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Les Schumers Presentation Pcehr Nsw Health Update 23 June 2011
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Les Schumers Presentation Pcehr Nsw Health Update 23 June 2011


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  • Good morning it’s a pleasure to be here with you today.
  • This is our work program, based on the national infrastructure components of healthcare identifiers, terminology, secure messaging, and authentication. National infrastructure will have a strong emphasis on trust and security, ensuring the health sector has a sustainable authentication system for eHealth. The NASH will deliver a nationwide authentication service for healthcare providers and organisations. In late 2009 and through 2010, NEHTA worked closely with stakeholders to ensure that the NASH concept was understood, and fit for purpose. In September 2010 NEHTA sought organisation(s) with proven ability to deliver the NASH from design (defining the components that will be built and implemented to meet the requirements of the NASH), build (creating and constructing the authentication services that will be operated), and operations (day-to-day operation and management of the NASH including the supply of secure tokens and supporting infrastructure). At the time of writing, NEHTA is in the final stage of determining the successful bidder and the outcome would be announced shortly.
  • I would like to start by acknowledging the traditional owners of the land on which we meet – the Gadjagal people of the Eora nation – and pay my respect to Elders past and present.   I have been asked to lead the Change and Adoption Team for the personally controlled electronic health record (PCEHR), at the National E Heath Transition Authority . I have worked as a rural GP for over 20 years with a hospital appointment at the local district hospital as a VMO – so I have experience of both the hospital and the community sector I have been a rural GP with a hospital appointment at the local district hospital for over 20 years. During those years I have had many roles with GP groups most recently with the Royal Australian College of General Practitioners where I am the immediate Past President . I am also a board member of the National Prescribing Service and the Therapeutic Guidelines Limited, the RACGP and RACGP Oxygen, as well as The Northern Rivers GP Network and North Coast   GP training my local GP Regional Training Provider. So my experience reaches across private and public sectors, hospital and community , individual and organisational, regional, state and national . That gives me a pretty broad perspective about what works and what doesn't across a lot of our health care system. The reason I care deeply about the Personally Controlled Electronic Health Record is that it relates directly to people - the people I care for, who need a far better system than the one we have had until now.   As a GP I’ve had the opportunity to see first-hand what works and what doesn't across many sectors of our health care system I love my job as a GP and I want the personally controlled electronic health record to work To work for clinicians and patients I’m a bit biased – but I think its great that NEHTA has asked a clinician to lead Change and Adoption I’d feel the same way if it was clinician other than me - Frankly I would probably feel even better about it! The Change and Adoption team has only just started My first day was February 14 Bianca Jordaan is the other member of the Change and Adoption leadership team at NEHTA Bianca has over 13 years consulting experience and for the last 10 years specialising in Information and Communication Technologies and Clinical Change Projects Were building the team now at NEHTA but we are building on what has come before
  • The process on the procurement of a Change and adoption partner is a decision of DoHA The Change and Adoption Work Program comprises five major work components: Component 1 – National Change and Adoption Strategy; Component 2 – Strategic Engagement Program; Component 3 – Marketing and Communication Program; Component 4 – National Change Program; and Component 5 – Local and Regional Change Program which will be delivered through the e-Health sites My teams job will be to manage the contract To create conduits into the reference groups clinical leads, vendors and professional organisations We are looking for a partner that can help make it happen through delivering strong capability Our partner also needs to engage with us to formulate some ideas for innovative solutions We need not just a theoretical strategy but a strategy that must be able to inform the change agenda We know that consumers have not used their equivalent systems in the UK as well as they could, what can we do differently to drive uptake? We know there are potential issues around enrolment and consent and we know there are concerns around medico-legal risk that could be a deal breaker if their not managed We know that there will be vendor issues that need to be worked through We know there will be challenges for high risk groups Like those with Chronic and Complex health conditions the Frail aged Aboriginal  and Torres Straight Islanders People with Disabilities Mothers and newborns We expect the potential partners to bring their national or international experience to bear and show how we can learn from this Show us what worked and what didn’t, what should be considered for Australia Most importantly we need to leverage of what has already being done – programs with a great track record like the Primary Care Collaboratives and build on the work of meetings like this
  • This is a summary of the indicative timelines The tender for the Change and Adoption Partner was released as a Presentation to Industry in Sydney on the 1 st of March The contract is to be Executed on the 27 th May 2011 As you can see there is a journey all the way to June 2012 The Final Concept of Operations is due Late June 2011 The National Change and Adoption Strategy is due August 2011 A Social Marketing program kicks off Late Sept. 2011 The Build and Test for release 1 is due Mid May 2012 National C&A Program Package will be released Early in June 2012 And the personally controlled electronic health record goes live Late June 2012 In fact that may not be the end of the journey but further investments and releases will be subject to a business case and consideration by government Note : Any conversations with suppliers cannot include discussions about the tender – except what is already in the public domain.  If a potential supplier begins to ask about the tender, please refer them to the tender web page and for them to address their questions through the DOHA point of contact. All queries regarding this Request for Tender should be directed to: Contact Officer Bill Simeonovic (02) 6289 4115 [email_address]
  • The National Change and Adoption Strategy is going to be key It is intended to present an integrated view of all aspects of stakeholder engagement, marketing, communications, benefits evaluation and change and the adoption programs for the PCEHR Program in one document. The National Change and Adoption Strategy will provide the long and short term views of how to accelerate uptake of the PCEHR across Australia. The National Change and Adoption Strategy will provide an analyse the needs and expectations of consumers, clinicians and vendors There will be an impact assessment of the PCEHR on key stakeholder groups and a training needs assessment . The Change and Adoption Strategy should also give consideration to indicators that should be included in the PCEHR Monitoring and Evaluation Framework, being developed by the Benefits and Evaluation Partner. A plan to promote the connection of local eHealth solutions to the national PCEHR system will also need to be developed. And the Change and Adoption Strategy will to be updated in June 2012 to capture all learnings from the implementation of the PCEHR Program between now and June 2012 .
  • National change and adoption training will provide a training capability for the PCEHR Program with the preparation of training materials , guidance materials and other tools suitable for use by a third party Content will be developed for inclusion in online consumer and provider portals And also training materials which could be integrated with software vendor and National Infrastructure Partner training products And a centralised help-desk facility . The call centre capability we're looking for from the change of adoption partner is actually pre-operations of the PCEHR solution itself. The National Infrastructure Partner also has call centre responsibilities
  • The Change and Adoption work will have a focus on the e-health sites supporting change and adoption activities and including the lessons learned into the national plan But we need to role out change and adoption services across Australia More generis services but also targeted change and adoption services for target groups And then the change and adoption really starts after June 2012 when we start to role it out across the Nation
  • Transcript

    • 1. PCEHR – NSW Health Briefing
      • Les Schumer
      • Manager – PCEHR Design Authority
      • 23 June 2011
    • 2. Overview of the PCEHR consultation to date
    • 3. PCEHR consultation since November 2010 Group Work Package Stakeholder Reference Forum
      • Used to review PCEHR wide issues and deliverables (escalated from co-chairs)
      • Co-ordination of PCEHR work packages
      • First point of contact for resolution of cross group issues
      • Tiger team for indexing service
      Identification, Authentication and Access (IAARG) Tiger team
      • Consumer Registration
      • Provider Registration
      • Privacy Controls
      • Access Channels (Consumer Portal, Provider Portal and Call Center)
      • Participation and Authorisation Service
      • Audit Service
      • HI / NASH integration with PCEHR
    • 4. PCEHR consultation since November 2010 Group Work Package Medication Management (MMRG) Tiger team
      • Medicines List/Profile Detailed Clinical Model
      • Integration of PCEHR with sources of medication information (e.g. GPs, Pharmacies, Hospitals, PES, PBS, etc)
      Diagnostic Services (DSRG) Tiger Team
      • Pathology and Diagnostic Imaging Detailed Clinical Models
      • Pathology and Diagnostic Imaging integration with PCEHR
      Clinical Terminology & Information (CTIRG) Tiger Team
      • Detailed clinical models for PCEHR content (joint work with other groups)
      • Clinical Terminologies for supporting detailed clinical models
    • 5. PCEHR consultation since November 2010 Group Work Package Continuity of Care (CCRG) tiger team
      • Health Summary
      • Event Summary
      • Discharge, Referral, Specialist Letters
      • Care plans
      • Template Service
      • Provider Service Directory
      Clinical Leads
      • Individual leads participate in relevant groups
      • Clinical Leads meeting provides sounding board for provider issues (e.g. Provider Registration, Provider Portal, Privacy and Control, PCEHR records, implementation, etc)
    • 6. PCEHR consultation since November 2010 Group Work Package Consumer Reference Forum
      • External representation for review of design decisions
      • Includes Privacy lobby groups and Privacy Commissioner
      NEHIPC sub-committee
      • Jurisdictional governance of PCEHR implications and investments
      • Jurisdictional impacts and investment planning assessment
    • 7. Further consultations
      • “ Four-cornered Roundtable”
      • DoHA public consultation process
      • Chronic Disease Management Groups
      • Aboriginal & Torres Strait Islander Community
      • Rural & Remote
      • Aged Care
      • Mental Health
      • ICT Industry Forums
    • 8. What we have done with this input?
      • Input from all these groups has informed the Personally Controlled Electronic Health Record (PCEHR) draft system design and Concept of Operations
    • 9. PCEHR Design Elements
    • 10.
      • The PCEHR is a vehicle for Consumers to:
        • Share key pieces of their Health Information with
        • Providers of their choice
      • It is not a replacement for existing point to point messaging
      Principles of the PCEHR
    • 11.
      • Participation is voluntary – “Opt-In”
      • Provider Access is under Consumer Control
      • The PCEHR is not a replacement for organisational clinical records
      • The clinical component contains Copies, not Originals
        • The “Source of truth” remains where it is today – in local clinical records
      The PCEHR - How is it different?
    • 12. Is the PCEHR a complete health record?
      • No, it will only contains clinically significant information that is deemed important to the ongoing care of an individual
      • Individuals may request that information not be loaded on to their PCEHR.
      • Individuals may limited access to certain classes of information
    • 13. Product & Solutions Development Update
    • 14.  
    • 15. Product & Solutions Development Roadmap
    • 16. PCEHR Proposed Scope
    • 17.
      • Opt-In Participation
      • Consent to View established through Personal Access Controls
        • “ Open” Consent
        • “ Specific” Consent
        • Consent to View “Limited” information
      • Ability to obtain “Forward Consent”
      • Consent to Post is “Opt Out”
      Consent Model
    • 18.
      • Requires IHI
        • Assume Verified IHI is required
      • Self-Registration via Internet Portal
        • VOI as per Federated AGOSP Model
      • Facilitated Registration
        • VOI at point of Registration
      • Postal Registration
        • VOI supplied through notarised documents
      Consumer Registration
    • 19.
      • Option #1 – “Open Access”
      • Option #2 – “Access Code” (PAC)
        • Option to Override for “Emergency” or “Forgotten PAC”
        • Support for Limited Information Access through “PACX”
      • Support for Consumer Notifications
        • New Provider
        • Override Access
      Provider Access Controls
    • 20.
      • Health Summary
      • Event Summary
      • Discharge Summary
      • Medicare Data (MBS, PBS, ACIR, ODR)
      • Consumer Data
        • Personal Health Diary
        • Advanced Care Directives (Custodian)
        • Medicines & Adverse Reactions
      • Support for Diagnostic Reports
      • Consolidated View
      Supported Content – 1/7/12
    • 21.
      • Referrals
      • Specialist Letters
      • Prescriptions and dispense notifications
      • State based registries
      Future Content
    • 22. PCEHR Registries Clinical Record GP Health Summary Event Summary Provider Clinical Record GP Health Summary Event Summary Provider Prescriptions Referrals Diagnostic Requests Event Summaries Discharge Summaries Specialist Letters Dispense Notices Diagnostic Reports Hospitals Pharmacists Dentists Optometrists Physiotherapists Specialists Diagnostic Labs Etc… Other Providers Immunisations Directives and Notices PCEHR Consolicated View View Service Nominated Nominated Provider Health Summary Abstract
    • 23. Consolidated View
    • 24.
      • Participation “By Behaviour”
        • No anticipated requirement for separate “Participation Agreement” or Registration
      • Will require:-
        • Registration of HPI-O
        • Publication in HI PDS
        • Implementation of Conformant Software
        • Notice of Connection with PCEHR Service Operator
      Organisational Participation
    • 25.
      • Authorised Representatives
        • Authorised under Law to “Stand in the shoes” of the Individual
        • Has the full Authority to manage the PCEHR on their behalf
      • Nominated Representatives
        • Authorised through an agreement with the Individual
        • Individual may establish the “limits of access and control”
      Authorised & Nominated Representatives
    • 26.
      • Affords Read Only Access to the PCEHR
      • Individual Authentication through the use of a PKI Certificate
      • Organisational Authorisation established by the OMO (HPI-O/HPI-I Link in the HI PDS)
      • Where an Individual Provider has Authorisation from multiple Organisations, the Individual may select the Organisation they are acting for
      Provider Portal
    • 27.
      • Audit log records all PCEHR “Events”
        • Access by Providers
        • Access by Representatives
        • Changes to Access Controls
        • Changes to Individual Details
      • Views Provided for
        • Individuals
        • Provider Organisations (OMO)
        • Contracted Service Providers
        • Conformant Portal Providers
      Audit Log and Views
    • 28. Change and Adoption: bringing eHealth reality into play
      • Dr. Chris Mitchell, NEHTA Change & Adoption Lead, FRACGP, FACRRM, FAICD
    • 29.  
    • 30. Key milestones
    • 31. National change and adoption strategy
        • Analyse the needs and expectations of consumers, clinicians and health care providers
        • Provide an impact assessment of PCEHR across key groups
        • Provide a training needs assessment
        • Provide a methodology and approach to change and adoption
        • Identify initiatives to promote take up of eHealth solutions
    • 32.
        • Provide a training capability for the PCEHR Program
        • Develop training materials, guidance materials and other tools suitable for use by a third party
        • Develop content for inclusion in online consumer and provider portals
        • Develop training materials which can be integrated with software vendor and National Infrastructure Partner training products
        • Develop a centralised help-desk facility
      National change and adoption training
    • 33. Change and adoption services
        • Implement the National Change and Adoption Strategy by providing change and adoption services to key stakeholder groups
        • Deliver services such as training, customised programs for targeted stakeholder groups and online webinars
        • Develop a delivery plan of all change and adoption activities to be rolled out nationally