Rapid System Development: Variable Service Models For The Well Child Initiative Leona Latham, Portfolio Manager Gerard Paver, Health System Architect Information Directorate HINZ, 17 October 2008

B4SC (Before School Check) Policy: Well Child Tamariki Ora schedule of services was New Entrant Check Requirement national approach Agreement on objectives

Policy:

Well Child Tamariki Ora schedule of services

was New Entrant Check

Requirement

national approach

Agreement on objectives

Service models Driven by policy to enable person access Local, regional and national Vary across health sector DHB contracts provider profiles eg PHO, NGO, Well Child provider, GP… shared service eg VHT, ECE, B4SC Nurse Evolving decisions informed by field experience (pilots) requirements in parallel to development Flexibility Roles Users Service model components

Driven by policy to enable person access

Local, regional and national

Vary across health sector

DHB contracts

provider profiles eg PHO, NGO, Well Child provider, GP…

shared service eg VHT, ECE, B4SC Nurse

Evolving decisions

informed by field experience (pilots)

requirements in parallel to development

Rapid System Development Development from policy to delivery RFP sought options waterfall/cascade Selected phased, cascade with an agile approach bare bones for Feb 08 planned enhancements Deliver in 4 months

Development from policy to delivery

RFP sought options

waterfall/cascade

Selected

phased, cascade with an agile approach

bare bones for Feb 08

planned enhancements

Deliver in 4 months

Challenges How to compress time Manage Parallel activities policy development business processes service delivery requirement development time resources quality benefits

How to compress time

Manage

Parallel activities

policy development

business processes

service delivery

requirement development

“ Vision into systems” Recognise very ambitious very constrained! Strong business ownership Consult and engage Prioritise (triage) Manage expectations

Recognise

very ambitious

very constrained!

Strong business ownership

Consult and engage

Prioritise (triage)

Manage expectations

Keys Remember no ONE solution no RIGHT solution do not try to please everyone BUT think and do it in new ways – try it phased improvements continue flexible small teams generic components

Remember

no ONE solution

no RIGHT solution

do not try to please everyone

BUT

think and do it in new ways – try it

phased improvements continue

B4SC IS Is a national system - as if it is local in time for Feb 08 delivery Has role driven access, control and privacy with full audit capability Does support continuity of delivery mobile providers referrals provide a system for those who don’t want to or are not ready to build a local system provide a system to enable information available nationally irrespective Can be re-used for further initiatives/campaigns other population activities

Is

a national system - as if it is local

in time for Feb 08 delivery

Has

role driven access, control and privacy with full audit capability

Does

support continuity of delivery

mobile

providers

referrals

provide a system for those who

don’t want to or

are not ready to build a local system

provide a system to enable information available nationally irrespective

Can be

re-used for

further initiatives/campaigns

other population activities

Collaboration Is essential Reference groups early adopters Review process seek feedback ongoing, controlled B4SC IS has a growing dynamic community

Is essential

Reference groups

early adopters

Review process

seek feedback

ongoing, controlled

B4SC IS

has a growing dynamic community

Lessons Shared vision facilitates the process and understanding! Communications Governance project control decision-making challenges stakeholder Requirements not all agreed on the “right way” coding changes to pathway Buy-in the technical part = easiest!

Shared vision

facilitates the process and understanding!

Communications

Governance

project control

decision-making challenges

stakeholder

Requirements

not all agreed on the “right way”

coding

changes to pathway

Buy-in

Next steps Electronic connections referrals updates, GP, specialist links Reporting management and coverage Remote access Person access Other campaigns …

Electronic connections

referrals

updates, GP, specialist

links

Reporting

management and coverage

Remote access

Person access

Other campaigns

…

B4SC has … delivered, phased and is reflecting B4SC users experience benefited from a collaborative team policy partners users managed time and resource constraints through reuse and providing reuse opportunities shown it can be done! http://www.moh.govt.nz/b4schoolcheck

delivered, phased

and is reflecting B4SC users experience

benefited from a collaborative team

policy

partners

users

managed time and resource constraints through reuse and providing reuse opportunities

shown it can be done!

http://www.moh.govt.nz/b4schoolcheck

Glossary B4SC Before School Check B4SC IS Before School Check information System DHB District Health Board GP General Practitioner JAD Joint Application Development ECE Early Childhood Education / Educators HINZ Health Informatics New Zealand PHO Primary Health Organisation RAD Rapid Application Development Rapid System Development: development in a short time frame RFP Request for Proposal SAD Solutions Architecture Document Variable Service Model B4SC: service delivery across NZ Technical: development approach VHT Vision & Hearing Tests/Technicians

B4SC Before School Check

B4SC IS Before School Check information System

DHB District Health Board

GP General Practitioner

JAD Joint Application Development

ECE Early Childhood Education / Educators

HINZ Health Informatics New Zealand

PHO Primary Health Organisation

RAD Rapid Application Development

Rapid System Development:

development in a short time frame

RFP Request for Proposal

SAD Solutions Architecture Document

Variable Service Model

B4SC: service delivery across NZ

Technical: development approach

VHT Vision & Hearing Tests/Technicians