Ross McKenna Information Directorate Ministry of Health, New Zealand www.moh.govt.nz IHE and Connected Health in New Zealand

Agenda What/who needs connecting to what/who? Where does IHE fit? New Networking and Interoperability capabilities for the NZ Health System Example of a practical application to clinical workflow

What/who needs connecting to what/who?

Where does IHE fit?

New Networking and Interoperability capabilities for the NZ Health System

Example of a practical application to clinical workflow

Potential collaboration across market segments

What is “connected health”? Sector-wide collaborative patient care “ Islands” of Information joined up National approach to information sharing National reference standards on connectivity & interoperability Some general principles… How do we achieve it?

Sector-wide collaborative patient care

“ Islands” of Information joined up

National approach to information sharing

National reference standards on connectivity & interoperability

Through; people, process and technology…

Enablers for a connected Health Sector Vendor Development & Supply Key data elements NHI, HPI Terminology and coding Health records – security, storage, reference, retrieval Adoption and application of health information standards Telecommunications infrastructure capability - Interoperability - Application access ..nationally agreed and nationally referenced

The roadmap… 2005 HISAC AZ 1 National network strategy 2006 Phase 1 Planning (NGHN) 2007/8 Phase 2 Design (Connected Health) 2008/9 Phase 3 Implementation 2009/10 Phase 4 Consolidation Telecommunications infrastructure capability - Interoperability - Application access

2005 HISAC AZ 1 National network strategy

2006 Phase 1 Planning (NGHN)

2007/8 Phase 2 Design (Connected Health)

2008/9 Phase 3 Implementation

2009/10 Phase 4 Consolidation

Connected Health Programme The Imperative for Change: Inability to share and access health data electronically reduces the effectiveness of health care delivery The next steps in 2008/09: Core networking infrastructure components for the entire health system Reference Architecture, Interoperability and Security Standards A new second level domain for health providers Information sharing and interoperability are proven by pilots The Payoff: A foundation for significant national improvements in collaborative care delivery and reduction in heath care risks by enabling secure information sharing

The Imperative for Change:

Inability to share and access health data electronically reduces the effectiveness of health care delivery

The next steps in 2008/09:

Core networking infrastructure components for the entire health system

Reference Architecture, Interoperability and Security Standards

A new second level domain for health providers

Information sharing and interoperability are proven by pilots

The Payoff:

A foundation for significant national improvements in collaborative care delivery and reduction in heath care risks by enabling secure information sharing

The Integration Pyramid Interoperability High Level Architecture Standards Framework Typical Designs Specific Designs IHE Industry provided Connected Health supported

High Level Architecture

Connected Health Architectural Framework Network-to-Network Interface. This interface will only be used by Telecommunications Service Providers (TSPs) and covers the Interconnection points between IP carrier networks. NNI-1 and NNI-2 defined This is the User-to-Network Interface definition. This covers the physical and logical IP connectivity to the network from one of the end-points UNI-0 to UNI-5 are defined This is the System-Interface definition. This covers the connections of equipment (servers, workstations etc) to the UNI. SI-0 to SI-6 are defined

Architecture Overview Wireless LAN (WLAN) Direct Connections Virtual LAN (VLAN) Mobile Static IP Address Routing Version of IP DNS TSP Interconnections Quality of Service (QoS) DNS DHCP NTP HL7 Message Hub Message Spoke SSL/TLS Web Services Authentication/Authorisation SI 0-6

Wireless LAN (WLAN)

Direct Connections

Virtual LAN (VLAN)

Mobile

Static IP Address

Routing

Version of IP

DNS

TSP Interconnections

Quality of Service (QoS)

DNS

DHCP

NTP

HL7

Message Hub

Message Spoke

SSL/TLS

Web Services

Authentication/Authorisation

With interconnected networks , interoperable applications and standards applied consistently across the health system… How would a GP get instant access to a lab test result?

Applying Connected Health Standards and Architecture VPN Established VPN Example 1: GP establishes VPN Link to the “health.nz” domain Switch On

Applying Connected Health Standards and Architecture VPN GP identify verified using HPI through the “connected.health.nz” domain

and on the GP’s screen… Applying Connected Health Standards and Architecture through a web portal

VPN Established VPN Applying Connected Health Standards and Architecture + XDS (IHE) GP can view test results

Applying Connected Health Standards and Architecture with full application interoperability and ESB VPN Converts message to lab format and redirects PMS Application Converts message back to PMS Application format and redirects Test results modify treatment plan

Summary The health system is probably not one It will take more than just technology A lot of good work is being done but there is a lack of national leadership/approach/picture Architecture and standards to enable national connectivity advances are progressing Pilots will be established but suppliers and participants in the health system need to all support a national view for wide integration/collaboration benefits

The health system is probably not one

It will take more than just technology

A lot of good work is being done but there is a lack of national leadership/approach/picture

Architecture and standards to enable national connectivity advances are progressing

Pilots will be established but suppliers and participants in the health system need to all support a national view for wide integration/collaboration benefits