Achieving Outcomes  for  NZ  using  Health IT  Prof Jim Warren Chief Scientist
National Institute for Health Innovation <ul><li>Funded by a $7M TEC endowment and 12 Foundation industry partners </li></...
Achieving Better Health Outcomes <ul><li>A three-pronged attack on sub-optimality of healthcare </li></ul><ul><ul><li>Inte...
A national Health Data Interoperability Laboratory (HDIL) <ul><li>To create a standing demonstration of inter-systems comm...
And just beyond  Interoperability  per se … <ul><li>What it’s  really  about is </li></ul><ul><ul><li>Getting important th...
<ul><li>Examining use of PREDICT CVD/Diabetes under Medtech32 </li></ul><ul><ul><li>Protocol of ‘medical actors’ with real...
Going beyond the ‘healthcare system’ <ul><li>We should be extending the boundaries of the healthcare system </li></ul><ul>...
Consumer tech <ul><li>The vision of consumer empowerment is often filled with a lot of fairly overt technology </li></ul>
Working with Monash University based on their Breast Cancer Knowledge Online portal The BCKOnline main screen encourages t...
A ‘medical’ perspective page <ul><li>Basically informative </li></ul><ul><li>Largely 3 rd person </li></ul><ul><li>Essenti...
A ‘supportive’ perspective page <ul><li>Both the medical and supportive documents use the word ‘breast’ with roughly equal...
Decision Tree Induction <ul><li>We are inferring decision trees based on the contexts in which words are used so we can  a...
Business Intelligence: Healthwest Fono <ul><li>Largely Pacific practice in West Auckland </li></ul><ul><li>Looking at deve...
Tools for Clinical Reporting <ul><li>Temporal relationships around issues like Medication Possession Ratio are easily misc...
Adherence study <ul><li>4 th  year pharmacy student group </li></ul><ul><ul><li>Assessed medication possession ratios for ...
Forums <ul><li>University is a natural meeting ground for sharing ideas </li></ul><ul><li>E.g., post MEDINFO workshop </li...
NIHI Capability and Contribution <ul><li>Pathways (HDIL) </li></ul><ul><li>Research (applied, but ‘big-picture’) </li></ul...
NIHI Capability
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Achieving Outcomes for NZ using Health IT

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Achieving Outcomes for NZ using Health IT
Prof Jim Warren Chief Scientist

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Achieving Outcomes for NZ using Health IT

  1. 1. Achieving Outcomes for NZ using Health IT Prof Jim Warren Chief Scientist
  2. 2. National Institute for Health Innovation <ul><li>Funded by a $7M TEC endowment and 12 Foundation industry partners </li></ul><ul><li>NIHI aims to </li></ul><ul><ul><li>Develop internationally competitive health technology </li></ul></ul><ul><ul><li>Accelerate the uptake of technologies that improve health outcomes and reduce inequalities </li></ul></ul><ul><ul><li>Improve the effectiveness and efficiency of health systems </li></ul></ul><ul><ul><li>Develop the health innovation workforce </li></ul></ul><ul><ul><li>Provide a forum for national and international collaboration </li></ul></ul>
  3. 3. Achieving Better Health Outcomes <ul><li>A three-pronged attack on sub-optimality of healthcare </li></ul><ul><ul><li>Interoperability – make it easier to make the system work better </li></ul></ul><ul><ul><li>Supported self-management – expand the boundaries of the healthcare system to the entire citizenry; empower everyone </li></ul></ul><ul><ul><li>‘ Business intelligence’ – measure what’s going on; innovate to find relevant instrumentation and metrics </li></ul></ul>
  4. 4. A national Health Data Interoperability Laboratory (HDIL) <ul><li>To create a standing demonstration of inter-systems communications among NZ health sector software </li></ul><ul><ul><li>Aid to innovation, testing of new (and existing!) features, education </li></ul></ul><ul><ul><li>Facilitate adoption of international inter- operability standards </li></ul></ul><ul><ul><li>Similar to an IHE ‘connectathon’ but it’s permanent and co-operative (we don’t tear it down at the end of the conference) </li></ul></ul>
  5. 5. And just beyond Interoperability per se … <ul><li>What it’s really about is </li></ul><ul><ul><li>Getting important thoughts apropos to the care of a patient from one brain to another </li></ul></ul><ul><ul><li>To achieve continuity of care; support a virtual care team; reliably achieve essential communications </li></ul></ul><ul><li>Hence, we’re also interested in usability </li></ul>Note: brain in head image from http://arbredespossibles2.free.fr/FutursTimingCT.html
  6. 6. <ul><li>Examining use of PREDICT CVD/Diabetes under Medtech32 </li></ul><ul><ul><li>Protocol of ‘medical actors’ with real GPs and nurses in real consulting room (Tamaki clinic) </li></ul></ul><ul><ul><li>Medtech32 advanced Web forms </li></ul></ul><ul><ul><li>Enigma’s PREDICT </li></ul></ul><ul><ul><li>Clinically significant cases loaded in research Medtech32 database </li></ul></ul><ul><ul><li>Morae usability testing software (logs screen, audio and video) </li></ul></ul><ul><ul><li>Additional digital camera angle </li></ul></ul>Fine-grained usability analysis
  7. 7. Going beyond the ‘healthcare system’ <ul><li>We should be extending the boundaries of the healthcare system </li></ul><ul><ul><li>Systems should empower the ‘citizen’ (aka, the patient, consumer, client) </li></ul></ul><ul><li>Supported self management </li></ul><ul><ul><li>Traditional providers need to be trained, enabled and motivated to help the citizen to be ‘activated’ to their maximum potential role in their own care (and care of others) </li></ul></ul><ul><ul><li>Citizen should have appropriate tools to help themselves </li></ul></ul>
  8. 8. Consumer tech <ul><li>The vision of consumer empowerment is often filled with a lot of fairly overt technology </li></ul>
  9. 9. Working with Monash University based on their Breast Cancer Knowledge Online portal The BCKOnline main screen encourages the user to indicate their preferences These are then matched to the meta-data for 1000 resources that have been reviewed and indexed by hand by trained breast cancer survivors
  10. 10. A ‘medical’ perspective page <ul><li>Basically informative </li></ul><ul><li>Largely 3 rd person </li></ul><ul><li>Essentially a message from the medical establishment to their patients </li></ul>
  11. 11. A ‘supportive’ perspective page <ul><li>Both the medical and supportive documents use the word ‘breast’ with roughly equal frequency </li></ul><ul><li>But aspects of the context of words (what words are near them) differ </li></ul>
  12. 12. Decision Tree Induction <ul><li>We are inferring decision trees based on the contexts in which words are used so we can automatically classify a Web page as Supportive or Medical in perspective </li></ul><ul><li>Getting >90% accuracy at present </li></ul><ul><li>Great potential in other consumer areas, too (e.g., depression or anxiety, MS) </li></ul>
  13. 13. Business Intelligence: Healthwest Fono <ul><li>Largely Pacific practice in West Auckland </li></ul><ul><li>Looking at development of criteria for a quarterly quality audit report around antihypertensive prescribing </li></ul><ul><ul><li>Provide baseline for quality improvement </li></ul></ul><ul><ul><li>Identify specific cases for recall or adjustment at next visit </li></ul></ul><ul><li>Goal is to reduce CVD events (e.g., stroke, MI), and also renal protection </li></ul>
  14. 14. Tools for Clinical Reporting <ul><li>Temporal relationships around issues like Medication Possession Ratio are easily miscoded in SQL </li></ul><ul><li>Challenge to manage the ‘ontology’ of all relevant drug and problem classification concepts to get reliable lists for ‘diabetes’, ‘ACEi/ARB’ etc. </li></ul>
  15. 15. Adherence study <ul><li>4 th year pharmacy student group </li></ul><ul><ul><li>Assessed medication possession ratios for chronic care drugs from GP prescribing </li></ul></ul><ul><ul><li>Telephone surveyed sample of patients for their self- reported experience </li></ul></ul><ul><ul><ul><ul><ul><li>Requested NZHIS HealthPAC dispensing data for matching </li></ul></ul></ul></ul></ul>
  16. 16. Forums <ul><li>University is a natural meeting ground for sharing ideas </li></ul><ul><li>E.g., post MEDINFO workshop </li></ul><ul><ul><li>National Library of Medicine (NLM) speakers on SNOMED and MedlinePlus </li></ul></ul><ul><ul><li>Oracle VP on SOA </li></ul></ul><ul><li>On the cyberspace end, probably we should extend to a Health IT ‘innovation knoweldgebase’ </li></ul>
  17. 17. NIHI Capability and Contribution <ul><li>Pathways (HDIL) </li></ul><ul><li>Research (applied, but ‘big-picture’) </li></ul><ul><li>Advanced Development (GP reporting capability) </li></ul><ul><li>Evaluation (e.g., usability) </li></ul><ul><li>Forums and… </li></ul><ul><li>Education </li></ul><ul><ul><li>Coursework (Postgrad Diploma in HI, electives, short courses) </li></ul></ul><ul><ul><li>Thesis work (research training via PhD, masters, projects and dissertations) </li></ul></ul><ul><li>‘ Ad hoc’ research/consulting capability </li></ul><ul><ul><li>Recently investigated ‘Roadmap for Chronic Care IT’ for FRST and HealthPhone via the Cluster </li></ul></ul>
  18. 18. NIHI Capability

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