EHR Strategy for New Zealand

Health Informatics New Zealand www.hinz.org.nz Health Information Strategy for New Zealand Electronic Health Records Purpose • Share the thinking on shared health information that has evolved from HISACs work on further defining HIS-NZ Action Zones • Stimulate debate and identify key issues 1

Health Informatics New Zealand www.hinz.org.nz Context • Built on HIS-NZ and Wave • Views expressed to us by the sector have been taken into consideration • International examples have been considered from a NZ perspective Key Direction from HIS-NZ • Information should be available at varying levels of detail according to the decisions that need to be made, with the richest information locally • No central / single electronic health record nationwide • Electronic health records are distributed but can be linked and referenced • Health event summaries are the starting point for shared information • Make accessible key event summaries to support safe delivery of care / integrated care • Common standards and information anchors that allow disparate systems to share information 2

Health Informatics New Zealand www.hinz.org.nz The Health Information Hierarchy (HIH) National National Views Views Relevant views of information above. Po it y Appropriate views / un pu District / /Regional District Regional subsets of the mm lat Views Views information below. ion Co Capture, use, and share Local Views Local Views information locally at the point of care. Individual Standards Standards Indicators Indicators Health Outcomes Health Outcomes Basic Principles 1. Data collection is integrated into every day work practices. 2. Detailed data is used and maintained locally at the point of care National National Views (enter once and use many times).Views Relevant views it y of information P P Po Appropriate views / un District / /Regional above. p p pu District Regional 3. Appropriateofinformation subsets the views orViews subsets flow upwards through groups mm l l lat information below. Views i i i Co on that regularly use the information / ensure its accuracy. Capture, 4. Relevantuse, and of information Local Views given level are available to views held Views Local at any share the levels below, and to individuals / communities / populations. information locally. Individual 5. Information flows are governedStandards by agreed principles and processes. Standards Indicators Indicators Health Outcomes Health Outcomes 3

Health Informatics New Zealand www.hinz.org.nz A ‘Collections’ Type Example – Chronic Care Information National CCM Systems National National Views Views DHB CCM Systems Relevant views it y of information P P Po Appropriate views / un District / /Regional above. p p pu subsets of the District Regional mm l l lat Views Views information below. i i i Co on PHO CCM Systems Capture, use, and Local Views Local Views share The full data set is used information PMS Systems locally delivering care locally. e.g. Chronic Obstructive Individual Pulmonary Disease (COPD) Standards Standards Standards COPD Data Set and Business Indicator Set Rules (coding, extraction etc.) Indicators Indicators Indicators Health Outcomes Health Outcomes Health Outcomes Increase early recognition and Slow the rate of progression response to individuals with and reduce the incidence of chronic care avoidable complications. A Health Event Summary Example – definitions Appropriate views or extracts Lo ng itu d (h inal ist or view y) NHI# AB1654 Date 7-Sep s Name John Blogg Description words go here which describe what happened to the final model of change NHI# AB1654 NHI# AB1654 Date 7-Sep Date 7-Sep Name John Blogg Name John Blogg Description words go here which describe what Description words go here which describe what happened to the final model of NHI# AB1654 happened to the final model of change Date 7-Sep change Name John Blogg Description words go here which describe what happened to the final model of change NHI# AB1654 Date 7-Sep Name John Blogg Description words go here which describe what happened to the final model of change NHI# Date Name AB1654 7-Sep John Blogg Description words go here which describe what happened to the final model of Point in time view change (e.g. health status summary) NHI# Date AB1654 7-Sep NHI# Date AB1654 7-Sep NHI# Date AB1654 7-Sep Health Name John Blogg Description words go here which describe what Name John Blogg Description words go here which describe what Name John Blogg Description words go here which describe what (clinically relevant subsets Event happened to the final model of happened to the final model of happened to the final model of change change change from an encounter / contact) Summaries Electronic Medical Electronic Records Health Record (detailed) (rich subset) 4

Health Informatics New Zealand www.hinz.org.nz HES Scenario: Stu’s throat Stu is on holiday and visits a GP complaining of sore and swollen throat GP inspects Stu’s throat and glands and suspects Stu has tonsillitis GP checks Stu’s HES records to ascertain whether prior history of tonsillitis. None found GP takes a swab of Stu’s tonsils and books an appointment to meet again next day The swab is couriered to community Lab, matched to patient via HES. Test results returned to GP NHI# Date Name AB1654 7-Sep John Blogg NHI# Date Name AB1654 7-Sep John Blogg NHI# Date Name AB1654 7-Sep John Blogg NHI# Date Name AB1654 7-Sep John Blogg Health Event Description words go here which describe what Description words go here which describe what Description words go here which describe what Description words go here which describe what happened to the final model of happened to the final model of happened to the final model of happened to the final model of change change change change Summaries SWAB + Lab tests Lab results GP ordered Lab GP HES Scenario: Stu’s diagnosis and prescription Stu returns to the GP 1 day after the tonsil swab was sent to lab for testing GP checks lab results and sees microboligical confirmation that Stu’s tonsillitis is a bacterial infection As Stu’s records show he is not allergic to penicillin, GP prescribes a treatment course of Amoxicillin Stu presents a copy of his prescription at a pharmacy Pharmacist confirms prescription is valid, checks allergies and current medications, and fills the prescription Lab results NHI# Date Name AB1654 7-Sep John Blogg NHI# Date Name AB1654 7-Sep John Blogg NHI# Date Name AB1654 7-Sep John Blogg NHI# Date Name AB1654 7-Sep John Blogg Health Event Description words go here which describe what Description words go here which describe what Description words go here which describe what Description words go here which describe what happened to the final model of happened to the final model of happened to the final model of happened to the final model of change change change change Summaries Medications Prescribed Dispensed GP Pharmacy Claim 5

Health Informatics New Zealand www.hinz.org.nz HES Scenario – Stu’s Accident Stu loses control of his mountain bike and has a serious crash Ambulance paramedic finds Stu unconscious. Identifies him from Drivers License Paramedic accesses HESs (emergency care view) and notes Stu is a diabetic After further assessment, paramedic treats for diabetic shock, dresses wounds and take Stu to hospital Hospital treats Stu including X-Ray, stitches and overnight observation, then discharges him GP examines a week later and removes stitches Diabetes! NHI# Date Name AB1654 7-Sep John Blogg NHI# Date Name AB1654 7-Sep John Blogg NHI# Date Name AB1654 7-Sep John Blogg NHI# Date Name AB1654 7-Sep John Blogg NHI# Date Name AB1654 7-Sep John Blogg Health Event Description words go here which describe what Description words go here which describe what Description words go here which describe what Description words go here which describe what Description words go here which describe what happened to the final model of happened to the final model of happened to the final model of happened to the final model of happened to the final model of change change change change change Summaries Referral/ Discharge Ambulance Discharge Hospital GP HESs – Stu’s health system history Health NHI# Date AB1654 7-Sep NHI# Date AB1654 7-Sep NHI# Date AB1654 7-Sep NHI# Date AB1654 7-Sep NHI# Date AB1654 7-Sep NHI# Date AB1654 7-Sep NHI# AB1654 Date 7-Sep Event Name John Blogg Name John Blogg Name John Blogg Name John Blogg Name John Blogg Name John Blogg Description words go here which describe what Description words go here which describe what Description words go here which describe what Description words go here which describe what Description words go here which describe what Name John Blogg Description words go here which describe what happened to the final model of happened to the final model of happened to the final model of happened to the final model of happened to the final model of happened to the final model of Description words go here which d change change change change change change happened to the final m change Summaries Ambulance Hospital GP GP Lab GP Pharmacy Diagnose Diagnose Treat Diagnose Diagnose Prescribe Dispense Treat Treat Discharge Treat Discharge Refer Discharge Refer Refer Refer Discharge 6

Health Informatics New Zealand www.hinz.org.nz Lo ng itu d (h ina ist l v Views ory iew ) s NHI# Date Name AB1654 7-Sep John Blogg Description words go here which describe what happened to the final model of change (appropriate NHI# Date AB1654 7-Sep views or Name John Blogg Description words go here which describe what happened to the final model of change extracts, NHI# Date Name AB1654 7-Sep John Blogg Description words go here which describe what Point in time view nationwide (e.g. health status happened to the final model of access) change summary) NHI# Date Name AB1654 7-Sep John Blogg Description words go here which describe what NHI# Date Name AB1654 7-Sep John Blogg Description words go here which describe what NHI# Date Name AB1654 7-Sep John Blogg Description words go here which describe what NHI# Date Name AB1654 7-Sep John Blogg Description words go here which describe what NHI# Date Name AB1654 7-Sep John Blogg Description words go here which describe what NHI# Date Name AB1654 7-Sep John Blogg Description words go here which describe what Health Pointer to happened to the final model of happened to the final model of happened to the final model of happened to the final model of happened to the final model of happened to the final model of change change change change change change Event more info Summaries (clinically relevant View, Push, Pull subsets from an encounter / contact) Electronic Medical Electronic Records Health (detailed) Record e.g. Home Care e.g. GPs e.g. Hospitals e.g. Specialists (rich e.g. Labs, subset) Pharmacies, Radiology e.g. Gym, Coach, ‘My portal’ Possible Stepping Stones to HES – build from the bottom up 1. Identify priority ‘events’ with defined data sets and supporting business rules. 2. Capture standardised event data sets in local systems at implementation leads. 3. Provide HES from local systems at implementation leads to information hubs with local indexing / use. 4. Increase participants and implement other event types. 5. Connect information hubs via a federated architecture (e.g. PAS model, national index). 7

EHR Strategy for New Zealand

by Health Informatics New Zealand on Apr 04, 2010

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EHR Strategy for New Zealand — Document Transcript