Jane grimson

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Jane grimson

  1. 1. Building a sustainable health information infrastructure Jane Grimson Director of Health Information and Deputy Chief Executive Health Information and Quality Authority
  2. 2. The perfect storm G a p
  3. 3. Good quality information is critical
  4. 4. Role of the Health Information and Quality Authority: To drive continuous improvements in the quality and safety of health and social care in Ireland.
  5. 5. Health information function Develop standards and guidance for health information Identify gaps in health information Publish accurate information about the performance of the health and social care system
  6. 6. Work completed to date Develop standards and guidance for health information Guidance on Information governance for health and social care services Guidance on Privacy Impact Assessment What you should know about information governance What you should know about data quality Catalogue of national health information sources Guiding principles for health and social care data collections GP messaging standard (v2) Referral data set, discharge data set, demographic data set Guidance on messaging standards for Ireland Guidance on classification and terminology standards for Ireland Overview of healthcare interoperability standards Identify gaps in health information Provide advice in relation to identifiers for individuals, professionals and organisations Publish accurate information about the performance of the health and social care system All inspection and investigation reports published
  7. 7. Key principles for a sustainable health information infrastructure 1. Patient-centred 2. Integrated 3. Standards-based
  8. 8. Key principle 1: Patient centered Informed, knowledgeable and empowered patient
  9. 9. E N C O U R A G E D D I S C O U R A G E D $ Tertiary Secondary Professional Care Primary Self-Care (off the Map) ¢ INDUSTRIAL AGE MEDICINE Source: Tom Ferguson, “Consumer Health Informatics,” Healthcare Forum Journal, Jan/Feb 1995, pp 28-33. (doctom@doctom.com, wwwfergusonreport.com
  10. 10. E N C O U R A G E D ¢ Individual self-care Friends and family Self-help networks Professionals as facilitators D I S C O U R A G E D Professionals as partners Professionals as authorities $ INFORMATION AGE HEALTHCARE Source: Tom Ferguson, “Consumer Health Informatics,” Healthcare Forum Journal, Jan/Feb 1995, pp 28-33. (doctom@doctom.com, wwwfergusonreport.com
  11. 11. Patient Pathway Day Care Facilities Local Authority Age Action Social Services Primary/ Community Housing Services Community Nursing Secondary / Acute Care General Practice Physiotherapy Ward Care Operating Theatre Diagnostics Ambulance Service Emergency Dept. Ambulance Journey Information flows the wrong way Local Health System Voluntary Sector
  12. 12. Ambulance Journey Ambulance Service Threatens patient safety and increases costs Patient Pathway Day Care Facilities Local Authority Age Action Social Services Primary/ Community Housing Services Community Nursing Secondary / Acute Care General Practice Physiotherapy Ward Care Operating Theatre Diagnostics Emergency Dept. Local Health System Voluntary Sector
  13. 13. Source: eHealth Strategy for Ireland, Department of Health, 2013.
  14. 14. The ability of share information is at the heart of patient-centred eHealth
  15. 15. Key principle: 2 Integrated Eliminate duplication and fragmentation
  16. 16. Current information infrastructure in Ireland very fragmented
  17. 17. Drivers for integrating health information • • • • Connect multiple locations of care delivery Support team-based care Deliver evidence-based healthcare Improve safety – Reduce errors and inequalities – Reduce duplication and delay • • • • Improve cost-effectiveness of health services Empower and involve citizens Underpin population health and research Protect patient privacy
  18. 18. Key principle: 3 Standards-based Support efficient information sharing
  19. 19. Benefits of standards • Major role in ensuring safety e.g. Safe Surgery Saves Lives (WHO) • Support health service improvements • Deliver economic benefits • Benefits stakeholders including patients
  20. 20. “the lack of ICT systems interoperability and of widely accepted standards directly implies compromised quality of healthcare and unnecessarily high costs” [Empirica 2008]
  21. 21. Standards in healthcare
  22. 22. Conclusions
  23. 23. Why has progress been so slow? • What’s the best approach? • How much will it cost? • Will it deliver the benefits? • How do we get there? • What standards should we use? • ……
  24. 24. What can we learn? • Don’t assume that solution which works well in one context will work well in another • Identify and implement the key building blocks for eHealth • Build on local solutions based on standards to ensure that everything fits together • Benefits claimed should be evidence-based • Strategic goal should be better healthcare, not cash • Engage pro-actively with all stakeholders including patients • Make sure all information flows are identified from direct patient care, to clinical audit, quality improvement, reimbursement, population health, service planning, and research • Put in place robust governance to ensure privacy and confidentiality • Leadership for the long term is critical • Ensure that eHealth strategy enables and supports all policy objectives
  25. 25. Can we leapfrog? • Go directly to Personal Health Records at national level? • Adopt an integrated approach to primary and secondary information
  26. 26. Thank you

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