally <ul><li>Directory services </li></ul><ul><ul><li>Linked to HPI </li></ul></ul><ul><ul><li>Search and allow linking – provider to provider, provider to service/application </li></ul></ul><ul><li>DNS and RADIUS </li></ul><ul><li>Certificate Authority </li></ul><ul><li>2 nd level domain </li></ul><ul><ul><li>Registered practitioners + RAs and Ambulances </li></ul></ul><ul><ul><li>Moderated – compliance audited and managed </li></ul></ul><ul><ul><li>URLs available from July 2009 </li></ul></ul><ul><ul><li>Could be used for patient online interactions </li></ul></ul>
    17. 17. What is happening next…
    18. 18. Reference information E- Business Guide for SMEs New Zealand Digital Strategy and Broadband Investment Fund Connected Health Architectural Framework and Standards – refer to Connected Health Industry Forum pages Broadband Demand map For copies of the Connected Health sector segmentation model Email: New 2 nd level domain for health: