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Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application
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Andrew Young, Endoscopy Information System, HealthShare NSW - NSW Health Case Study: Leading The Planning, Design And Roll Out Of A Statewide eHealth Application

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Andrew Young delivered the presentation at the 2013 eHealth Interoperability Conference. …

Andrew Young delivered the presentation at the 2013 eHealth Interoperability Conference.

The 2013 eHealth Interoperability Conference program is a balance between updates on state-wide interoperability projects, health service eHealth project case studies, and discussions of overarching principles such as information governance, data standardisation, and the future direction of eHealth in Australasia.

For more information about the event, please visit: http://www.informa.com.au/eHealth13

Published in: Healthcare, Technology, Business
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  • 1. NSW Health Case Study – Endoscopy Information System eHealth Interoperability Conference 12th September 2013
  • 2. Overview • Project Planning • Setting Standards • Sustainable Change • Interoperability • Lessons Learned
  • 3. NSW Health • 15 Local Health Districts & 1 Children’s Hospital Network • 84 acute public hospitals • Approx 1.6 M hospital admissions (2010/11) • 26.3 M non-admitted visits • 2.5 M emergency department attendances
  • 4. Endoscopies • Approx 120,000 endoscopies performed per year • Facilities perform up to 7,200 endoscopies per year
  • 5. Project Planning • Initiated by Agency for Clinical Innovation Gastroenterology Network (2008) – National Bowel Cancer Screening recommended EIS – Required for patient safety, quality, productivity benchmarks • Implement standardised local, district and state level
  • 6. Setting Standards • Minimum data set – Defined by clinicians (gastroenterology network) • Adult • Paediatric – National bowel cancer screening data • Capture billing codes (MBSE)
  • 7. Prior to EIS • Largely paper based reporting – Scanned to medical records • Siloed hospital unit based systems – Sharing of data via USB, scanning, email • Manual counting – Procedure numbers – Endoscopist accreditation
  • 8. Sustainable Change • Program sponsor: Agency for Clinical Innovation – NSW Health clinical pillar for clinical leadership – Project and BAU sponsorship • Implemented by HealthShare NSW – Corporate arm of NSW Health
  • 9. Endoscopy Information System • Record clinical procedure documentation • Capture digital images • Automated reports, letters and follow-up instructions • Used by endoscopist consultants, fellows and registrars – Gastroenterologists and surgeons • Structured data for research
  • 10. Procedures • Upper and lower GI – Gastroscopy – Colonoscopy – EUS: Endoscopic ultrasound – ERCP: Endoscopic retrograde cholangio pancreatography
  • 11. Interoperability • HL7 v2.3 • Patient administration feeds to EIS – Demographic feeds – Episode details • Scheduling interface to EIS – Appointment details – Procedure information • Results interface to eMR – Procedure notes and URL
  • 12. Data and Message View ORU PAS Appt eGate/JCAPS Endoscopy Information System Demographics Episode Details Appointment Procedure ADT / SIU eMR Results
  • 13. Infrastructure • 9 Instances • Prod, Test, Train HUNTER NEW ENGLAND NORTHERN SYDNEY CENTRAL COAST SOUTH-EASTERN SYDNEY ILLAWARRA SHOALHAVEN WESTERN SYDNEY NEPEAN BLUE MOUNTAINS NORTHERN NSW MID NORTH COAST WESTERN NSW FAR WEST SOUTH-WESTERN SYDNEY SYDNEY CHILDRENS NETWORK WESTMEAD SYDNEY HSS IT SITES SOUTHERN NSW & MURRUMBIDGEE TRAINING Bateman’s Bay Goulburn Wagga Wagga Health Network LHD eMR LHD PAS PC: Citrix client DATA BASEDATA BASE DATA BASE Application Server DATA BASE Application Server DATA BASE Application Server Application Server Citrix Farm PVMD Terminal PVMD session Application Server Citrix Client Citrix session PRODUCTION TEST ENDO PC: Thick client PVMD Terminal PVMD session
  • 14. PAS/Cerner/EMR HSS Cumberland data-centre 9 * MS Windows.net application servers State-wide EIS Server Oracle 11g server with 9 DB instances MS SQL Server 2008 R2 ProVation image capture workstation in the procedure room Accessing application servers via ProVation ‘thick client’ application installed on PC Citrix Server Farm (5 servers) Workstations other than image capture workstations can access application servers via Citrix System Architecture
  • 15. HL7 Interfaces: - Demographics (ADT) - Procedure Note Results (ORU) Endoscopy Procedure with Image Capture Doctor’s Procedure Documentation Immediate Electronic Data Retrieval IBM Patient Report Hospital eMR Past Procedure Notes Previous Procedure Images Data Reports Information Architecture
  • 16. Procedure Report
  • 17. Patient Instructions
  • 18. Nation Bowel Cancer Screen Program
  • 19. Results View in PowerChart
  • 20. Results Text View in PowerChart
  • 21. Procedure Note via EMR
  • 22. Program Rollout • Goal 33 sites – 80% procedures • Currently 25 sites since Nov 2012 – Plus 14 HNE sites
  • 23. Benefits • Improved access to information leads to time saving – Discharge summary – Patient enquiries – National bowel cancer screening forms – Common reporting, data capture, processes
  • 24. Lessons Learned • Interfaces – ADT manipulation required – Legacy MRN pools – Dropped network connection – Handling error messages – Scheduling: Single procedure codes only – Results: mismatch episode
  • 25. Lessons Learned (cont) • Information Technology – Buy-in – Citrix – Limited use of network logins, impacts LDAP
  • 26. Lessons Learned (cont) • Clinical – Clinical champion – Endoscopist buy-in, change management – Accessing doctors for pre-training – Ideally reduce list on first use • 1.5 times longer at the end of first list – Nursing buy-in
  • 27. Lessons Learned (cont) • Lack unique identifier • Common systems often require different interfaces • Different processes exist – Pathology ordering – Booking, arrival / check-in
  • 28. Questions Andrew Young Program Manager, EIS Andrew.young@hss.health.nsw.health.gov.au Tel: 8918 1610

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