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Organisational Strategy for General Practice - Direction and Challenges

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Fiona Thomson

Fiona Thomson

Published in: Health & Medicine
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  • 1. Health Informatics New Zealand - www.hinz.org.nz Organisational Strategy Direction and Challenges General Practice Position First level care provider Principal referrer to other services Only repository of longitudinal health information Up to date demographic and clinical information for all of the enrolled population (eg. Pre-school dental) Only “enrolled” provider (therefore ongoing accountability) Central to the provision of primary/community health care 1
  • 2. Health Informatics New Zealand - www.hinz.org.nz General Practice Information Framework Provided by RGPG – Standard practice server and OS, consolidation from 5 to 2 PMS – HealthLink and Health Intranet connection – Radio VPN (includes a/hrs clinic, hospital and several Pharmacies) – Overnight backup – High speed internet access and individual e-mail for all – Level 1 Helpdesk for all issues (remote support over VPN) – Level 2 Helpdesk PMS and IT Engineering services – Practice Technology Facilitator (PMS) – Quality Manager (clinical systems/processes, remote clinical audit) – Practice Liaison (business systems/processes) – PHO Services (Capitation, Population Health etc) – Training programmes (group, individual) Clinical Information Capability NHI, Ethnicity, Deprivation recording (over 96%) Electronic prescribing/lab investigation ordering (100%) Electronic results (100%) Electronic Referral and RSD (100%) Smoking status recording (86%) Standardised READ disease coding (100%) Consultation coding (85%) Prescribing link to diagnosis (50%) Systematic approach to clinical information collection 2
  • 3. Health Informatics New Zealand - www.hinz.org.nz Organisational Priorities An environment which enables general practice to focus on the person, their family/whanau and the health the community Collective responsibility for the health and well-being of our community through Organised General Practice Demonstrating leadership in a multidisciplinary healthcare environment Technology and IM critical enabler Environment An environment which enables general practice to focus on the person, their family/whanau and the health the community – Centralised clinical and support service referral (including case management) – Development of clinical management and referral templates – Complete clinical and social overview in PMS – Facilitate electronic information sharing wherever possible – Centralisation/standardisation of business and clinical support activities 3
  • 4. Health Informatics New Zealand - www.hinz.org.nz Organised General Practice Collective responsibility for the health and well-being of our community through Organised General Practice – Population health = sum of individual health – Implement population health management tools Managed screening programmes Opportunistic tools (eg. alerts) Clinical management templates EDS – Data standards to enable population health data collation – Information sharing (horizontal and vertical care integration) Leadership in Multidisciplinary Care Demonstrating leadership in a multidisciplinary healthcare environment – Building relationships and developing understanding – Sharing information / sharing care – Building on the general practice information repository – Providing support to other primary care providers – Including other providers on RGPG VPN – e-Pharmacy pilot (applies to e-Lab as well) Close the gap between prescribing and dispensing Extend clinical partnership (med mgmt and adherence) – Rest Home Clinical Information pilot Provide clinical view to Rest Home and Pharmacy Enhance clinical safety 4
  • 5. Health Informatics New Zealand - www.hinz.org.nz Vision Single, centrally hosted community database of all enrolled patient information Profile ASP interface for general practice HCC interface for other primary/community providers – After hours ED – Pharmacy Community Mental Health – Laboratory Out patients – Radiology Hospital – Physiotherapy Rest Homes – Specialists Enrolled patients InSync interface for PHO and Population Health management Accession interface for enrolled patients (self management) Access to information determined by explicit referral process and/or type of provider Challenges General Practice sovereignty of patient information MoH/DHB paternalism Cost of supporting technology Confidentiality/security of patient information 5
  • 6. Health Informatics New Zealand - www.hinz.org.nz Opportunities Maximising our investment Enhancing clinical management Enabling multidisciplinary care with information sharing Simplifying the patient journey Empowering patients around self care More effective use of resources 6

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