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Comparing Lessons from Two Health Systems and Two Projects

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Kate Bukowski
ProCare Health Limited
(Friday, 3.00, Innovation in Practice 3)

Explores two domains which, on the surface, may seem very different – the US policy directing metrics to measure HIT adoption across the nation and the implementation and utilisation of a practice management system auditing tool (Dr Info) within a region of New Zealand’s general practices. Yet, when looked at under a different view, there are similarities which drive the use of HIT to improve results that engage patients in self-management of their health and clinicians in population health management. Both can improve the delivery of healthcare and provide value for money but both also need support and systems that foster innovation at a patient and practice level. This will continue to be an issue as the health workforce ages and becomes smaller. It is therefore crucially important how we utilise and train our workforce, that they have HIT systems that support their work with the approach that through showing results and improving results, clinicians will engage and want to use the technology to improve their practice. At the same time patients will need support to self-manage their conditions through the utilisation of patient portals and other innovative HIT initiatives.

Published in: Health & Medicine
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Comparing Lessons from Two Health Systems and Two Projects

  1. 1. Comparing Lessons fromTwo Health Systems and Two Projects
  2. 2. Presented by• Kate Bukowski • Project Manager, Health Promotion and Workforce & Strategy • ProCare Health Ltd. • Email: kateb@procare.co.nz • Phone: +64 21 984 070 • LinkedIn: http://nz.linkedin.com/in/katebukowski Liz Schoff Director, Business Intelligence Orion Health Email: liz.schoff@orionhealth.com Phone: +64 21 496 801 LinkedIn: http://nz.linkedin.com/in/city4liz
  3. 3. and
  4. 4. Differences New Zealand United States
  5. 5. Commonalities Wal Footrot Homer Simpson
  6. 6. InnovationIf ever a field needed a makeover, its medicine. Chaotic, expensive, inefficient, and often ineffective, health care is dying for innovation.’ 1. Gardner Morse, Harvard Business Review; 2011
  7. 7. Clinical ProblemCLINICAL PROBLEM
  8. 8. Clinical Problem • Change management and health IT • Secondary healthcare implements change through large management structure • Primary care less resourced to support change • Patients also need to adapt to new health IT • Electronic records • New recall methods • Patient portals
  9. 9. Population Health in Primary CarePOPULATION HEALTH MANAGEMENT IN PRIMARY CARE
  10. 10. Population Health• ‘… making use of demographic and health needs data to plan clinical programmes• … also involves promoting health above and beyond diagnosing and treating illness’ Winnard, Crampton, Cumming, Sheridan, Neuwelt, Arroll, Dowell, Matheson & Head (2008).
  11. 11. Barriers for Clinicians Barrier 2010 (N=226) Insufficient time 79.1% (n=167)Limited access to a computer with ‘Dr Info’ to 30.3% (n=64) audit PMS for follow-up or recallComputer skills insufficient to use an IT system 31.8% (n=67) to monitor populationToo few nurses to provide healthcare in clinics 55% (n=116)
  12. 12. DrInfo 2010 rollout User friendly Quick updates Identify and target hard to reach populations
  13. 13. GeoCoded Maps
  14. 14. Population Health Management with ‘Meaningful Use’
  15. 15. Metrics US ‘Meaningful Use’ Approx 50 metricsChange Management Adoption Best Practice Patient Engagement Personalised Education Resources, Reminders, Electronic copies Timely online access to records
  16. 16. Adoption 42,000 registered to obtain funding (June 2011) 100,000 primary care physicians have signed up with Regional Extension Center to get assistance for implementing EHRs (30%) 2011-2012 2013 2015 • Data • Advance • Improved capture & clinical Outcomes sharing processes
  17. 17. Lessons Shared & Future Directions SHARING LESSONS
  18. 18. Shared Lessons• Better population heath • Identifying and recalling management patients• Meaningful use of data • Access and time for HIT• Use then improve, then • Workforce capacity measure outcomes building  Clinicians’ meaningful use of health IT  Patients’ understanding of and accessing to health IT
  19. 19. Future Directions  Development of health workforce IT skills  Using health metrics to improve population health  Improved health outcomes through patient health literacy and self management using IT

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